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Uploaded: Wednesday, August 1, 2012, 7:06 PM
Updated: Monday, August 6, 2012, 2:02 PM
What happens when you can't pay your medical bills?
To fight back, your best bet is to be a well-informed consumer
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by Jason Alderman
Pleasanton Weekly Staff
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 | It's no secret that health care costs have been spiraling out of control for years.
To fight back, your best bet is to be a well-informed consumer: Know the true costs of medical procedures, supplies and medications so you can bargain effectively; carefully anticipate and track medical expenses; and stay on top of your bills.
But sometimes, even when you follow the rules you still can get burned. I've heard many appalling stories about people – even those with comprehensive insurance – who have been denied benefits, over-charged, sent to collections or even forced to file for bankruptcy because they couldn't pay their medical bills.
Here are a few coping strategies:
Carefully review each doctor, lab or hospital bill and match it against the Explanation of Benefits statement that shows how much they were reimbursed by the insurance company. Also, watch for items that may have been charged to you by mistake such as:
• Medications, supplies, treatments or meals you didn't receive while hospitalized or getting an outpatient procedure.
• Duplicate charges for a single procedure (such as x-rays, MRIs and lab work), including those that had to be redone due to a technician's error.
• Charges for a full day's hospitalization when you checked out early; or private room rates when you shared a suite.
The summary hospital bill you were sent probably doesn't contain many details, so ask for an itemized bill along with a copy of your medical chart and a pharmacy ledger showing which drugs you were given during your stay.
If you're having difficulty paying a medical bill, don't simply ignore it. Like any creditor, doctors and hospitals often turn unpaid bills over to collection agencies, which will wreak havoc with your credit score. Contact creditors as soon as possible, explain your situation and ask them to set up an installment payment plan or work out a reduced rate.
Many people with no insurance discover that they're often charged much higher rates than those negotiated by insurance companies, Medicare and Medicaid. Don't be afraid to ask for those lower rates and to work out a repayment plan – just be sure to get the agreement in writing. Most doctors and hospitals would rather accept reduced payments than have to deal with collection agencies and possibly no reimbursement at all.
Ask the hospital's patient liaison to review your case and see whether you qualify for financial assistance from the government, a charitable organization or the hospital itself. Most will forgive some or all bills for people whose income falls below certain amounts tied to federal poverty levels. Also pursue this avenue with your doctor or other provider – ideally before they've begun collections.
A few additional cost-savings tips:
• Ask whether your employer offers flexible spending accounts, which let you pay for eligible out-of-pocket health care and/or dependent care expenses on a pre-tax basis.
• Use online price-comparison services like Healthcare Blue Book and OutofPocket.com to research going rates for a variety of medical services.
• Unless it's a true emergency, try to avoid emergency rooms and use an urgent care network facility affiliated with your insurance company or ask your doctor for recommendations.
Bottom line: Know what health services cost and don't be afraid to negotiate. You'll haggle over the price of a car – why not your health?--Jason Alderman directs Visa's financial education programs. Are you receiving Express, our free daily e-mail edition? See a sample and sign-up for Express.
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Posted by GOMER, a resident of the Danville neighborhood, on Aug 7, 2012 at 10:42 am The problem is that the charges are all inflated and phoney -- they bear next to no relationship to what will actually be paid by insurance.
I had a hip replaced five years ago -- in one noon and out the next evening. No complications, no unusual meds, one night in the H: the bill I was shown was $87,000+ smackers with completely opaque information. What's more, my surgeon -- the guy who Really added the value, soon thereafter left town because he said he could no longer afford raising a family in the Bay Area. And he was doing over 200 hips/year -- pretty clearly he wasn't getting paid enough.
The current system is completely SNAFU'd and FUBAR. I do not believe you CAN be a really intelligent consumer, because neither the insurance companies nor the medical establishment seems to want you to know costs, nor how much of my bill goes to subsidize those who can't pay.
I am hopeful that the cost-control aspects of ACA will have some helpful impact.
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Posted by Rick, a resident of the Danville neighborhood, on Aug 7, 2012 at 7:38 pm The "affordable Care Act" aka Obamacare--would not have ALLOWED gomer to HAVE the surgery. Under Obamacare---that ALL FEDERAL workers are EXEMPTED from---if your cardiac pacemaker needs battery replacement--it ain't gonna happen if you are over 60. Let them die----soylent green IS Obamacare.
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Posted by Derek, a resident of the Danville neighborhood, on Aug 9, 2012 at 8:04 am Nice job with your puppet Rick, Mr. Hannity. Why, I didn't even see your lips move!
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Posted by Mike, a resident of the Danville neighborhood, on Aug 9, 2012 at 9:13 am Obamacare is just the first step in modernizing our healthcare system. Our system costs twice as much per covered individual than any other industrialized nation and delivers half as much care.
Two years ago my wife needed a biopsy at Alta Bates and had to stay over night for observation. The hospital billed the insurance company more than $100,000. Just one night.
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Posted by Julia, a resident of the Alamo neighborhood, on Aug 9, 2012 at 10:19 am To Mike...Mike why don't you tell us the rest of the story. You know the real end of that statement, but you and the rest of the folks love to direct us to comments that make us only focus on your statement. Come Mike tell us...the hospital billed the insurance company $100,000.00 and Mike how much did the doctor bill the Insurance company. Now that just half the story....tell them Mike and be honest.
Okay, you have no guts to tell us the rest of the story. The Insurance company sends you (Mike) and EOS (Explanation of Services). It tells the insurance company reduced the hospital by 75% and the doctor bill by almost 80%...NOW THAT'S THE REAL REST OF THE STORY.
And for those that do not believe this fact, you are living in a cave. I experienced those 100's of thousands of dollars in bills and I also am very aware how much the insurance reduces what they pay the hospital and the doctor services.
THANKS FOR LISTENING, Julia Pardini from Alamo.
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Posted by Dave, a resident of the Danville neighborhood, on Aug 9, 2012 at 12:50 pm Mr. Alderman makes it all sound so simple. However, often you cannot find out the various costs associated with medical procedures beforehand. They simply will not tell you. Or they will tell you that it will depend on how the surgery goes once it starts.
Our health (insurance) system is broken. What other conclusion can you reach when hundreds of thousands of people each year have to declare bankruptcy because they are unable to pay the their medical bills that were (for whatever reason) not covered by insurance? That is simply unacceptable in a country as wealthy as ours.
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Posted by Sharon, a resident of the Danville neighborhood, on Aug 9, 2012 at 4:22 pm @Julia, I think you might want to give Mike a chance to respond to questions before you accuse him of lacking the guts to do so. My guess is that he made the complete statement that is meaningful to him - you are free to add your $.02, but why the low blow?
BTW - I believe you mean "EOB" referring to the explanation of benefits provided by insurance companies. I'm not sure what an "EOS" refers to.
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Posted by Julia, a resident of the Alamo neighborhood, on Aug 10, 2012 at 12:12 pm Thank you Sharon...you make one correct statement...it is EOB (Explanation Of Benefits).
I stand by what I said to Mike and I hope the shoe doesn't fit for you and your experience with medical cost.
Everyone that deals with medical expenses and insurance knows the hospital and the doctors do not get what they are bills for.
That is a fact...Well the statement that Mike said was not the full story. So tell us the full story Mike. Sharon seems to be on your side...so made her proud of you and tell us. Tell us more about that $100,000.00 bill from the hospital and most of all tell us how much the Ins paid the hospital???? By the way Sharon. the low blow as you call it was to get his attention....which it didn't...but it got yours. Thank you Sharon for listening and thank you for responding. That's what keep the Danville Express publication active. If it wasn't for you and I chatting about this...who needs the Danville Express.
Again, thank you for listening, Julia Pardini from Alamo
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