Health Informatics News |
| Posted: 19 Feb 2011 07:05 PM PST When it comes to getting bills from a doctor’s visit, it can get pretty confusing pretty quickly. It is important to understand that just because you are in your doctors office does not mean that office is the only entity providing a service. You must consider lab work, pharmaceuticals, medical devices, and specialists. In rare cases, your primary physician may take on the billing for all of the services but usually the bills are all handled through insurance. Your insurance will pay the various providers and then provide you an EOB or Explanation of Benefits. Then the various companies involved will all send bills to you. So, when you pay the co-pay at the doctor’s office visit, it doesn’t end there! Pay close attention to your bills. Make sure to stay engaged with the various providers. Also, make sure everything seems normal. If a bill seems high, you need to call about it. It is possible your doctors office forgot to add a billable diagnosis code or perhaps a clerical error during processing. It is very important that you know your in network and preferred providers for medications and labs as well. Sending to an out of network provider can cost you a lot of extra money. It is a lot like going to a store to shop but later being billed by the manufacturer. It is just important to understand that your doctor’s office is a business that is providing a service to you. In doing so, they have the ability to refer and prescribe many other services. We refer to the office as a store front so that people can remember the analogy and think about the services being provided at the office. Do not be afraid to ask questions. You are paying your doctor to be an expert in examining your physical health but you are paying your doctor whether through insurance or direct pay. Take the time to make sure you know what is happening. That being said, most doctors are extremely happy to explain, discuss and teach…. so ask them about anything that might be confusing to you! |
| Posted: 13 Feb 2011 10:29 PM PST We wanted to take some time and focus on medical insurance in comparison to self pay patients because many people get their credit destroyed by medical bills. In later articles, we will also delve into medical insurance, co-pays and the seemingly endless number of bills that can accumulate from one visit to the doctor. In that regard, it is very important to think of your doctor as a store front offering many products by many different manufactures just like your local supermarket. But, back to the self pay patients. If we had to wrap it up in a word, we would simply say “negotiate”. Ironically, many people do negotiate with their doctors. However, there are more bills than just from your doctor. Again, your doctor is the store front. Your doctor sends your blood work to a laboratory. He gets medications from a pharmaceutical company. He refers you to specialist doctors, physical therapy and other medical products. All of these entities are separate businesses and they bill separately for their services. Anyone spent any time in the hospital or at the doctors office (even if it is just to have a baby) knows that the bills add up very quickly. Now, what makes it manageable is medical insurance. The insurance companies have negotiated rates with the businesses in the medical world. There are countless hours and competitive maneuvering behind the scenes where companies compete to be preferred with different insurance companies and in network with others. Medicine is big business. And, in that light, everyone wants a deal. So, insurance companies offer in network status and medical practices offer discounted services to that insurance company. The benefit being increase volume of patients (as patients will go to in network providers). What happens to self pay patients? Well, by default, they will be billed at list price. DO NOT pay list price. Call the office, medical device company, or laboratory and negotiate a discounted rate. Unless you are very wealthy, the bill will likely be a hardship on you and you need to tell them that is the case. However, many people see the high bills, assume they cannot pay it and they just try to forget about it. Then, the medical companies send the bill to a collection agency and people get penalized on their credit scores. Usually, when things turn around, they try to get a line of credit and realize they have a bad credit score due to a forgotten medical bill. Unfortunately, once the bill is in collections, there is little that can be done to reduce the cost of the bill. The conclusion is simple. If you want your credit to remain in tact, call up the company that provided the service. Talk to them. Let them know your situation. They may very well put you on a payment plan as well as reduce your rate. Just do not wait until the bill has gone to collections and there is a very good chance you can save a significant amount of money and your credit score. |
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