Understand Your Health Care Bills and Save Money

One of the best ways we know to save money on health care (or anything else, for that matter) is to not pay for services you didn’t receive or pay more for a service than it’s worth. You don’t need to be a rocket
scientist, but you do need to be attentive to details. Don’t take it for granted that your doctor’s office, health care provider or health insurance company is 100% accurate. Cross check to be sure. Here’s how.

Compare and complain. When you leave your doctor’s office or lab, you should be given a list of services performed. If it isn’t provided automatically, ask for it. When you get the bill from your provider, it should contain the list of services and the fee for each of them. Finally, when you receive the EOB (explanation of benefits) from your health insurance company, it should explain what the provider billed the insurer and what the insurer paid. What you need to do is compare all these documents and check for discrepancies. Were you charged for a service you didn’t receive? Was your insurance company charged more for a service than what was indicated on your bill? If you have questions, call the health care provider for an explanation. And don’t hesitate to report any discrepancies to your insurer.

Grok the jargon. Every industry has its own language. Health care is no exception. Between doctor-speak and insurance company-speak, there’s a mysterious lexicon of terms, codes and abbreviations. Understanding the most basic ones will help you navigate your health care bills. Fortunately, the Internet has made it easier to research unfamiliar terms using online glossaries, medical dictionaries and
encyclopedias, medical tests and lists of drugs (pharmacopeia).

Decode the codes. You can also access online lists of current CPT (current procedural terminology) codes; those are the five-digit numeric designations assigned to describe medical, surgical, radiology, laboratory, anesthesiology and evaluation/management services. There are also ICD (International Classifications of Diseases) codes.These are diagnostic designations used to identify symptoms, injuries, diseases and conditions. They correspond to CPT codes to make it easier to flag obvious typos. But with thousands of codes, and frequent coding revisions, you shouldn’t be surprised to learn that typos happen. As with all online research, make sure you’re using the latest version from a reputable source.

Flub or fraud? Honest mistakes happen. So does intentional billing fraud, and that costs all of us in the form of  higher health care costs. Be on the outlook for upcoding, a practice of billing your insurance company at a higher level for the same service. An example would be charging your insurer for treating bronchitis when all you had was a cough. Providing unnecessary tests and procedures is another way to
squeeze money out of your insurer. So is renaming an uninsured procedure to something that is covered.