LINCOLN PARK, Mich. (WXYZ) — Imagine going in for a routine procedure or a Doctor's visit, and weeks late, a bill arrives in mail, sometimes for hundreds, even thousands of dollars. Despite new federal protections, surprise medical bills are still hitting families hard.
Watch Keenan's video report below
For 22-year Army Veteran Robert Holbird, his $12 office visit became a whole lot more. That $12 copay was charged separately for everything they did. $12 for a vaccine and $12 for the needle.
"Every time you turned around, it was $12. It was all-inclusive in the one visit," Holbird said.
Robert said he thought his visit was covered, until the unexpected charges arrived.
"You get hit with a bill that you don't understand and you're arguing about it, and you know it's wrong," Holbird said.
Thankfully, Robert didn't have to go far for help. His daughter is a billing expert and the owner of Anderson Health Bill Advisors in Allen Park.
"That's where they get you, the devil is in the details," said Stephanie Anderson.
Stephanie said one common source of surprise medical bills is when a test shifts from routine screening to diagnostic, like in a colonoscopy.
"It's supposed to be screening, and then it switched to diagnostic because they found something and they have to test it. And then that's where you have a surprise copay," Anderson said.
Copays are a form of cost sharing, just like a deductible. A medical visit or treatment have both a copay and a deductible, meaning the surprises can add up. Even prescription costs can change without warning.
"I've had a patient come to me and it's just like 'Wait a minute, one month ago it was ten dollars, now it's a hundred and fifty. What happened?'" Anderson said.
Anderson has saved patients thousands, simply by questioning charges. And the savings can add up. I asked her what the largest amount was that she's helped folks with.
"$10,000," she replied. "And all they had to do was just step up and question. Sometimes the hardest thing is being your own advocate."
So what can you do to protect yourself from surprise bills? Experts say to keep these six tips in mind:
- Check networks, and confirm doctors, labs and hospitals are in-network
- Ask for a good faith estimate, and get costs in writing before care
- Understand screenings vs diagnostics, and ask about cost for both since procedures can evolve
- Review & Appeal, dispute charges that don't match what you were told
- Negotiate, and ask providers to re-check billing codes or lower costs
- Know your credit rights, medical debut under $500 no longer appears on credit reports
Stephanie also said to use your health insurance company's app. It can check your contract to find out what's covered and what's not.
"I know it's a lot of legal jargon," Anderson said. "But that's where you're gonna get to your bread and butter, what's covered and what's not covered."
Anderson's website is a tool you can use when battling insurance and unexpected charges.
The bottom line is: Ask questions, and don't be afraid to challenge a bill. And whatever you do, don't ignore it. Call your provider and your insurance company right away, and know that you do have the right to appeal.
