One Phone Call Before You Pay a Dime on Your Medical Bill

The single most important thing you can do when you receive a medical bill is make one phone call.

Have you ever gotten a medical bill that you didn't know how you were going to pay?

Medical bills are one of the leading causes of personal bankruptcy in the U.S. After an unexpected medical emergency, the last thing you need is a bill you don't have the money to pay. When you get a large medical bill, you do have options. The single most important thing you can do is make one phone call. Call your provider and ask questions.

If you do this, you can ensure you never overpay a medical bill, you don't miss out on the chance that your bill could be brought down to $0, and you don't end up in collections before you even had time to verify what you owed in the first place.

It's natural to not know what to ask. Today, we are going to get into the questions to ask when you receive a medical bill.

When you get your bill, call your provider and ask these questions:

• What is the timeframe before my bill is sent to collections?
• Will you please send me an itemized bill?
• Have you billed my insurance company?
• Are you a non-profit hospital?
• Do I qualify for charity care?
• If I don't qualify for charity care, what do I qualify for?
• I can only pay $_______, can we set up a payment plan?
• Can you make a settlement offer?

With this one phone call, you are able to get vital information that could save you a lot of money and stress.

Let's go through these questions one by one.

What is the timeframe before my bill is sent to collections? The timeline for when a medical bill can legally be sent to collections varies by state. In some states, like California, a medical bill can only be sent to collections after 180 days. In other states, it can be in as little as 30 days. This is why it's so important to call and ask, "If left unpaid, when will my medical bill be sent to collections?"

Will you please send me an itemized bill? When you receive your medical bill, check to see if it is a detailed account of the care you received. If it isn't detailed, you can call and ask for an itemized bill. An itemized bill gives you a line-by-line detailed account of the care you received.

Billing errors are unfortunately more common than you would think. It's easier to catch a mistake on an itemized bill because you can go line by line and check to verify that you actually received everything you are being billed for. One common billing error is double billing, being charged for the same thing twice. Make sure you weren't billed for the same thing twice.

**Be sure to ask them to put your bill on hold while you are waiting to receive the itemized bill.**

Have you billed my insurance company? I understand that this may sound like an obvious question, but it is very important to verify that the bill has actually gone through your insurance company and that they've paid their part first. Unfortunately, some billing departments jump the gun.

Are you a non-profit hospital? Non-profit hospitals are held to a different standard when it comes to providing financial assistance for medical bills, also called charity care. If you were treated by a non-profit hospital, they are required to have a financial assistance policy and must offer assistance to those who qualify. This leads directly to the next question.

Do I qualify for charity care? Charity care is also called financial assistance. When you ask this question, you can also ask about "prompt-pay discounts" or a "self-pay/uninsured rate." Almost all hospitals will only provide financial assistance if asked. Non-profit hospitals are legally required to give you a copy of their financial assistance policy, but they are in no way required to explain it to you or check whether you qualify.

Most hospitals hand you a copy of this policy when you arrive, exactly the moment you are least likely to read it because you're in crisis. Most people don't realize how big a deal that policy is, and that it could lead to a lower bill or even having your bill written off entirely, meaning you would owe nothing for the care you received.

If I don't qualify for charity care, what do I qualify for? Just because you don't qualify for a discount or a full write-off doesn't mean your only option is paying the full amount in one payment. Hospitals often have other forms of financial assistance, the most common being payment plans.

I can only pay $_______, can we set up a payment plan? The payment plan a hospital first offers you may not fit your budget. They may break it into three or four payments that still feel unaffordable. Instead of only asking what plans they offer, tell them what you can pay each month and see if they'll accommodate you. Some states prevent hospitals from sending a bill to collections if the patient is actively making an effort to pay.

Can you make a settlement offer? A settlement offer is the lowest total amount the hospital will accept for your bill. Many hospitals would rather get a smaller amount directly from you than go through the lengthy process of sending your bill to collections. So ask what the lowest lump sum, meaning a one-time payment, they'll accept.

One More Thing Before You Hang Up

Write down who you spoke with, when you called, and what they told you. Ask for a reference number, too.

If anything gets disputed later, that's what you'll point back to. Billing departments keep records of every call. You should keep one too.

A simple way to track it:

• Who: the name of the person you spoke with
• When: the date and time of the call
• What: a short summary of what they told you
• Reference number: ask for one before you hang up

Keep this note with the bill itself, so everything is in one place if you need it again.

This may feel like a lot, and that makes sense. Anything dealing with money is stressful. Today, we've looked at what to do when you receive a bill and what questions you must ask to protect yourself. Hospitals are looking out for their bottom line, which is why you have to ask these questions and advocate for yourself.

This is exactly the kind of step-by-step verification I walk through in the Decoding Healthcare Program, in the Verify Every Financial Step piece of the framework. If you're staring down a bill right now and want to talk it through, I offer a free 15-minute consult, you can grab a time here.

Definitions

Itemized Bill - A bill that has every charge broken down into every single detail of the care you received

Billing Error - When a mistake is made on your bill. It could be that they billed the wrong code or you were double billed.

Double billing - Being charged for the same thing twice, when you only got it once.

Charity Care - Financial assistance

Written off - When your bill is brought to a $0 balance by a hospital, so they can decrease the amount they pay in taxes

Prompt-pay discounts - A type of discount for paying your whole bill quickly

Self-pay/Uninsured rate discount - A type of discount that is the same rate given to people who don't use their insurance, even if you do use your insurance

Financial Assistance Policy - The document non-profit hospitals are required to have and required to give every patient that details what types of financial assistance are offered by the hospital

Settlement Offer - The lowest amount the provider will accept for your medical bill

Lump sum payment - A one-time payment, when you pay all of the bill at once

Advocating for yourself - Standing up for yourself

Coming Next Week: Medical Debt Doesn't Have to End in Bankruptcy