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How To Contest An Inflated Medical Bill

How To Contest An Inflated Medical Bill

 

Under HSA-qualified health plans, accountholders are responsible to pay all medical expenses (except certain preventive services, potentially) before they hit their deductible. And if you want to invest your HSA funds for future healthcare costs, you’ll want to pay for as many medical expenses out of pocket as you can, so you don’t dip into your HSA savings.

Since healthcare costs often can vary by provider, it’s a good idea to price-shop for medical services to make sure you’re getting the best deal. However, despite your best efforts, sometimes you’ll get slapped with a medical bill that feels too high. If that happens, here are some simple hacks to help you cut your bill down to a more manageable size:

Check to see if there were any billing mistakes.

Just because a bill came from your medical providers doesn’t mean it’s accurate. Mistakes happen. If you think your bill is too high, ask your medical provider to review it for errors.

Find the CPT codes for the services you received.

All medical services have a five-digit code called a CPT code that medical providers use in their billing. The codes might be on your bill; if not, call your medical provider and ask for a detailed line-item bill with CPT codes.

Find fair pricing for the services you received.

Once you have your CPT codes, use the links in the “Comparing Medical Prices” section of this page to find standard pricing for your services. Plug in your codes to see what typical costs for those services are. You can also use Medicare pricing (find it on this page) to see how much the government is charging for a particular service.

Negotiate pricing with your medical provider.

Once you know standard prices for the services you received, go back to your provider and ask them to lower your bill. Make sure to give clear examples of how much the services you received cost in other areas. If you went to the ER and felt you were given a code that was out of line for the services you received, give reasons why your bill should be coded lower. Also, if you plan to pay with cash, make sure your medical provider knows that; a simple payment process could help lower your bill.

File an appeal with your insurance provider.

If you feel like your insurance provider isn’t covering enough of your bill, file an appeal with them. Use fair pricing examples to help build your case. If you do this, be sure to let your medical provider know, so they can push back the payment date on your bill.

File an appeal with your State Insurance Commissioner.

If your medical and insurance provider don’t budge, consider filing an appeal with your state’s insurance commissioner. Give him/her all the information you’ve obtained and ask them to formally review your case. Also, this insurance complaint tool is a helpful resource to guide you through the appeal process.

 

The more money you’re able to save on medical services, the easier it becomes to not touch your HSA funds and let them grow for retirement healthcare expenses. Imagine having a dedicated nest egg to pay for qualified medical costs in retirement tax-free (and after age 65, HSA funds can also be used for non-qualified expenses without a penalty; you just pay regular income taxes like you would with a 401(k)). Learn how you could save as much as $134,000 with an investment HSA or open an account here.

Author: James Denison