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Jessica Schmor
Jessica Schmor

Incorrect medical bills can negatively impact both personal finances and health. Reviewing explanation of benefits statements and medical bills is important to check for errors in charges, diagnoses, or procedure codes which could lead to unnecessary costs or improper treatment over time. Small errors in bills may accumulate and eventually exceed lifetime maximums for insurance coverage. Additionally, rising healthcare costs that result from erroneous billing affect insurance premiums for everyone. It is advised to carefully review all medical documentation received and seek help from insurance plans or billing experts if unable to resolve any identified errors or anomalies.

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June 2016 Cover: Studio T Photography MEET YOUR NEIGHBORS THE DIOGUARDI FAMILY isleworth Keene's pointe lake butler sound n. Bay S. Bay bay hill + enclaves cypress point, isle, Shores & the reserve BUTLER CHAIN 16 BUTLER CHAIN LIVING Expert Contributor Errors In Medical Bills Can Impact Your HealthAnd Your Wallet! Why you should review that pesky Explanation of Benefits (EOB) from your health plan. By Jessica Schmor, Allegiant Experts Everyone has been on the receiving end of that envelope from your health plan that contains the explanation of benefits (EOB) for the health services that you received. If you even open the envelope, you stare glassy-eyed at the document. First, panic: $1,100! Second, relief: THIS IS NOT A BILL. Third, confusion: OK, so why do I care? Finally, resignation: into the filing bin. When the actual bill comes later, most of us just pay it or question it based upon the amount of the bill, not whether or not we believe it to be correct. Reviewing EOBs and medical bills can be confusing, burdensome and frustrating, but it is critical. These records can impact your financial and physical health and healthcare costs for all. Incorrect medical bills can cost you hundreds of dollars and, even in some cases, risk your ability to have coverage at all because of how out-of-pocket and lifetime maximums work. An incorrect charge of $800 might not be the end of the world, but its $800 that you didnt need to spend. Over time, adding these incorrect bills to the correct ones could add up to your lifetime maximum, leading to your insurance company no longer providing coverage. Incorrect medical bills arent only about wrong charges, but also incorrect diagnoses or procedure codes. Your records are transferred to other providers who treat you. If you arrive unconscious in an emergency room unable to share your accurate health history, you may end up being treated for a diagnosis that you do not have. The converse is also true: If your record is silent on a critical diagnosis, you may not get the treatment you need. Everyone feels the sting of rising health insurance premiums. Rising health insurance premiums are directly related to the cost of care, and if some of that cost is erroneous, it costs everyone more. So when you see an incorrect charge or service on your EOB or medical bill, even if the insurance company is paying it in full, it is still costing you and everyone else eventually. Tips to keep your healthcare costs down: Be proactive with your health record. Keep a list of appointments and what was done (treatment list). Review your EOBs and bills as soon as they arrive. Check your credit often. Seek expert help if you cant solve it on your own. There are many sources of help out there. All health insurance plans have customer service representatives that can help you understand your EOB. If you dont get the information you are looking for, try contacting the Special Investigative Unit or Fraud Hotline. Even if it is not true fraud, this departments job is to deal with fraud, waste and abuse. They often have more time to review the information and help solve billing anomalies. If you cant get any resolution from your health plan, you can always reach out to an expert who can assist with ensuring your bill is correct and resolving it. While reviewing your medical bills can be painful upfront, the long-term consequences of not doing so can be significantly worse. So begin as soon as possible and make it one of your personal habits, just as you do budgeting and financial planning. Protect ALL of your assets and review your medical bills. About the Author Jessica Schmor, RN, owner of Allegiant Experts, is a clinician with more than 15 years of experience working with facilities, health plans, providers and attorneys. Her knowledge of how all parties function within the medical system has given her rare insight into the healthcare industry.

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  • 1. June 2016 Cover: Studio T Photography MEET YOUR NEIGHBORS THE DIOGUARDI FAMILY isleworth Keene's pointe lake butler sound n. Bay S. Bay bay hill + enclaves cypress point, isle, Shores & the reserve BUTLER CHAIN 16 BUTLER CHAIN LIVING Expert Contributor Errors In Medical Bills Can Impact Your HealthAnd Your Wallet! Why you should review that pesky Explanation of Benefits (EOB) from your health plan. By Jessica Schmor, Allegiant Experts Everyone has been on the receiving end of that envelope from your health plan that contains the explanation of benefits (EOB) for the health services that you received. If you even open the envelope, you stare glassy-eyed at the document. First, panic: $1,100! Second, relief: THIS IS NOT A BILL. Third, confusion: OK, so why do I care? Finally, resignation: into the filing bin. When the actual bill comes later, most of us just pay it or question it based upon the amount of the bill, not whether or not we believe it to be correct. Reviewing EOBs and medical bills can be confusing, burdensome and frustrating, but it is critical. These records can impact your financial and physical health and healthcare costs for all. Incorrect medical bills can cost you hundreds of dollars and, even in some cases, risk your ability to have coverage at all because of how out-of-pocket and lifetime maximums work. An incorrect charge of $800 might not be the end of the world, but its $800 that you didnt need to spend. Over time, adding these incorrect bills to the correct ones could add up to your lifetime maximum, leading to your insurance company no longer providing coverage. Incorrect medical bills arent only about wrong charges, but also incorrect diagnoses or procedure codes. Your records are transferred to other providers who treat you. If you arrive unconscious in an emergency room unable to share your accurate health history, you may end up being treated for a diagnosis that you do not have. The converse is also true: If your record is silent on a critical diagnosis, you may not get the treatment you need. Everyone feels the sting of rising health insurance premiums. Rising health insurance premiums are directly related to the cost of care, and if some of that cost is erroneous, it costs everyone more. So when you see an incorrect charge or service on your EOB or medical bill, even if the insurance company is paying it in full, it is still costing you and everyone else eventually. Tips to keep your healthcare costs down: Be proactive with your health record. Keep a list of appointments and what was done (treatment list). Review your EOBs and bills as soon as they arrive. Check your credit often. Seek expert help if you cant solve it on your own. There are many sources of help out there. All health insurance plans have customer service representatives that can help you understand your EOB. If you dont get the information you are looking for, try contacting the Special Investigative Unit or Fraud Hotline. Even if it is not true fraud, this departments job is to deal with fraud, waste and abuse. They often have more time to review the information and help solve billing anomalies. If you cant get any resolution from your health plan, you can always reach out to an expert who can assist with ensuring your bill is correct and resolving it. While reviewing your medical bills can be painful upfront, the long-term consequences of not doing so can be significantly worse. So begin as soon as possible and make it one of your personal habits, just as you do budgeting and financial planning. Protect ALL of your assets and review your medical bills. About the Author Jessica Schmor, RN, owner of Allegiant Experts, is a clinician with more than 15 years of experience working with facilities, health plans, providers and attorneys. Her knowledge of how all parties function within the medical system has given her rare insight into the healthcare industry.