Medical Bill Mysteries: New Tool

Stethoscope with a $100 bill

For the past year-and-a-half I have joined others in being surprised, frustrated and horrified by the “Bill-of-the-Month” news stories presented cooperatively by National Public Radio (NPR) and Kaiser Health News (KHN). The NPR/KHN team receives real bills from real people across the U.S., for treatments ranging from a cat bite and a knee brace to spinal surgery and stroke.

In every case, the consumer submitted the bill because it either seemed outrageously high or it just didn’t make sense. The investigative reporters dug into the issues, usually gathering information from the medical provider and the insurance company as well as the consumer. Sometimes they found errors that could be corrected to reduce the bill; more often, they uncovered prices that were simply inexplicably high. Sometimes, but not always, shining the light of publicity on the situation led to a reduction or elimination of the bill.

Last month Kaiser Health News launched “Your Go-To Guide to Decode Medical Bills.” This new tool includes three components: 1) Pro Tips for Navigating Surprise Medical Bills; 2) a helpful Glossary; and 3) an example of a medical bill and corresponding insurance documents, with notes highlighting key items to pay attention to. The guide is not a magic wand – it doesn’t make navigating difficult medical bills easy. But it does point consumers in the right direction, so we can get started advocating for ourselves and our loved ones.

The guide reminds us that our consumer options begin even before we seek medical treatment – with a set of items to check on before going in or making an appointment. If, despite advance preparation, you end up with a surprising medical bill, a key step is to request an itemized bill. Medical providers are required by law to provide this if consumers request it. Along with other tips, the guide identifies two websites that can help you compare the price you were charged with prices of other providers: Health Care Blue Book and Fair Health Consumer.

As consumers we need to be our own advocates. It helps to have some guidance on how to do that effectively!

Barb Wollan

Barb Wollan

Barb Wollan's goal as a Family Finance program specialist with Iowa State University Extension and Outreach is to help people use their money according to THEIR priorities. She provides information and tools, and then encourages folks to focus on what they control: their own decisions about what to do with the money they have.

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Medical Bills

medicalJust recently a man described to me his efforts to avoid financial crisis after some higher-than-usual medical bills.  He has insurance, but the deductibles and co-pays are significant, and his income allows payment of only $50-$100/month toward medical bills.

One of his recent health issues involved a short stay in the hospital, and while he was there he asked to talk with someone about hospital financial assistance.  A very helpful staff member came to his room, helped him fill out the application for assistance, and explained how the process worked.  Based on that positive experience, he now plans to apply for financial assistance at another hospital where he had an outpatient procedure, and at the clinic that is home to his surgeon and his general physician.

The man had come to me for ideas, but he had already taken some valuable steps.  I was able to help him with a referral to one other agency that might provide some assistance.  I also offered a couple of other tips:

  • I encouraged him to make only modest payments until he hears back about his applications for assistance – perhaps the assistance will cover the entire bill.
  • I explained that paying a medical bill with a credit card can backfire if he thinks he might be able to get assistance or a discount.  Once the bill is paid with a credit card, the medical provider sees no need to provide any financial assistance.  It’s certainly unlikely he’ll find any agency interested in helping him pay off his credit card balance.
  • Once he finds out the final amounts of his bills, after insurance and financial assistance have been applied, he may need to make payment arrangements.  I encouraged him to inquire about whether it would be sent to a debt collection agency, and to request that they not send the bill to collection if he sticks to the agreed-upon payment schedule.  Depending on the providers’ policies, they may or may not agree, but it is worthwhile to ask.

The Consumer Financial Protection Bureau offers a fact sheet with more information about dealing with medical debt.  ~Barb

Barb Wollan

Barb Wollan

Barb Wollan's goal as a Family Finance program specialist with Iowa State University Extension and Outreach is to help people use their money according to THEIR priorities. She provides information and tools, and then encourages folks to focus on what they control: their own decisions about what to do with the money they have.

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