How To Save On Hospital Bills

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Okay, so I dont exactly know any magic tricks to save money on medical bills.

But here’s my big tip:

Always, always, always double check your explanation of benefits (EOB’s)!

This post is inspired by my recent experience of pushing back on the insurance company and a hospital, which saved me almost $6,000! That’s how much they wanted to charge me; and, once resolved, my obligation was a big, fat ZERO!

How It Started

I had two issues with this outrageous medical bill:

1. It was saying I had not met my high deductible, and was saying I needed to pay the $3,000 deductible!
2. My In-Network hospital was on divert, so I had to go out of network. I knew that I still should only have been charged for In Network expenses because I didn’t intentionally go to an Out-of-Network hospital.

I hate, hate, hate having to deal with insurance companies or be on hold on the phone for hours, trying to get things straightened out. My child was born on October 22nd and this was finally resolved on February 25th. That’s how long it took to push back and get the correct amount charged.

My First Step To Tackle This Hospital Bill

Whenever I get medical bills- especially sizable ones, like this one for a childbirth, or other surgeries- I always get our little “cheat sheet” out to make sure that I understand what our obligation is. By “cheat sheet”, I”m talking about that summary you get during the annual enrollment period that lays out your insurance obligations in a consice format.

I made sure I understood what our deductible was and if it had been met, as well as what our out-of-pocket maximum was!

Because I do always check our EOB’s when they come in the mail, I already had a pretty good idea that both of those (the family deductible and out-of-pocket maximum) had been met and we shouldn’t be charged for ANYTHING.

When I looked at our summary of benefits, it appeared that I was correct!

Call Your Insurance

I called our insurance to explain the situation.

One thing that made our situation a little complicated was that I wasn’t able to go to an In-Network hospital. Of course, try to make sure you’re going to In-Networks doctors and/or hospitals, but this isn’t always possible if those hospitals are not accepting patients for whatever reason (not enough staff or any other reason).

Even if you are forced to go to an Out-of-Network hospital, did you know that you should still be charged In-Network? Hospitals will have some sort of “agreement” if another hospital takes patients that otherwise would have gone to them. However, be prepared to fight about this! I had my insurance call the both the In-Network and Out-of-Network hospital to confirm that they were indeed not accepting patients, and that the other hospital was accepting patients, but neither one had a record of this. How frustrating! I ended up having to appeal their decision, which they then decided to accept.

I explained what my understanding was of our benefits, and the issue of having been sent to an out-of-network hospital. I also explained that I expected that we should be charged nothing. If my insurance could explain to me why I was incorrect, I was willing to hear it. But, I was willing to have them explain it over and over to me and until I was sure that I understood. I wasn’t just going to take their word for it!

Have Patience, Save Money

As I said already, it took several phone calls, several months, an appeal, and lots of hours waiting on the phone, but I finally had the bill completely ELIMINATED!

I had referenced previous EOB’s that had showed I had already met my high deductible, so that was $3,000 (the bulk of the cost) that was taken off right there.

The last part was getting them to acknowledge that I should have been charged as if I had gone to an In-Network hospital, and that I should be charged nothing because I had already met our out-of-pocket maxumum for in-network services. And I was right!

Closing Thoughts

I’m just curious how many people don’t push back on these larger bills becuase they don’t have an understanding of what their insurance should be covering or not. What if someone ended up just accepting this bill and then had to make payments on it!

So, always review your EOB’s so you have an idea throughout the year how much you’ve already spent towards your deductible and out-of-pocket expenses. And keep your insurance summary cheat sheet handy!

RELATED

Read for more details on health savings accounts, one of my favorite accounts!

See tips on how to stick to a budget easily.

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