ATLANTA — It is a problem thousands of Georgians have faced after they visit a hospital or medical provider – being slammed with a high or unexpected medical bill.
That leaves consumers on the hook for hundreds or even thousands of dollars.
According to Georgia Watch, health care costs are the No. 1 reason people file for bankruptcy.
Channel 2's Clark Howard speaks with a woman who was billed $1,900 for a shot she's recieved multiple times, plus hear the nightmare that a man with no insurance went through after having a hernia operation. Clark's key warning to make sure something like this doesn’t happen to you, MONDAY AT 6.
That leaves you vulnerable to lawsuits by health care providers and debt collectors. But Georgia Watch says medical debt is not beyond your control.
Channel 2 Action News spoke with Georgia Watch’s Berneta Haynes, who gave a list of things you should do even before going to see a doctor.
Understand what your insurance policy covers:
“Pay close attention to all the steps you should take before you make an appointment, to sort of cut down on the risk of getting a surprise medical bill,” Haynes said.
Is your doctor or hospital in network or out of network? Contact your insurer to double-check and verify that the provider is in network. If the provider is not in network, you will pay higher out-of-network costs.
Take time to understate what you’re being billed for:
Georgia Watch says you need to look for codes on your Explanation of Benefits, or EOB.
An EOB lays out how much your health care provider is charging your insurer, how much the insurer will pay and how much you have paid or may have to pay. This amount is usually your co-pay, deductible or any other balance due.
“When you get a bill that you just don’t understand, it is so important to make sure you contact the provider’s office, so you know what they are charging you for,” Haynes said.
When speaking to your insurer or provider, make sure to take detailed notes until you have resolved the issue.
How to dispute a bill:
If your health insurance company will not pay for something you think should be covered, you have the right to appeal. There are two things that you will need to do to dispute the bill.
First, file an internal appeal with your insurance company. You have 180 days from the time you find out your claim has been denied to file this appeal.
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If that doesn’t work, you can file an external appeal with the Georgia Department of Insurance. You have 60 days from the results of the internal appeal to file this appeal.
“If you get rejections from both of those, now you have to start thinking, ‘OK, how do I work this out with the provider? Let me get the provider on the phone and figure out what kind of deal I can negotiate with this provider,’” Haynes said.
You can negotiate a lower lump-sum payment or payment plan.
Do not ignore a medical bill:
“It will definitely end up on your credit report,” Haynes said.
The credit bureaus will wait 180 days from the date a medical bill is past due before adding the medical debt to your credit report. This waiting period gives you time to receive and pay the bill.
Also, the credit bureau should take the debt off your report as soon as it is paid by you or an insurance company.
For more in-depth details about dealing with medical bills and debt, Georgia Watch has put together a guide for consumers that will help you navigate everything.
Cox Media Group