Simplifying Patient due Balance Collection

When you have a health insurance, it is expected that the insurance would cover most of your health care. But unfortunately that’s not always the case. Your frequent visit to Doctors and at times, getting admitted, you may end up being responsible for more than the co-insured percentage. The sad part is they are often unexpected. According to statistics, eight percent of individual have enrolled in out-of-network providers and forty percent of them have received, which is supposedly called, “surprise bills”. Not everybody would have enough savings to pay off these bills.

What is balance billing?

Balance billing is the bills that the providers send to the patients when the insurance company does not cover their entire amount. This happen in scenarios where the person is in need of an emergency care is treated by physicians who are out-of-network. Clearly, patients do not voluntarily choose to visit an out-of-network physician. Most of these services are provided by emergency cared physicians, where in the patient wouldn’t have consider the insurance formalities in a life-or-death circumstances. These doctors being outsourced, the bill is passed on to the unaware patience.

Tips to avoid these “surprised” bills

• If you are billed for the service after your payment of your health insurance plan, in most of the cases you are not supposed to be charged for the balance bill.
• Balance billing is banned in most of the countries. Therefore, when you are billed with your health insurance coverage with the in-network price, the company has agreed to upon it and they are to bill you only with the reminder of the balance fee. In case their special fee is justified in special circumstances, file a case.
• These surprised bills are more likely only in out-of-network cases. Even though the procedures are pre-approved by the insurance plan they often try getting you paid. The insurers wouldn’t pay you in such cases.
• Double check the insurer’s information. Do no blindly rely on the website or the advertisement. There can be loopholes that are blinded on the website or other advertising form.
• Maintain a documented communication log.
• Always make sure the one who treats you, including the nurses are within your health insurance network. They may send you with different bill if any of them don’t cover your network
• If all the above tips fail, trying negotiating with the hospital or the providers office. This could be an advantage if done beforehand, nevertheless can be given a shot even after the procedures.
• If your insurance is through your employer, make sure you talk to the human resource department

This could be avoided if the information regarding this balance billing is specifically disclosed in advance of a procedure and to obtain informed consent. The health care wouldn’t favor this aspect. Unfortunately, in most of the places they wouldn’t work without changes in the way the insurers and the health care operate. Also informed consent wouldn’t cover the emergency care or situations where the patients are too incapable of giving a proper consent.