Dont Overpay On Individual Medical Insurance Claims

Dont Overpay On Individual Medical Insurance Claims

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With ample opportunities for billing errors within todays complex health care claims and reimbursements systems, its a wonder people carrying individual medical insurance dont spend more time carefully checking each Explanation of Benefit (EOB). The EOB shows what was charged less what the insurer agreed to cover, the balance being what you owe. Checking your EOB is the first line of defense against overpaying on a health insurance claim.

Your EOB may not reveal a lot, but you can check to see that your name, address, and policy information are correct. You should also confirm that you were charged the allowable rate set by your insurer and not a penny more. Deductibles can be as high as $10,000, and payment comes entirely from your bank account, which makes group discounts all the more important.

Other common errors the EOB may reveal include: Failing to get credit for a deductible that has been paid, in-network providers classified as out-of-network, legitimate claims denied as medically unnecessary, upcoding (being charged for more expensive services than you received), and unbundling (when a single procedure is broken down and billed as many). At Blue Cross/Blue Shields Web site http://www.bcbs.com/betterknowledge/anti-fraud/explanation-of-benefits.html, theres a brief tutorial on how to read and double-check an EOB.

According to a 2001 Harvard study, illness and its associated costs are responsible for 50 percent of all bankruptcies, so it literally pays to request itemized bills from hospitals and other service providers. They are your next line of self-defense against overpayment. The problem is making sense of them, which may require hiring a patient advocate.

Lee Taber works for HealthCare Mediation Group auditing itemized bills, coordinating appeals, and, when possible, negotiating reduced payments and workable payment schedules to keep clients from getting a damaging credit rating. While costly mistakes are rare, Taber estimates that 40 to 50 percent of hospital bills contain errors: The potential for error is high when a bill is 15 pages long and lists every aspirin and other medical supply.

Advocates receive a percentage of the money they save you. Their cut varies but can run as high as 30 percent. He concisely sums up the benefit of working with an advocate: If you dont know what youre looking for, how would you find it?

Indeed, visit the Individual Services page at Medical Billing Advocates of America at http://www.billadvocates.com/ where you can read about a patient who was charged $12 for a mucus recovery systema box of tissues.

If paying someone to fix a mess you didnt make gets you mad, imagine being the victim of medical identity theft. Its like losing control of your social security number and private financial info, but this is a loss that can be deadly. If a phony claim is made using your benefits, your chart could contain wrong information when you need urgent care. If your benefits are tapped out by an impostor, youll have none left for your own care. According to a World Privacy Forum report on the crime, all levels of the medical system may be involved, in addition to organized crime.

When it comes to your individual medical insurance, do your homework and prepare in the event of inflated bills or medical identity theft. It can save your money and your life.

About the Author:
Ryan Patterson is Chief Marketing Officer of All Web Leads, which provides information to consumers via USInsuranceOnline.com. He and partner Jim Waltrip founded the company in 2005 to provide quotes and information on individual health insurance.



Article Originally Published On: http://www.articlesnatch.com


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