Do you have medical bills your insurance company doesn’t want to pay? You have several options as you explore different ways to pay the bills.
If your insurance company won’t pay the bill, consider these ideas:
- Understand the out-of-network rules. Receiving care out-of-network is one of the most common reasons an insurance company denies payment. Did you visit a hospital, clinic, or doctor outside your network? Insurance companies have strict rules for what they will cover. They may not want to pay for hospitals or doctors who are not part of their network. Unless you had an emergency that couldn’t be treated at an in-network provider, you may not be able to get the insurance company to pay. Your city or state may have specific rules forcing insurance companies to pay for out-of-network services in emergencies. However, you may still be responsible for some of the charges.
- Negotiate your payment. If your insurance company won’t budge on the medical bills, you can try to negotiate a payment with the hospital or doctor. Depending on your financial circumstances, you may be able to get a discount or payment plan to help you. You may also qualify for a grant, financial assistance, or other program.
- Consider contacting local charities. If your medical bills are excessively high and you can’t pay them, a local charity might be able to help. Local charities may have ideas for helping you raise the money. They may have fundraisers or grants that can assist you with the bills.
- Check for mistakes. It’s possible that an error prevented your insurance company from paying the medical bills. Double-checking the actual bills and contacting the medical provider for help is essential. Hospitals and doctors sometimes make billing mistakes. They may bill the wrong insurance company or send the wrong codes. You may want to contact the doctor and insurance company multiple times if you have questions about the bills. You have to become your advocate and try to get the bills covered.
- File an official dispute. Your insurance company should have an official dispute process. It may take a lot of paperwork and an ocean of phone calls, but you can handle the dispute. Documentation is the key to winning a dispute. Keep careful records and make multiple copies of each medical document. Find policy and state rules that back up your claims.
- Make phone calls and write letters. Experts recommend doing both for the maximum effect and response rate. Phone calls may not be enough to get the attention of your insurance company. You may have to write letters or send faxes to document your issues. This will create a vital paper trail that can help your case.
- Consider getting a medical billing advocate. These advocates can charge fees but also help you negotiate your bills and deal with insurance. If you have significant medical bills, then it may be worth the fee to get professional help. Medical billing advocates are trained to help you pay the smallest amount possible on your medical bills. They know the negotiation tactics that work for hospitals, doctors, and insurance companies. They can handle the massive paperwork and calls required to accomplish your goals.
Insurance companies can deny payment for a variety of reasons. However, you have rights. Before you pull out your checkbook, you may want to explore different ways to handle the medical bills. Perhaps you can get them paid or reduced for your time and trouble.