How to Fight Medical Bill Overcharges

IF YOU RECEIVE BALANCE BILLS, FOLLOW THE STEPS BELOW TO WAIVE OR LOWER THE COST:

1. Request an itemized bill and dispute inaccuracies:

Ask the provider or hospital for an itemized bill. Because 80% of medical bills contain an error, you may find duplicate or incorrect charges.

Use this medical coding tool to translate medical procedure codes and medical diagnosis codes to understand each charge. If there are any discrepancies, immediately dispute them.

2. Ask to see the contract:

If debt collectors are calling insisting on payment for an unfair bill, demand they provide you with the contractual agreement in which you are obligated to pay. With no written agreement, you have no legal obligation to pay.

3. Address out-of-network services and refuse to pay for inappropriate care:

Many patients are unaware that they can receive an out-of-network charge at an in-network hospital for non-urgent care, resulting in 57% of Americans receiving an unexpected bill. If you received unnecessary care or had an avoidable complication, call the hospital or provider and demand that you not be charged for these services.

4. Research the fair market price and use that to negotiate:

Look up what Medicare and commercial insurance companies pay for the service that you need. Healthcare price checking platforms such as Healthcare Bluebook and Clear Health Costs are also available to help patients find the best price.

For surgical procedures, you can also comparer your charges with the transparent prices at The Surgery Center of Oklahoma and Texas Free Market Surgery. You can then use those prices to negotiate.

5. Call your insurance company:

If you have insurance, check your explanation of benefits (EOB) to determine if the service or procedure is covered. Call your insurer’s customer service line if your health plan isn’t covering something you thought would be covered. If the bill should be covered according to your EOB and the insurance company is refusing to pay, contact the National Association of Insurance Commissioners. You can also contact your state and file an appeal.

6. Call your employer’s head of Human Resource department:

If you have health insurance through your employer, you can ask your Human Resources Department to advocate on your behalf.

7. Call your hospital’s leadership:

If none of the steps above have produced results and you have been unfairly charged for services not rendered or egregiously overcharged for services received, write to the hospital’s CEO’s and CFO. You can also contact the hospital’s board members through their offsite office and inform them of the hospital’s predatory billing practices.

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