Surprises Keep Stinging: How to Stop Out-of-Network Blindsides & Bills. Are you feeling blindsided and overwhelmed by unexpected medical bills? Read this post to learn more about out-of-network surprises and how to avoid them. Get tips on taking control of your health care so you’re not taken aback by costly, unexpected expenses.
Surprises Keep Stinging
Are you feeling blindsided and overwhelmed by unexpected medical bills? Read this post to learn more about out-of-network surprises and how to avoid them. Get tips on taking control of your health care so you’re not taken aback by costly, unexpected expenses. Are you feeling
Out-of-network health care bills can be difficult to navigate. Understand why these bills still sting and the steps you can take to avoid surprises.
What Is an Out-of-Network Surprising Bill?
Getting blindsided by an unexpected medical bill is never a welcome experience. An out-of-network health care surprise bill is a medical bill that you receive that you weren’t expecting or that exceeds what you initially thought you would owe for your medical care services. The term “out-of-network” signifies that the provider who rendered the medical services is not in your insurance plan’s network. So even if the provider is within your geographical area, you may not have coverage.
Surprises Keep Stinging
Out-of-network surprise bills can occur for various reasons. One instance could be in an emergency setting, as it’s common for patients to see out-of-network caregivers due to the emergent nature of the care. Surprise bills can also happen as a result of a mishap, like a miscommunication in the doctors office, or due to out-of-network specialists or anesthesiologists being needed for a procedure. Patients may also receive an out-of-network surprise bill if they don’t ask their medical team to check for in-network providers in advance.
What Does the Out-of-Network Billing Process Look Like?
When you receive care from an out-of-network provider, typically, some portion of the bill will not be covered by your insurance. This portion is often referred to as the balance billing, meaning that the balance due on the bill is your responsibility.
The out-of-network medical billing process typically starts after the provider sends a claim to your insurance company. The insurance company will review the claim and cover whatever portion the plan includes, and then processes the payment accordingly. The remaining balance, or the portion that is not covered, will be sent as a bill either directly to you or your insurance company – depending on your plan’s policy.
Why Do Out-of-Network Health Care Bills Still Sting?
Out-of-network surprise bills still sting for a few reasons. Firstly, they can be difficult to navigate. It can be difficult to find out in advance what services are covered by your insurance plan when you need to use a provider that isn’t in your network.
Surprises Keep Stinging
Moreover, surprise bills generally cost more than you expect. As the bill amount can sometimes be double the amount that an in-network provider would have charged. Additionally, patients can be charged for the entire balance even when insurance has paid some of it.
What Can You Do to Avoid an Out-of-Network Surprise Bill?
When it comes to health care, there are countless variables that can affect what you end up paying. But that doesn’t mean that you can’t take control of your health care costs. Here are a few tips to help you avoid an out-of-network surprise bill:
Assess Your Plan
It’s always a good idea to review your insurance plan and any policy documents before your appointment. That way, you can have a better understanding of what costs you will be responsible for during and after your visit.
Confirm Coverage
Always call the billing departments before your appointment to confirm that any provider you are about to see is within your insurance plan network. Moreover, you may also want to contact the health care provider to confirm payment policies and make sure that they accept your insurance plan.
Shop Around
It’s a good idea to shop around and compare the services, availability, and cost of different health care providers before you make a decision. This is particularly important if you’re seeking highly specialized services.
Know Your Rights
Check with your insurance company to understand your rights when it comes to out-of-network surprise bills. Some states have passed legislation that requires insurers to provide insurance coverage for certain industries, such as hospitals. So if you receive a surprise bill, your insurance company may still be responsible for some portion of the costs.
Negotiate the Bill
It’s always a good idea to negotiate your out-of-network bill as much as possible. When you negotiate your bill, you can either pay less up front or have the provider offer an installment payment plan.
Research Patient-Assistance Programs
Patient-assistance programs can be another great way to manage your health care costs. These programs are usually jointly funded by providers, charities, and insurers and are designed to lower the cost of care for financially-struggling families.
Conclusion
Out-of-network health care surprise bills are a frustrating reality for many patients. The best way to avoid them is by being proactive and doing your research to make sure you understand your insurance plan and the billing process. That way, you are more likely to avoid the headache of a surprise bill.
What is an out-of-network health care surprise bill?
An out-of-network health care surprise bill is a medical bill that you receive that you weren’t expecting or that exceeds what you initially thought you would owe for your medical care services.
What does the out-of-network billing process look like?
When you receive care from an out-of-network provider, typically, some portion of the bill will not be covered by your insurance. This portion is often referred to as the balance billing, meaning that the balance due on the bill is your responsibility. The out-of-network medical billing process typically starts after the provider sends a claim to your insurance company.
Surprises Keep Stinging
The insurance company will review the claim and cover whatever portion the plan includes, and then processes the payment accordingly. The remaining balance, or the portion that is not covered, will be sent as a bill either directly to you or your insurance company – depending on your plan’s policy.
What can I do to avoid an out-of-network surprise bill?
Here are a few tips to help you avoid an out-of-network surprise bill: assess your plan, confirm coverage. Shop around, know your rights, negotiate the bill, and research patient-assistance programs.
What are patient assistance programs?
Patient-assistance programs are usually jointly funded by providers, charities. Insurers and are designed to lower the cost of care for financially-struggling families.