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How To Dispute Surprise Medical Bills



One of the most frustrating things we run into is surprise medical bills that seem much too high. The NY Times article "How To Dispute Surprise Medical Bills" from June 30, 2022 is very interesting. Here are 3 bullet points from that article:

1. Determine whether your bill is covered by the No Surprise Act, and dispute it, if so

- This law basically says that if you go to an in network hospital and are treated by an out of network doctor (this occurs regularly with ER visits), you are not allowed to be billed for more than the in network copay


2. Even if the bill is legitimate, you can still fight it

- It is VERY common for medical bills to be filed incorrectly, with insurance companies...the code used is incorrect or additional procedures are included that are not accurate. This can result in you getting the bill directly, without it going through insurance, or with the insurance company rejecting the claim. Sometimes, the doctor's office/hospital will bill you directly and not even file with the insurance


- Make sure, the claim has been filed with insurance, check the codes on the billing for accuracy (we have the internet....you can see what the codes mean), make sure you get an explanation of benefits from your insurance company for EVERY claim (this is proof that the claim was filed with insurance)


- DON'T pay a bill if there is no explanation of benefits. If none exists (check with the insurance company)


3. Don't give up the fight

- The process can be time consuming and frustrating, but if a lot of money is at stake, it is worth it. Knowing that there are steps you can take and, ESPECIALLY, if you know you are in the right, the correct end result should be where you end up. Most hospitals, doctors offices and insurance companies are honest and want to be fair, but getting to the bottom of it might be the hard part


Contact me at kyle@healthmarketgenius.com or 828 266 1369.


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