Let's say you get in an accident (I hope you don't) and have to be taken by ambulance to the nearest emergency room. You have absolutely no say in where you go. You end up at a hospital that is out-of-network with your insurance.
You get all patched up and sixteen hours later (if you're lucky) you get to go home. Two weeks later the bills start pouring in. Bills from the hospital, the emergency room doctor, the anesthesiologist, the radiologist. And none are in-network with your insurance. All up, you owe $15,545.76 for that one visit to the ER.
Now let's say you check in to a hospital for elective surgery to your knee. You do your homework this time. The hospital is in-network and so is the surgeon who will be fixing your knee. You check-in, the surgery goes well and you go home the next day.
A few weeks later, you get a bill from an anesthesiologist. And then one from a radiologist. And another one from a pathologist. Even though you were treated at an in-network hospital the other providers involved in your care were out-of-network. So you end up with bills totaling $32,550.32 from that 'elective' surgery at an in-network hospital.
Sound crazy? It is. But sadly these 'surprise bills' are killing millions of Americans financially. For some, like the teacher in Texas who owed $109,000 after a heart attack, the bills can total in the hundreds of thousands. Fortunately, there is a rare bipartisan agreement that surprise bills are a serious problem that needs to be addressed. Congress is working on legislation to prevent out-of-network providers from slamming us with these huge charges.
Who knows if anything will come of this. In the meantime, here are a few tips to help you deal with surprise medical bills.
6 Tips to Deal With Surprise Medical Bills
- Choose hospitals that are in-network when you can.
- If you have to have surgery, make sure the surgeon and hospital are in-network. Ask about the potential role of out-of-network providers in your care. Request in-network providers when possible.
- If you have to be in the hospital, write this disclaimer on your admission paperwork (the section that asks you to accept financial responsibility for your care): "I do not consent to out-of-network providers being involved in my care. I will not accept financial responsibility for any out-of-network providers involved in my care without my consent." This doesn't mean you won't get surprise bills, but at least you'll have something to work with when you contest the charges.
- If you do get surprise bills, call the hospital or providers to try to negotiate lower prices. You may be able to work out a payment plan or get a 'prompt-payment' discount. You can also ask your insurance company if they'd be willing to pay the out-of-network providers as if they were in-network.
- Learn how to read your medical bills and check them for errors. An estimated 90% contain mistakes. Finding them can save you lots of money.
- Write to your elected officials. Tell them that you support legislation to prevent surprise bills.
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I hope this helps you understand a little more about surprise medical bills and what you can do about them.
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