How to figure out complicated medical bills

Michael Finney Image
Wednesday, August 8, 2018
How to figure out complicated medical bills
The last thing you need after a medical procedure or hospital stay is a pile of confusing bills. Especially if those bills contain unexpected charges or incorrect fees.

SAN FRANCISCO (KGO) -- The last thing you need after a medical procedure or hospital stay is a pile of confusing bills -- especially if those bills contain unexpected charges or incorrect fees.

In a partnership with Consumer Reports, 7 On Your Side's Michael Finney looks into these common and sometimes complicated problems that Consumer Reports says can take years to resolve.

When Bill Linden's wife, Katie, was rushed into an emergency C-section, he was only thinking about one thing. "It's a life or death situation. Baby has to come out now. Period. End of story," he said.

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He was not thinking about the anesthesiologist that was brought in or whether insurance would cover it. "I was not really thinking about paperwork at that point in time," said Linden.

But soon paperwork was all he would be thinking about. Bills started arriving, saying he owed roughly $2,500.

Many phone calls later, he found that it came down to a network classification. The anesthesiologist was being considered out-of-network, even though the hospital was in-network.

Sounds simple enough to correct, but Linden says it took 14 months to determine they did not owe the money. "It was a lot. It was a lot," admitted Linden.

Penelope Wang, Money Editor at Consumer Reports, says this is hardly uncommon. "There's a very good chance that your billing problem will drag on for weeks, months or even years and it may never be resolved correctly," she said.

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A Consumer Reports survey recently found two out of three people who had a major health expense in the past two years had an issue with their bill. More than a third said they paid bills they were not even sure they owed. "They felt it was too much trouble or too much effort to fight," said Wang.

So, what can you do to ease the pain? Linden ultimately worked with a nonprofit patient advocacy group, which laid out the steps he should take.

"This is the documentation you need to get. This is who you chase down. Send things certified mail," said Linden.

You can also hire a medical billing advocate for a fee. And if the unexpected charge is one you actually owe, Wang suggests trying to negotiate with your provider. "They may offer you a payment plan or if you agree to pay in cash right away, they may discount the amount," said Wang.

Consumer Reports also says if possible know exactly what's covered before you go in for a procedure. That can help avoid surprises later. Also, if you are asked to sign a document that says you accept financial responsibility, write in that you agree only for services that are in-network. No guarantee, but it may help if you need to dispute a charge later.

Click here for a look at more stories by Michael Finney and 7 On Your Side.

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