How to Prevent Unexpected and Expensive Medical Bills – The Nitty Gritty

In last week’s blog post, I shared with you four basic – but important – questions to ask in order to prevent unexpected and expensive medical bills.

I also mentioned that I got stuck with a $1,000+ bill for a test that wound up being unnecessary.

What happened was the specialist that I went to told me to get two tests done, which required going to two different labs. I asked his admin assistant if both labs were covered by my insurance. She verified that they were and reviewed the pre-test prep I needed to do so that I’d make sure to schedule the appointments when I’d med the requirements. She even called to make the appointments for me, which I thought was quite helpful.

When I arrived at STRIC (South Texas Radiology Imaging Centers), I had to pay up front. That was no surprise. I winced when the clerk told me that the bill was $189. As a mentioned in my last post, I got really spoiled with Humana’s plan and wasn’t used to paying this kind of out-of-pocket with my new Blue Cross Blue Shield health insurance. I noticed that the fine print on the bottom of my receipt said that the amount was “an estimate.” I asked the clerk how close this estimate was to the actual final amount and she said, “It should be pretty close.” Stupid me.

The following month, I received a bill from STRIC for $872.99 for that exam. Yes, that was after they deducted my payment of $189.35. If math isn’t your strong point, this one test cost me a total of $1,062.34. I almost fell over. What made this bill even more painful than the fact that I had to pay it was that by this time I’d found out that the less expensive test that I took at the other lab showed what the specialist needed to know and that this expensive test was inconclusive!

I immediately called STRIC’s billing department. Vanessa told me that the clerk should’ve verified my coverage, whether or not my deductible had been met, and what my total would be. The clerk did not. And I was too ignorant at the time to realize that I’m the only person in this situation who truly cares about my wallet and well-being, and I should’ve become my own advocate from the get-go.

I am blessed that while I would have to make some adjustments in my budget over the next couple of months, I’d be able to pay the bill. But I was curious what others would do if they didn’t have the money, so I asked Vanessa about a payment plan. She said to pay whatever I could each month. There’d be no interest and no surcharges. Just make some kind of payment each month. To test this out, I made a $25 payment.

The next month, I received a letter from Erin Palermo – a Patient Account Services Representative with STRIC – stating that I’d been placed on a monthly payment plan of $141.34 and that if I did not pay, my account would be referred to a collection agency. So, in addition to STRIC’s clerks not helping patients be fully informed about their financial responsibilities, the right hand isn’t talking to the left hand in their billing department.

Instead of spending my time making all sorts of calls and fighting what would most likely be a futile battle, I decided instead to use my time to help educate others.

Here are the questions that I should’ve asked at the specialist’s office and of the clerk at STRIC in order to prevent unexpected and expensive medical bills:

Question 1 to the specialist: What is the purpose of each test?

The more informed you are about what’s happening, the better you’ll be able to advocate for yourself.

Question 2 to the specialist: Is there a certain order that the tests must be completed in?

If I’d asked this question, I would’ve learned that in my case, the order didn’t matter – which means I could’ve taken the less expensive test first before undergoing the expensive one.

Question 3 to the specialist: What time frame do I have to complete these tests?

Because my initial lab work came back normal, I was considered low risk, which meant that the tests that the specialist ordered were not dire emergencies. While I’d want to complete them as soon as possible to figure out what’s going on, they could’ve been completed a couple of weeks apart, which would’ve allowed me to get my results from my first test before needing to undergo the second more expensive one.

Question 4 to the specialist’s admin assistant and the lab clerk: What is my total cost for each test/procedure if my deductible is met?

Question 5 to the specialist’s admin assistant and the lab clerk: What is my total cost for each test/procedure if my deductible is not met?

Question 6 to the specialist’s admin assistant and the lab clerk: At this time, how much of my deductible has been met?

Question 7: If I have not met my deductible, and my insurance covers very little – if any – of this test/procedure, can I negotiate my cost since I will be paying out of pocket for this?

And remember, for Questions 4-7, make sure that you get this in writing!

If your health insurance does not cover the majority of your costs, you must ask questions in order to prevent unexpected and expensive medical bills!

Here’s to you staying in good health!