18 Medical Bill Tips

If you are like a lot of people, you may be worried about unpaid medical bills or drowning in medical bill debt. If you are a family member of someone with special needs, or if you or a loved one has a disability, an illness or had an accident, hospital and doctors’ bills are probably piling up on your desk. You might be asking, do medical bills go on credit reports or can they be sent to collections? If you’re struggling to pay medical bills, or figure out medical tax deduction, or wondering who can help, keep reading! Here are the top tips to help you manage medical bills and get out of medical bill debt!

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1. Keep your medical bills organized. Get a binder and put the bills in it, organized by date of service, medical facility or specialty – whatever makes the most sense for you. Start a spreadsheet and write down the name of the biller, the date of service, how much was charged, how much you paid and when you paid it and so on. This will help you know when you get double-billed for something you’ve already paid for or when you’ve already met your deductible. It will be invaluable at tax time and will be helpful when you have to argue about a bill with insurance or a biller!
2. Pay attention to your bills. You will most likely be billed incorrectly. We have received dozens of incorrect bills. When you receive an incorrect bill, you can work with the biller and insurance. Medical facilities typically have a patient liaison who you can call and should work as an intermediary between you and the biller to help you get the problem resolved. You can also try working with the medical facilities’ social workers who might direct you to other resources or intercede on your behalf.
3. Get to know what your insurance covers and what you should or should not be paying for. Actually sit down and read the parts of your medical benefits guide that apply to your situation. It will help you! I’ve had insurance representatives give me information over the phone that conflicts with their benefits guide and after arguing it with them, was able to get them to cover items they had refused. Additionally, many doctors’ offices will just charge a co-pay whether it’s the right one or not. Know what you should be paying and question it if you think it’s incorrect.
4. Know how much your deductible is. A deductible is what you have to pay up front before insurance starts covering things. For instance, you may have a $300 deductible for doctors’ appointments, so you pay the first $300 of each calendar year and after that, the benefits kick in. If you have lots of medical bills you will probably meet this early. Make sure you know when you’ve met your deductible and don’t allow doctor’s offices to charge you for it. It’s much easier to ask them to bill you for what they think they are owed AFTER insurance pays than it is to convince them they owe you a refund.
5. Know what your maximum out of pocket expense for the year is and be sure your insurance plan has one! The out of pocket maximum is the entire cost you can be charged for items not covered by insurance for medical bills for the year. It might be $10,000 for example. So if your child is in the hospital for a month, you will have to pay for things insurance doesn’t cover and co-pays that may add up to or exceed $10,000. Once you exceed $10,000, you are not responsible for paying for ANYTHING else beyond that limit for the rest of the calendar year. Insurance will cover it or they will negotiate it with the biller. Once you reach that, be sure that you hold insurance and doctors’ offices to that. The out of pocket limit is a safety-net so bills don’t continue accumulating forever, but many doctor’s offices will try to charge your without knowing that you’ve met this limit. We met our limit last year and we saved tens of thousands of dollars by arguing this point with doctors’ billing and our insurance.
6. You may be able to deduct medical bills not covered by insurance from your taxes if they total more than 10 percent of your adjusted gross income. As of this writing, people over 65 are temporarily exempt from the 10 percent rule. Read the tax rules to see what you can deduct each year by checking the IRS website but some examples of deductible items besides doctor bills include: breast pump and supplies; formula and other medical foods; a mileage rate for driving to and from doctor’s appointments; parking fees; hotel costs if you had to stay close to a hospital for an extended period; cost for medical supplies; co-pays for therapy; cost of insurance payments and so on.
7. You can often negotiate medical bills with the healthcare facility. You can’t do this with co-pays or deductibles typically, but if your insurance doesn’t cover something, you can and should ask for a discount. Be persistent and explain that you have many medical bills and you’d like to pay your bill but they should work with you. If need be, explain how much you make to show your inability to pay the entire bill. If you make $40,000 per year and you are facing a $10,000 bill, they should be more willing to work with you than if you make $300,000 per year.
8. Many healthcare facilities charge a “facility fee”. If you have more than one appointment in the same facility on the same day, (say for two different doctors or for a doctor and a procedure), they may charge the facility fee twice. We have gotten this dropped but we had to call and ask for it.
9. Medical bills CAN affect your credit rating! Also, medical bills can be sent to collections. There is a widespread myth that neither of these happen, but they do!
10. Stay on top of your medical bills to avoid extra fees. If you can’t pay something, call the biller and let them know. First ask for a discount. Then try to set up a payment plan. As long as you are paying on a bill, you can probably avoid late fees.
11. If you are charged a late fee by a medical biller, call and ask to speak to a manager. Explain you have lots of medical bills and you have every intention of paying the bill. Then politely ask for the late fee to be dropped if you make a payment. Often they will drop the late fee in favor of working with you to get the rest of the bill paid.
12. If you need to fight a medical bill, be persistent. The biller is not supposed to send it to collections as long you’re working with them on it and especially if there is a dispute over it. . (Example: We fought one bill for over a year and finally ended up paying only $200 on a bill that was originally $8,000 because we thought it was fraudulent. Hospital charged us for a private room but they only offer private rooms. Insurance refused to cover a private room. We insisted repeatedly that we never requested a private room and this was actually a standard room since that was the only thing the hospital had. Finally, insurance agreed and they negotiated with the hospital and we paid only a co-pay. We won and didn’t even need a lawsuit, although we threatened it!)
13. Know your benefits but double check with insurance. Read your explanation of benefits to be sure they are covering things and call them to check if you see a discrepancy or have a question. Keep tabs on how much of your deductible you’ve met, how much of your yearly out of pockt maximum you’ve met and other items such as how many therapy visits you have left.
14. Some insurance companies offer case managers who can help you access benefits, help you find resources, act as intermediaries between insurance and hospitals and more.
15. Finally, even if you don’t qualify for Medicare or Medicaid, there are still programs that can help your pay back medical bills for a certain time period – for instance, 3 months prior to the date of application. Contact these programs as well as your state health agencies and find out what you might be eligible for. Some programs will let you “spend-down” to qualify, meaning you can deduct the cost of your medical bills from your income to get a more realistic picture of your financial situation.
16. Keep a paper calendar or day planner with all your medical appointments written on it, and keep it for a few years. Write a note with the name of the doctor, type or appointment or what it was for. If you ever need to look up what you’re being billed for, this record will be invaluable. Many electronic planners and email calendar programs delete old information to save memory, but if you need to look back at information for a disputed medical bill, it may be months or years old.
17. Never put large medical bills on a credit card. You can negotiate bills with a medical office and typically get a reduced rate for a payment plan, get a discount or get a government program, such as Medicaid or a non-profit organization to help pay some of what you owe. You lost that negotiating power if the bills are on a credit card, and their rates may be much higher.
18. Some insurance companies allow a set number of therapy visits for each calendar year. If your insurance company does that, you may be afraid you will accidentally exceed your number of visits. Some companies take so long to bill that by the time you realize you are out of visits, you’ve racked up a few thousand dollars in therapy bills that insurance won’t cover. To avoid this, first, inform the therapy company that you have a set limit on number of visits and write down who you spoke with and when. If they go over the number of visits, you can fight them about payment. Be sure to talk with a manager in billing. Many insurance companies don’t work this way, and the billing people may be oblivious. Write your appointments in a paper calendar or day planner that is easy for you to access. If you keep an appointment, place a check next to it – if it’s cancelled, cross it off – then tally the number of visits at the end of the month. It will help you keep a close watch on how many visits you’ve had and you can avoid going over the limit.

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