Many of us have been there. It’s that moment when your medical bill from a procedure you underwent weeks ago shows up in your mailbox.
Having to undergo a medical procedure can be traumatic enough; interpreting the charges itemized on your medical bill can be stressful in its own right.
Your medical bill may reflect costs for services you weren’t anticipating, items or services you aren’t sure you received, or reveal surprisingly high charges. Understanding the bill itself can be confusing. You may be wondering whether the amount listed is a charge you are required to pay or a statement alerting you that the amount in question was sent to your health plan carrier. There are ways, however, to know whether you’re being asked to pay more than you should for a medical claim.
Medical claims are incorrectly billed to your insurance company. It may be a simple case of an administrative assistant mixing up some digits on a billing code, or the claim may have been denied and you’re being told you owe an out-of-pocket cost when your procedure — from what you understand — should have been covered by your insurance. Other times, you may not be sure whether the claim has been processed.
What do you do?
Start by comparing any bills you receive with your corresponding Explanation of Benefits (EOB) from Blue Cross Blue Shield. Each time you receive a service from a health care provider, you receive an EOB that explains how much was covered by insurance and what amount is your responsibility. Typically, the provider submits a claim for the service they provided to the insurance company, which then sends you the EOB.
For added convenience, individuals who signed up for electronic EOBs can either log in to their account on the Blue Cross Blue Shield website or access that information on the Blue Cross Blue Shield app downloaded on their phone or tablet.
For bills reflecting more complicated procedures, such as an outpatient surgery or a hospital stay, you can request a detailed bill that lists a line item for every cost.
You Have an Advocate
If the amount from the EOB doesn’t match the bill for those services, or the EOB indicates the claim was denied, that is a clear indication there is a discrepancy issue that has to be resolved before you pay your bill. Rather than contacting Blue Cross Blue Shield or the health care provider in an attempt resolve the issue, simply call one of the four individuals from Brown & Brown Insurance who provide claims advocacy services. They have extensive experience in processing medical claims. Some have even worked processing claims for Blue Cross Blue Shield and are intimately familiar with the system.
Instead of prolonging your stress during a time when you have to focus on getting well, having an experienced advocate means turning over the hassle and headache of researching your medical claims to someone else. Brown & Brown’s claims advocacy services will make sure the proper diagnosis and procedure codes were entered, and will work with your provider to make the necessary corrections.
Don’t be concerned about your health care provider viewing you negatively for disputing a bill. Health care providers often use external billing agencies, and questioning a bill will not influence the quality of care you may in the future receive from a physician or hospital.
What you will gain, however, is peace of mind knowing your claim was processed correctly. For more information, call Brown & Brown Insurance and ask for the contact information of the four individuals who provide claims advocacy services.