Observe a strange item on a medical bill? Don’t overlook it.
Generally speaking, challenging it can highlight mistakes and possibly result in a more reasonable cost, according a report released on Friday in JAMA Health Forum.
Lead study author Erin Duffy, director of research training at the USC Schaeffer Center for Health Policy and Economics, advised people to “pick up the phone and call the billing office” if they received a charge that didn’t seem quite right or that they couldn’t pay. “Most people who do so experience positive outcomes.”
Approximately 1 in 5 respondents to the study stated they had received a medical bill in the last year that they disagreed with or couldn’t pay, and 61.5% of those respondents indicated they had been in touch with billing offices to voice their concerns.
According to Duffy, the majority of those who didn’t contact billing offices claimed they didn’t think it would matter.
“The bill was corrected the majority of the time,” she stated. “And even those who just thought it was unfair, many of them managed to bargain for a lower price, even if they could afford it.”
According to the research, nearly three-quarters of individuals who reported a billing error said that it had been fixed.
When consumers complained about an expensive charge, around 62% of them were able to get a payment plan or a price reduction; when consumers sought to bargain, about 76% of them were able to get financial assistance or had their account cancelled.
The poll’s results coincide with the news that, in a 2022 survey conducted by KFF, a nonprofit organization that studies health policy problems, more over half of American people reported having medical debt in the previous five years. People in the United States owe at least $220 billion in medical debt, according to a different KFF analysis.
Medical debt may “ruin people’s financial futures,” says Dr. Adam Gaffney, a critical care physician at the Cambridge Health Alliance destroy Massachusetts. This includes making it more difficult for them to secure a loan or a home. He said that others had either had their paychecks confiscated or been sued by hospitals for unpaid medical debt.
According to Duffy, certain respondents to the survey—extroverts and persons who are more likely to be skeptics, competitive, and forthright in their opinions—were more likely to contest a medical bill.
She said that the least likely people to challenge a charge were those without a college degree, those with poor financial literacy, and those without insurance.
The research was conducted using survey data collected from over 1,100 adult Americans between August 14 and October 14 of the previous year.
How to contest a health care bill
Make sure the medical bill is yours first if something appears off, advised Michele Johnson, executive director of the Tennessee Justice Center, a nonprofit advocacy group and legal practice. She continued, saying that’s particularly crucial if your last name is similar.
She remarked, “I’ve received bills in the past that aren’t even mine.” “My name is Johnson, my husband’s name is Hill, and it keeps happening. Is that your bill then? The first question to pose is that.
Johnson also advised requesting an itemized statement from the hospital, which would provide a comprehensive summary of all the services, interventions, and procedures a patient had while there. Hospitals must provide an itemized bill to requests within 30 days.
“We have observed instances in which a newborn boy was charged for a pregnancy test,” the speaker stated. “Check to see if those are services you actually used or could have used when they give you the itemized statement.” and if something appears amiss, then give the billing office a call.
In 2020, the No Surprises Act was enacted to prevent patients from receiving unexpected medical fees while receiving care at an in-network institution from an out-of-network physician, according to Johnson. (If a health care provider is in-network, it has an agreement with your health insurance to accept a lower rate; if it is out-of-network, there is no such arrangement.)
“They cannot have an out-of-network anesthesiologist if you are in an insured hospital and see a doctor who is in-network for you,” Johnson stated.
She also mentioned that those who do not have insurance or who are not utilizing it for a service might obtain a “good faith” estimate of the cost of care prior to their appointment. Then, someone has the option to contest a charge if it is at least $400 more than what was estimated.
According to her, many hospitals also provide charity care, which is also known as financial support. It is mandatory for nonprofit hospitals to establish a policy on charitable care and to post it online for public viewing. According to Johnson, even if they have already received a bill, individuals may be able to have the cost of their care lowered or even covered completely.
Johnson also suggested, if at all feasible, avoiding using credit cards to settle debt. This is due to the removal of medical debt from credit reports under a proposed regulation from the Consumer Financial Protection Bureau that is anticipated to go into effect next year.
Johnson advised asking for a payment schedule as an alternative.
She stated, “Medical bills are handled differently than credit card debt.” “You don’t want to pay that much on top of necessities like food and housing, which is something a lot of our elderly clients will frequently do even for unpaid bills.”
Patients should keep in mind that they have the right to contest a charge if they believe there is an error, according to Johnson.
Because of the power dynamics in the American healthcare system, which make consumers feel extremely vulnerable and powerless, “we think of health care bills as this whole other thing, like a black box that we don’t have any access to,” the speaker stated. “But in actuality, there are laws that protect you as a customer and give you the power to fight back if they’re charging you money.”
