How I Averted a Medical Billing Disaster

How I Averted a Medical Billing Disaster Photo (cc) by Rev Stan

This post comes from Gerri Detweiler at partner site

Over Labor Day weekend, I fell and broke my hand. Seeing my finger dangling at an odd angle was alarming, not to mention painful, but I’ll confess the first words out of my mouth when I arrived at the ER were, “I want to confirm that you are a participating provider in my insurance.”

I have decent health insurance, but I’ll admit I border on paranoid when it comes to medical bills. I have heard numerous horror stories on the blog from consumers whose medical bill nightmares have ruined their credit, often through no fault of their own. In fact, about half of all collection accounts on credit reports are because of medical bills, and medical debt often has a significant impact on credit scores.

I wasn’t about to take that chance.

3 things I did to protect myself

Sure enough, a few weeks later bills started rolling in from various providers. Although I spent only a few hours in the emergency room, I received bills from five different providers. And that doesn’t count the doctor and physical therapy bills from the services provided later.

Worse, the largest bill, the one from the ER, did not arrive until two months after my visit and after a lot of effort to hunt it down.

Although I was hampered by having my right hand in a cast (not ideal for a right-handed writer!) I was determined to stay on top of the bills as best as I could. I did three things:

  1. I reviewed my explanations of benefits from my insurance company online as they came in. EOBs explain which companies have billed the insurance company and how much the patient is responsible for.
  2. I did not assume that because I didn’t get a bill, all was OK. Three weeks after my visit to the emergency room, I still hadn’t heard a word from them. The EOB for the hospital visit was listed as “pending.” So I called the ER billing department to find out what was going on. They assured me it was in process.
  3. I kept good records. I started a file where I kept copies of bills, notes from phone calls, receipts, etc.

Nevertheless, despite my careful efforts, I suspect I narrowly averted a potential disaster with the ER bill. Fifty-two days after the ER billed my insurance company, the claim was processed. But a week later, I still hadn’t received a bill. I called the ER’s billing department (it was surprisingly difficult to find the right phone number without a bill), and they could not find me in their system.

They asked me to fax the EOB to them, which I did. Two days later I called again, and my bill couldn’t be located. I sent the EOB to them again, this time by email, and finally, that afternoon, I was told that they had found my account and a bill was on its way.

Although it would have been nice to not have to pay for that visit, I know better. Even if they never sent me a bill, there was a distinct possibility I could hear from a collection agency down the road.

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