The Affordable Care Act

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Has Your Medical Bill Been Denied by Insurance? Try These Strategies

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Do you have medical bills that your insurance company doesn’t want to pay? You have several options as you explore different ways to pay the bills.  If your insurance company won’t pay the bill, consider these ideas: 1. Understand the out-of-network rules. Receiving care out-of-network is one of the most common reasons an insurance company denies payment. • Did you go to a hospital, clinic, or doctor who is outside of your network? Insurance companies have strict rules for what they will cover. They may not want to pay for hospitals or doctors who aren’t part of their network. • Unless you had an emergency that couldn’t be treated at an in-network provider, you may not be able to get the insurance company to pay.  • Your city or state may have specific rules that can force insurance companies to pay for out-of-network services in emergency situations. However, you may still be responsible for some of the charges.  2. Negotiate your payment. If your insurance c...
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Strategies to Lower Your Medical Bills

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With health care costs rising, it's natural that more people want to lower their medical spending. According to Consumer Reports, only 31% of Americans try to negotiate the price of medical bills, but those who do usually succeed in saving big money. These are some methods that will help. Understanding Medical Charges and Discounts 1. Become familiar with routine discounts. Doctors and hospitals typically give discounts of as much as 60% to Medicare, Medicaid, and insurance companies. As an individual, you may have less leverage than the big payers, but you can usually save significant money by negotiating. 2. Look for the CPT code. Current Procedural Terminology (CPT) codes are the standard codes maintained by the American Medical Association. They're what billing departments use to determine the charges for any procedure. Once you know the CPT codes, you can comparison shop. 3. Know that it's okay to negotiate. Many health care providers are getting used to pa...
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