We all hate falling sick, the very thought of hospitals can make us break into cold sweats. But sometimes hospital visits are just unavoidable. Some medical visits maybe pre-planned and some might be due to an unforeseen situation. Health is something that should not be ignored, and thus health insurance becomes an extremely important thing to have for individuals, irrespective of your age. Because who can say that a young woman won’t need a medical intervention.
Unexpected hospital bills can aggravate you further
We often lack proper knowledge and are extremely trusting of our insurance providers. But we should remember that insurance companies at the end of the day are business organisations who are looking to make a profit, and it becomes easy for them to cash-in on our naivety.
Hospital stays are gruelling and can make the best of us nervous, but once you get back home-cured and well, you can get another shock, that can send the weak of heart back through those revolving doors. This dreadful thing is the hospital bill or insurance claim payment. You might believe that your insurance provider will cover the entire cost, but it is not so.
As a consumer, it is extremely important to be informed. Every year during insurance renewal the company will send you a huge pamphlet of terms and conditions, but most of us are so busy managing our delicate work-life balance that we end up ignoring the fine prints and for some the entire handout.
Ways to avoid unpleasant surprise medical bills
So, herein we will tell you how to avoid unexpected insurance payouts.
Be in network
Insurance companies have hospitals, diagnostic labs, doctors and other medical professionals who are associated with them or “in-network”. If you visit a doctor or medical facility that isn’t covered, then you end up paying a lot more.
Always talk to your insurance provider and the healthcare staff before undergoing any treatment or tests.
Sometimes a specialist or anesthesiologist might be out-of-network, and you may end up paying a steep hospital bill for their service. The facility fee is something else that you should be aware of, that is sometimes the consulting doctor might be covered under insurance, but the hospital or clinic might not be, and then you can end up being balance billed.
Information is a powerful tool for avoiding unexpected health bills. Before undergoing any tests, procedure or doctor consultation always inquire whether it is necessary and if it is included in your insurance coverage.
Remember, every procedure has a six-figure code for it, and insurance companies pay according to those codes. So, maybe mammography is covered but 3-D mammography might not be. So always inquire and look upon the essential information beforehand, since you might be frazzled on the day of the appointment.
When going for pre-planned surgeries, it is best to get pre-authorization from the insurance provider. Ask your doctor for the necessary information and complete the paperwork. This will help you to relax and heal in a stress-free manner.
Be prepared for emergencies
Emergencies don’t come with prior notice, so it is always best to be prepared. Make a list of nearby hospitals that are covered by your insurance network. This way you can suggest the emergency services take you to that particular facility. Also, most of the money goes paying for the out of network ambulance services. Hence, you can keep the numbers of insurance-covered ambulance providers handy.
In case of emergencies, if you are “balance billed”, immediately speak to the hospital authority and insurance company, to get your fees waived.
Get things documented
We mostly seek information over the phone or maybe in person, and we take things at face value. But attorneys warn against this, and rigorously advises people to get things in writing, so that later if a problem arises, there is documentation to corroborate your pleas.
Preventive care billing
Health insurance is nowadays covering preventive care treatments. But sometimes your doctor might make a mistake with the coding for the procedures and tests, and one mistake and you can end up paying since that particular code might not be included under the preventive care.
Get the best price for diagnostic check-ups
Most of us are under the assumption that the price is the same for diagnostic tests, but we are extremely mistaken. Do a quick research and opt for a place where the cost is minimum.
Surprise medical bills are not at all pleasant and can be an extremely unpleasant ordeal. Over 48% of insured people have received surprise medical bills, but by having adequate information and awareness you can avoid it.
Health is our primary asset, and in an emergency situation, we are often overwhelmed and become prey to business conglomerates. Know your rights and avoid being duped.