Common medical billing issues include denial of insurance benefits because the prescription or treatment is considered not medically necessary, claims partially paid that leave the consumer with an unexpected balance to pay, denials of assistance to those with substantial medical charges, incorrect medical bill collections and difficulty negotiating the internal or external appeals processes once a denial is issued.
To avoid these and other medical billing issues:
- Discuss your treatment plan with your doctor and hospital prior to receiving services to ensure there are no hidden charges.
- If you have insurance, make sure you know your policy’s guidelines for coverage before you receive treatment to avoid surprises.
- Be sure to keep the Explanations of Benefits (EOB) you receive from your insurer. If you believe a payment is incorrect or not sufficient, follow the appeal procedures available through your insurance plan.
- Contact your doctor or hospital’s finance manager to negotiate a reduction in anticipated or assessed medical charges. Often times, clinics, providers and hospitals offer financial assistance services to qualified patients.
- If you have issues with collection of a medical bill, see our information on debt collection practices.