![]() If it is a provider error, contact them immediately and ask that they review, recode, and resubmit the claim to your health insurer. If it is an issue with insurance coverage, you can request a reconsideration or file an appeal. In all cases it is important for you to research the code(s) independently. Other times, the provider may have submitted the wrong code. At times, the insurer may deem the procedure unjustified based on the diagnosis code submitted. There are some instances where coverage may be denied based upon the codes submitted. These codes are used nationwide in order to inform the insurers directly of what was done and how much it cost. There is billing code (HCPS/CPT) for every medical procedure that is performed by the provider, as well as, diagnosis codes (ICD-10) for every medical condition. Therefore, it is important to ask for an itemized statement of the medical so that you can make sure that you are only paying for the services and items provided to you. Errors are often made by the hospital or billing entities that can lead to duplicate or inflated charges– such as $20 for a box of tissues or $75 for a warm blanket. It is very common for medical bills to only show a grand total of all items and services without providing a detailed breakdown of them. Verify with your health insurer whether you should pay the bill at that time. Call the provider and ask for an invoice showing the insurance processing information. Look out for phrases such as"Due Now,""Estimated Amount Due" or"Amount You May Owe." Don't get tricked by this sleazy tactic. Many people pay these bills without realizing that the amount they owe might be substantially less once processed by their insurance company. ![]() They will send you a bill requesting payment while your insurance company is still processing your claim. NOTE – Some providers and billing entities are very aggressive. ![]() Always compare your medical bill to the EOB to verify that the amount on your invoice reflects the amount your insurance company says you owe. The EOB will provide details on how your claim was processed including any deductible and coinsurance amounts, as well as any services that have been denied. When claims are processed by your health insurance company you should receive a statement called an Explanation of Benefits (EOB). COMPARE THE INVOICE TO YOUR INSURANCE EXPLANATION OF BENEFITS (EOB).To avoid the hassle, make sure your insurance information on the bill is correct and that the bill has been processed by your insurance company. Many times, claims are submitted to the incorrect insurance carrier. Even if there is one digit missing from your insurance ID number or your name is misspelled, it can result in your claim being denied- and you being billed prematurely. There are many billing errors that occur due to a slight clerical error entered on the claim form submitted to your health insurance company. However, there are some steps you can take in order to avoid paying a hefty medical bill that you don't fully understand. ![]() This only adds to the confusion when trying to decipher your medical bills, explanation of benefits (EOB's), and how much you should pay your health care provider. Additionally, health insurers routinely deny claims erroneously. It is estimated that more than 80% of medical bills contain errors. Medical bills are an inevitable expense and often times patients are ripped off because of mistakes or errors in the bill itself which they failed to recognize beforehand. ![]()
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