Medical Bill Assistance


Medical Billing Process

The medical billing process is normally depicted as a complex relationship between health care providers, insurance companies and patients they serve. It can look a lot different from the patient's perspective.

Understanding this process can help patients determine how to best navigate the maze of billing that can confuse almost anyone. It can also help you understand how to best deal with medical debt in the most manageable manner possible.

The first step occurs when charges are incurred. If you are uninsured, you can either pony up the dough or work with their financial assistance department for help with a payment plan. We will assume that you are insured, since this tends to complicate matters.

Insurance will pay a pre-established percentage of the charges. You may be responsible for a copay, deductible or coinsurance, all of which reduce the amount paid by insurance. The remainder is generally zeroed out by a contractual adjustment, also known as a provider write off.

Your insurance company is responsible for paying their share of the charges. The rest is your responsibility, and you will be expected to pay it. An exception is sometimes made by some nonprofit hospital systems who must include some charitable services in order to justify their tax-exempt status.

Assuming that you will be held accountable for the charges against you, it is important that you understand these next steps of the medical billing process. You have a limited period of time to control the process before it begins to control you.

This is one of the best chances you have to go about negotiating medical bills that you will be expected to repay. In some cases, a medical billing advocate can help you reduce your bills.

Medical providers strongly recommend using a credit card so that they can get paid immediately. This is generally the worst option that you could ever consider (payday lenders and loan sharks are worse). Other options that they prefer include unsecured medical credit accounts such as CareCredit. None of these are preferred options.

Instead, you may enter into a payment plan for medical bills owed to each of your providers. These can be formal plans that you consent to through their financial assistance representatives, who are happy to establish automatic monthly ACH debits from your bank account.

They may also be informal, where you simply send in an acceptable monthly payment. In this case, acceptable is generally at least 2% of the beginning balance, with no payment of less than $15. As long as you can follow these guidelines, you can usually repay your medical debt at zero percent interest and without any negative credit repercussions.

If you fail to begin repayment in a reasonable period of time, you risk having your unpaid medical bills referred to or sold to an outside collection agency.

This step opens the floodgates for an onslaught of harrassing telephone calls, threatening letters, bad credit and oppressive interest charges. If the debt collectors so chooses, they have the right to pursue forced repayment through the courts.

Due to the substantial problems that can result from debt collectors buying your debt, it is strongly recommended that you take control of the debt before it is charged off. Otherwise, these debts can haunt you at least for 7 years, and longer if your state has an extended statute of limitations on your debt.