Avoid Claims & Billing Problems

Experts estimate that at least 30% of medical bills contain errors. The following are some ways you can help avoid errors and respond if you find a billing mistake.

  1. Know your coverage. You’re more likely to catch an error if you’ve read your policy.
  2. Get the paperwork. Ask for copies of all your bills, especially for hospital stays and hospital pharmacy charges, and review them closely to make sure charges match the care you received.
  3. Open bills and EOBs ASAP. Insurers typically have a deadline for appealing a charge, so open bills and EOBs (Explanation of Benefits) right away and call immediately if you see a problem.
  4. Stay in-network. Making sure physicians, labs, hospitals, etc. are in your insurer’s network offers two benefits. You will get the best prices, and in-network providers usually communicate with insurers better than out-of-network providers.
  5. Talk to your doctor. Physicians don’t always think about the cost of a test, medication, or procedure before ordering it. Ask for this information so you are not surprised when the bill arrives.
  6. Get help. If you find yourself confused by charges and bills, your employer’s Human Resources Department should be able to help you or connect you with someone who can.

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