Is It REALLY a Bill? And Do You REALLY Owe?
Nicole Broadhurst, BCPA
So you or your loved one has received a bill from a doctor or facility that you recently visited. Your first inclination may be to assume that your insurance was billed, paid their portion, and now you are billing billed for your part of the bill.
Don’t write that check or pay that bill until you have done the following:
Compare it to your insurance explanation of benefits to be sure the claim was submitted correctly and
That your insurance paid the amount they are contractually obligated to pay
You might be surprised to learn that I work with many clients who receive bills for medical services that either have not yet been submitted to their insurance company or have been submitted and not resolved with the insurance carrier.
In these situations, it is important that you DO NOT pay the bill and work with the provider’s office to assist in getting payment from your insurance carrier.
It has become standard operating procedure in our household to hold all medical bills until the corresponding explanation of benefits is received. Once I have both documents, I am able to review for accuracy and confirm that the billed amount is accurate.
If it is correct, I then submit payment. Once the bill has been paid, I notate on the bill how and when I made payment.
Finally, I staple the bill (with payment notations) to the corresponding explanation of benefits and file for future reference.
There are other issues that might arise during this process that could require additional assistance. However, taking these basic precautions will hold your insurance carrier and doctor’s office accountable for their role in your healthcare finances. In addition, these actions will ensure you are not paying unnecessary medical bills.
If you find yourself needing more assistance, please reach out to me directly at NBroadhurst@TennesseeHealthAdvocates.com
Nicole Broadhurst BCPA
Senior Patient Advocate
Dementia Care Advocate