Consumer Watch: Fighting Faulty Claims On Your Health Bills


Monday, July 25th 2011, 7:36 pm
By: News 9


Amanda Taylor, News 9

It happens all too often. You get a bill in the mail from an unknown company for a medical procedure you thought your insurance covered. It's possible you are covered and the bill is simply a very expensive error.

According to the American Medical Association, 20% of properly submitted claims are mishandled or rejected, leaving you with a hefty bill.

Amy Ford Keohane with Off Your Desk.net said, "Some of the most obvious reasons claims get rejected are eligibility or not filling out the forms completely or a wrong code."

"Off Your Desk" is one of several companies trying to help correct your bills. For a monthly fee, they will review all of your medical statements and resolve any issue that doesn't seem right.

But you can do it on your own too and this will help:

First, always ask your doctor for an itemized bill. That way you can compare it to the statement from the insurance carrier and catch any obvious errors.

You can also avoid unnecessary medical charges with a little research.

Before any procedure, call your insurance company and find out what's covered.

Most importantly, if you're referred to another doctor - make sure that physician is in your network.

"Even if you're going to an in-network facility hospital and you have an in-network doctor, it's often that the Anesthesiologist assigned to you is out of network," Keohane said. "So if you're having a baby and you're checking into the hospital, you should request an in-network Anesthesiologist."

Finally, if a bill does seem suspicious, call the company and question the charge.

Avoid the busiest hours of 8 to 10 o'clock in the morning. And be persistent