Medical debt is one of the leading causes of bankruptcy in the United States. Having health insurance is no guarantee against being swamped by bills after an emergency or a big procedure.
But one Palm Beach County man has found there’s room to negotiate.
Kenneth Klein is a former attorney who now runs the business Human Health Advocates—he works with clients to renegotiate bills and resolve insurance disputes.
Klein had a lot of good advice for avoiding surprisingly large, confusing medical bills.
What you can do before getting medical care:
Understand your plan. “Understand what their co-insurance is, what their co-pays are—in and out of network. Find those [in-network] physicians,” urges Klein. “My strong belief is people need to be more thorough than they are.”
Get a reference number. Taking good notes can help at all points in the process. “Any time you deal with your insurance company on any issue, you want a reference number,” says Klein. “Or at least get the name and phone number, and the date, and the substance of the conversation.”
Make sure you have pre-authorization. “The doctor's office, when you come in and sign their contract, now says you are responsible for your own pre-authorization,” says Klein. That means patients have to be extra diligent about calling providers and insurance companies to ensure the right paperwork has been filed ahead of time. Otherwise, insurance may not cover everything the patient might expect.
What you can do about unexpected bills after receiving medical care:
If you’re uninsured, negotiate. “Many hospitals are different from each other. Some have very strict protocols that are more limited,” says Klein. He suggests trying to get past customer service to the patient access department or decision-makers in the billing department. “Some hospitals will write off 85 percent of the bill.”
Before leaving the hospital, ask to speak with financial services. “Many of them to their credit have good financial aid programs. … Ask for an itemized bill. Ask what type of financial aid may be available and see if it's something you might qualify for.”
Check your bills. Klein works with a medical billing service to do sophisticated analyses of bills. But you might be able to catch some inaccuracies if you know what to look for. Double-billings, blatant errors, unfamiliar names. “Sometimes you see a medical bill and you don't recognize the doctors because it's coming from a different group,” says Klein. “We have to track it down.”