Six Steps to Overcome an Unfair Medical Bill

You can beat back bogus medical bills with the right actions and determination. Follow this quick guide.

Inaccurate and overpriced medical bills are a blight on the American people.

I hear almost every day from the afflicted. Patients are reeling from outrageous fees for medical services and don’t know how to sort through the confusion to make sure they get a fair deal.

This is why I called my book, Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win. And it’s why my health literacy campaign continues in an even more engaging format with my Never Pay Pathway videos, which are based on the book.

In my previous newsletter I mentioned a reader who got hit with a $306 charge for a hospital fee when she hadn’t even been treated in a hospital. Here’s an update: She followed the steps I provide in my book and videos and she got the excessive charge waived. Bravo!

People must read the book or watch the videos to be truly prepared. They offer a much better education than I can provide in this short column. But I wanted to provide a primer.

Know this: With the right knowledge and determination you can overcome unreasonable medical bills. In fact, you must, because if you sit back and take it you could be overcharged by hundreds or thousands of dollars.

Here are six steps you can take to overcome an unfair medical bill:

1. Get an itemized bill

Hospitals and other medical providers often give you a lump sum total on your medical bill. They don’t break down the charges for each service. You’d never stand for that at the grocery store or when you get your cell phone bill. So get the breakdown from the hospital or doctor who is billing you, or your insurance plan. Make sure the itemized bill includes the billing codes that document each charge. If anyone holds out on giving you an itemized bill, read my column to learn how to cite HIPAA to obtain it.

2. Check your itemized bill for errors

It’s incredibly common for medical bills to contain mistakes. Often they contain charges for services that were not provided - or they exaggerate the complexity of the care. Look up the billing codes on your itemized bill online and see if they accurately describe the services the patient received.

3. Make sure the prices are fair

Use the billing codes for each charge to check to see if you got a fair price. You can check prices on hospital websites or by calling other health care providers who offer the same services and asking for their prices. You can also go to FairHealthConsumer.org and put in the billing codes to check fair price estimates in your area.

4. Confirm that your insurance carrier properly adjudicated the bill

Insurance companies process millions of claims a day, often on antiquated IT systems. Mistakes are incredibly common. If you have insurance, make sure the plan processed the claims accurately. Again, my book and videos offer more assistance to help you understand your insurance plan.

5. Contest any inaccurate or unfair prices

If you see a mistake or overcharge on your bill, contest it to whoever is sending you the bill. Often these problems get corrected right away. But you may need to ask for a supervisor, and don’t be surprised if they don’t immediately correct the problem. If you’re insured, you can also bring the problem to your insurance carrier, but they often take the side of the doctors and hospitals doing the billing, so don’t be surprised if they don’t help you. You may need to persist. Again - my book and videos have many more strategies and resources to assist you.

6. Consider suing in small claims court

Small claims courts allow less powerful consumers to defend themselves against unfair practices, at low cost and without needing an attorney. In most states, the dollar limits for cases are high enough to cover common medical bills. If you’re getting overcharged and the medical provider won’t play fair, small claims court might be a good option. When you sue in small claims court you level the playing field. The medical provider will need to defend their billing practices in front of a judge. That’s an expense and a hassle for them. Your lawsuit might motivate them to settle the dispute in a way that’s fair. Need inspiration? Check out my column about a mom who used small claims court to defend herself against a bogus hospital bill.

It takes courage to push back against unreasonable medical bills. It may feel intimidating to try. But it’s often easier than you think and you could save hundreds or even thousands of dollars with each victory.

Plus, the cost of inaction is too high. Do you really want to keep paying more than you should for health care? Of course not - so let’s fight back!

Do you want your employees to be informed health care consumers?

There’s a massive problem right now with employer-sponsored health plans. Employers provide benefits that cost thousands or tens of thousands of dollars without teaching their employees how to navigate the health care system. That results in wasted spending for the employer and massive bills for the employees that could be avoided.

I’ve designed my Never Pay Pathway health literacy videos to help employees become engaged and informed health care consumers. I am looking for employers and benefits advisors who understand this problem and want to do something about it. Let’s partner together to educate your employees. Sound interesting? Let’s make it happen. Email me today at neverpay@marshallallen.com.