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How to avoid over-paying your doctor

Important tips to help you understand the claims paying process, so you don't get caught paying before your insurance pays.

By: Vernon Bonfield
Category: Insurance:Health
Posted: Mar 01, 2010
Updated: Mar 01, 2010
Views: 128


For anyone who’s been to the hospital, you know the paperwork afterwards can be overwhelming. Between the hospital bills, the surgeon, the anesthesiologist, the doctor you’ve never met before who must have come in while you were on the operating table…the bills start flying in.

Here’s a tip- WAIT to pay your provider bills until you’ve received confirmation from your insurance.

Since every claim must be submitted to your insurance first, you’ll receive a statement from your carrier for everything. The statement is called an EOB (Explanation of Benefits)

One big problem is that some providers (not all) like to get paid right away, and don’t bother to wait for the insurance company. So, they send the bill to you, the same time they send it to your insurance. Since the billed amount is usually higher than the insurance company’s “allowed amount”, if you pay the bill, you will more than likely pay too much.

What’s worse, the provider may not refund you the overage, they may just give you a “credit” towards you next visit.

So, the solution? Make a file that you drop every doctor invoice into. As soon as your insurance company sends you an EOB, pull out the file and match the doctor’s invoice with the EOB. If it matches, pay the doctor. If it doesn’t, call the doctor’s office and request a corrected invoice.

This way, you can be sure to never over-pay for your patient responsibility costs. *Note – be sure you don’t wait longer than 30 days to call your provider’s billing department, as some providers are quick to send you to collections.

For the best health insurance options in Washington State, visit us online at http://www.wahealthagency.com or give us a call for expert advice at 360-464-1622.

About Author

Vernon Bonfield has been an independent insurance agent since 1994, specializing in health and dental insurance for individuals, families, and businesses. He is the owner of the Washington Health Insurance Agency located in Tumwater, WA

Contact Author   Author Website




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