Saturday, December 27, 2014

Your Medical Provider May Not Give You Credit for Overpayment

Card trick quilt block pieces are like health insurance and providers
Card Trick Quilt Pattern Represents How Insurance and Medical Providers Work Together

Health insurance and medical providers work together, with most providers filing claims with your health insurer for you. You still need to check to be certain you get the benefits you pay for.

Recently, Hubby had a visit to the doctor, and since we have a high deductible, he was required to pay $140 for the office visit at a large Central Texas hospital. He had blood tests, and didn’t pay that charge in advance. We received a bill at the end of the month from the hospital for about $180, so I went online to check with our insurer. I was surprised to find that the charge for the office visit was limited to $102, so we had $38 credit on the advance payment that didn’t show on the billing. 

I called the hospital billing department and was told that, because of the way the computer program works, a credit never shows. You owe the total amount you paid in advance unless you call and request a credit. 

The lesson learned here is to compare the insurance payments and maximum allowable insurance charges with the charges from the hospital. The medical provider estimates the amount you owe for an office visit -- and you may owe less. You may find they don’t show a credit balance, and you lose any overpayment you make.

We saved $38 by comparing the charges with the insurance payments, using the insurance website. That may not seem like much, but if every patient is overcharged and the hospital or doctor’s office wipes the slate clean so billing begins at $0, that is a lot of money for the American consumer to lose. Don’t let it happen to you.

See you next year!


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