Stop! In the name of maternity bill errors
Before you pay too much
Expecting a baby? When I mention the words “medical bills,” what emotions start to stir? Bewilderment? Frustration?
Before working at Bernard Health and learning about medical bill errors, when I received a medical bill, I simply paid it.
What about you? Are you used to blindly paying bills, assuming the doctors and hospitals are billing you correctly?
Well, it’s time to stop.
According to Medical Billing Advocates of America, 9 out of 10 medical bills contain errors. These errors are said to raise the cost per bill an average of 25%. As having a baby is associated with many bills from different providers, it's critical to take all the necessary steps to ensure you aren’t the victim of medical bill errors that can lead to overpaying for care. Let’s look at four steps to help you avoid paying too much for prenatal care and delivery.
1. Keep detailed records.
Start a spreadsheet after your first doctor's appointment.
To avoid errors and overcharges, you'll want to record the following in the spreadsheet:
- Each visit to the doctor. You will want to keep a detailed record of all of your visits, tests, and procedures performed at your prenatal visits. For example, don’t just type “doctor’s appointment.” Include all the details about the appointment. A better description would read something like this, “Urine sample, nurse-administered flu shot, doctor measured uterus.”
- Every bill from every provider. Once you start receiving medical bills, these also need to be recorded in your spreadsheet. Include detailed records about what the bill is for, what you paid, and who you paid.
Keeping a detailed record of your visits and bills enables you to easily check for errors when bills arrive. Detailed records are the first step to ensuring you aren't overpaying for care.
2. Utilize your health insurance carrier’s tracking tool.
Your insurance carrier has a tracking tool on their website where you can track all of your medical bills and see how close you are to meeting your deductible and out-of-pocket max. Your provider should be billing your insurance company before they send you a bill. Therefore, you should be able to see the charges on your insurance carrier's website and compare them with your spreadsheet.
However, your doctor’s office may not bill your insurance company until after your deliver, a practice called “global billing.” What this means, is you may be asked to pay a lump sum (possibly your entire deductible) for your prenatal care upfront. If this is the case with your doctor, then the charges will not show up on your insurance company’s website until after you deliver. After you have your baby, check back to ensure your doctor’s office billed the insurance company accurately.
Utilizing your carrier's tracking tool will help you track your bills and ensure your carrier is paying what they are are supposed to.
3. Meticulously check each bill for errors.
Go through each bill, line by line, and make sure the charges match the descriptions on your trusty spreadsheet. You’ll especially want to pay attention to some of the most common instances of medical bill errors: double billing, incorrect length of stay charges, cancelled work, services that were never performed, and upcharges.
This is the step where things can get confusing. Why? For two main reasons. One, medical bills often have terms, abbreviations, or codes many don’t understand. Two, medical bills often include charges grouped together and don’t include a line item for each service performed.
If you can’t decipher your medical bills, call the provider who sent the bill and ask questions. If certain charges were grouped together, ask for a bill with each individual charge listed (so you can compare this to your spreadsheet). If you don’t get the answers you need right away, call back and talk to someone else. As it turns out, this process isn’t always a quick phone call with an easy answer.
One of our specialities at Bernard Health is to help people like you find errors in medical bills. If meticulously checking your bills for errors and overcharges sounds like the last thing you want to do, then you can hire us to do this for you.
4. Figure out who owes you money (and ask for a reimbursement).
In many cases, especially with more and more doctors billing globally, you may overpay and deserve a reimbursement. Let’s take an example.
After discovering she is pregnant, Julie visits her OB/GYN and is asked to pay $2,500 (her entire deductible) to cover her prenatal care. The office bills globally. Julie pays the $2,500.
Several months go by and Julie receives five bills in the mail. Three bills are for ultrasounds and two are for lab work. She’s already paid $2,500, so she calls the doctor’s office assuming there's a mistake. The administrators, however, tell her she needs to pay the bills because ultrasounds and lab work aren't included in the global billing. She pays $1,000 for the ultrasounds and lab work.
After 40 weeks and 3 days, Julie is finally in labor and delivers a healthy baby boy. Before checking out of the hospital she is told she owes $3,000. If she pays before she leaves, the hospital will grant her a 20% discount.
Bewildered with all the charges and just ready to get home, Julie hands over her HSA card and pays $2,400 (remember: the discount).
At this point, Julie has paid:
$1,000 for Ultrasounds and lab work
$2,500 for all her prenatal visits
$2,400 for delivery
Since Julie's deductible is $2,500 and her out-of-pocket max is $4,000, she knows she has overpaid. Either her doctor or the hospital owes her money. She needs to figure out who billed the insurance company first. In this case, her OB/GYN’s office billed Blue Cross first, which she knows by looking at Blue Cross' website and seeing the charges for prenatal care. Therefore, the hospital owes her money. She calls the hospital and asks for a reimbursement.
If you discover you have overpaid for prenatal and hospital care, check your carrier’s website to see who billed the insurance company first. Then, request a reimbursement from the other provider.
Anticipating a baby is a wonderful time in your life. But we know the financial side of things can be stressful. Let us know if any questions arise as you are trying to make sure you aren’t paying too much for maternity. We’re here to help.
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