A couple of months ago, this blog happily announced that the No Surprises Act will begin to take effect on January 1, 2022. On December 27, 2020, the U.S. Senate Committee On Health, Education, Labor & Pensions passed and signed into law this legislation to protect patients from surprise medical bills. It also establishes a fair payment dispute resolution process.
Are there any protections against surprise medical bills received this year?
Thankfully, William McGovern of U.S. PIRG provides an answer. Earlier this month, he revealed that patients who have insurance coverage through Medicare or Medicaid, or who are on Veterans Affairs Health Care are protected from surprise medical bills. However, your protection all depends on which state you live in.
Unfortunately, there are no protections for citizens of Alabama, Alaska, Arkansas, Hawaii, Idaho, Kansas, Kentucky, Louisiana, Montana, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Utah, Wisconsin and Wyoming.
How can you challenge a surprise medical bill if you receive one this year?
McGovern offers up a number of tips to help Americans challenge any surprise medical bills they may receive this year. It all starts with contacting your private insurance company. If you have one, he informs, it can help you to avoid getting such bills or lower the cost of a bill if you do receive it. McGovern also stresses the need to ensure that the hospital or health care facility you visit is in your insurance network before you get treated there.
“When planning hospitalizations at an in-network facility, check with the facility to ensure that all providers (surgeons, anesthesiologists, and others), lab services (such as blood work) and imaging services (such as X-rays, MRIs) are covered by your insurance plan,” advises McGovern, “Furthermore, specifically request that any additional services you may need are covered by your insurer.”
What can you do to reduce the amount you owe on a surprise medical bill?
Firstly, be sure to request an itemized bill. Check to make certain that you are not being mistakenly billed for a treatment you did not receive. If you are confused about anything on your itemized bill, be sure to question your provider. Secondly, compare your itemized bill to the Explanation of Benefits provided by your insurer. You want to make sure that your insurance company is paying its fair share.
In some cases, patients are billed for services because their providers sent the wrong billing codes to the insurers. It’s important to get in touch with your insurer to check into any possible mistakes they may have made as well. If you don’t understand a charge, be sure to ask about it. “Even if there are no mistakes, you can try to negotiate with your provider,” informs McGovern, “Many hospitals have patient advocate departments to help you manage your bills.”
At Allegiant Experts, we have decades of experience evaluating medical bills.
In many court cases, we have helped to determine the usual and customary charges for providers in specific geographic areas and fair market value reimbursement for like providers in the same geographic areas.Maybe we can help you! Call us at 407-217-5831 or email us at info@allegiantexperts.com if you have healthcare questions. If we can’t help you, we’ll be sure to point you in the right direction!