If you were sick enough to need to go to the emergency room, the last thing you should be thinking about is how much you will have to pay for your care.
But even if you have health insurance, you will probably end up with a few big bills depending on what kind of care you got. A lot of times, the charges on emergency room receipts are wrong or too high. If this is the case, you should fight the bill or try to get it lowered.
Find out what your medical records say.
If you went to the emergency room as a patient, you can only be charged for the care you actually got. Even though this might seem obvious, patients are often charged for care that was not given. Find out what is written in your medical records. This is the first thing you should do if you want to dispute an emergency room bill.
When you get different bills from different service providers, it can be even harder to figure out what you are being charged for. Most people think that their bills from the doctor and the hospital are the same, but they're not. Most doctors who work in emergency rooms are independent contractors who will send their own bills. Carefully compare the charges on these bills to what is in your medical records. If there is a charge for something that isn't in your records, you should dispute it right away.
A hospital bill will be broken down by category, such as blood work, drugs, supplies, etc., but it won't say what services added up to the total amount. In this case, you need to ask for a detailed bill that shows all of the costs for each line item. You can tell if this itemised bill is correct by comparing it to what you have on file.
Pay attention to out-of-network charges
Even if the hospital you go to is in your insurance network, that doesn't mean all the doctors and nurses who treat you are. If your doctor or specialist is not in your insurance network, you may have to pay extra money for their care.
In a medical emergency, you might not have any other choice but to go to the emergency room, where you might be treated by doctors who are not in your insurance network. But if you don't have a true medical emergency, you might want to go to an urgent care centre first. It will cost you hundreds of dollars, not thousands, and it will show your insurance company that you tried the least expensive option. This can help you negotiate for a lower bill if you end up in the emergency room.
Find the mistakes on your receipt from the emergency room
There can be mistakes on emergency room receipts that cost you more money. For example, the hospital may order tests but then decide not to do them. If the doctor who ordered the tests forgets to take them out of your record, they could end up on a bill.
On emergency room bills, there are also often mistakes in the levels of coding. Levels 1–5 are used to code emergency room bills, and each level has a different fee that was agreed upon. If the level of care you got didn't match what the code said, you should dispute the bill.
Make sure that your EOBs match your bills.
After checking your bills carefully to make sure they are correct, it is very important to compare them to the Explanation of Benefits (EOB) your insurance company sends you. When you compare them, pay close attention to:
(1) How much you paid
(2) How much did the insurance company pay?
(3) What the insurance company paid for or didn't pay for
It's not easy to understand an EOB. Check each line carefully to make sure that the amounts and services listed on your bills are correct. If there is a difference, you should call the hospital or insurance company to find out why. Also, it's important to make sure that an in-network provider isn't "balance billing" you. This is when a provider bills for the difference between what they would normally charge and what the insurance company will pay.
If you pay for yourself, always ask for a discount. Some hospitals will take as much as 70% off of your bill. You could also ask if you qualify for help with money.
Contact a lawyer with experience in fighting medical bills.
It can be hard to figure out how to pay complicated and high emergency room bills. An experienced medical bill dispute advocate can help you if you want to fight your emergency room bill.