Medical bills. They can be confusing and stressful. But with some basic know-how and organization, you can manage them—and avoid overpaying for your health care.
After you receive a health care service, you get:
A medical bill from your provider. If you have no health insurance, this is the amount that you pay. If you're insured, you will likely pay less than the provider has billed you for.
An Explanation of Benefits (EOB) from your insurer. This insurance statement shows how much of the bill you will need to pay.
This may sound simple. But when you get a bill, then an insurance statement, then a revised bill based on the statement or a payment you've already made, things can get confusing.
Take these simple steps to keep your medical bills in order. You can organize paper bills and statements, or electronic versions on a computer.
Keep a calendar of your medical appointments. Jot down each appointment, including the provider and the care you've received. Also record the dates you've paid for prescription medicine.
Organize your medical bills by date of service. If you have bills for more than one family member, keep a separate file for each.
Pair medical bills with insurance statements. Sometimes an insurance statement will be about more than one medical bill. Keep those papers together. If you can, make a copy of the statement and match it with each separate bill it mentions. Include any payment receipts and updated statements about those bills.
Create a list or a spreadsheet—whatever works for you. Across the top, label columns that best fit your health insurance. Include these types of headings:
Date, type of service, and provider
Allowable amount (see your insurance statement)
Amount insurance pays (see your insurance statement)
Amount I pay (see your insurance statement)
My payment/date paid
Amount I still owe
Amount I've paid toward my deductible (see your insurance statements or website)
Update your list or spreadsheet with each bill and insurance statement you receive and with each payment you make.
Don't be surprised if you get several bills for the same care. For example, for a surgery in a hospital, you might get bills from the surgeon, the anesthesiologist, and the hospital. Or for an X-ray, you'll get bills from the imaging facility and the radiologist who reads the image.
Compare your medical bill and insurance statement
Read carefully through your medical bill and insurance statement. Make sure that:
The date, provider, and type of medical care are correct on both.
You understand how much of the bill you need to pay. This is the amount that your insurer says you owe.
If you have questions about any part of a bill, call your provider's billing office. And for questions about what's on your insurance statement, call your insurer.
Billing mistakes can happen. Before you pay anything, be sure to read your billing paperwork carefully. Look at your health insurance policy.
If you think you have found an error, call your provider's billing office or your insurer. Ask to review the statement on the phone.
If your insurer won't cover a service that your policy says should be covered, file an appeal. Ask your insurer about the appeal process. For information about health insurance appeals, see the U.S. government website at www.healthcare.gov/using-insurance/managing/appealing-denials/index.html.
If you have payment problems
Not paying a medical bill can ruin your credit rating. Talk to the provider's medical billing office. This is one key to keeping your account from going to a collections agency.
If you realize you've missed a due date for a bill, call the billing office right away. Pay on the phone if you can.
If you can't pay a bill in full, ask to arrange a payment plan. Many providers are happy to do this, as long as you stay in touch and agree to make small, regular payments.
How this information was developed to help you make better health decisions.