This is a recap of some very useful information I got out of the How To Money Podcast, episode 716.
This episode featured guest Dr. Virgie Bright Ellington, doctor and insurance executive.
How to crush medical debt!
Ever receive a bill for a medical service and it didn’t seem right? How to not pay what you don’t owe. 80-90% of medical bills have errors. Most are not in your favor.
Many Americans are scared to get any medical services for fear of the cost. And people who are afraid of the medical debt end up having a lower life span because they don’t get the necessary screening and treatments.
Dr. Virgie suggests a 3 step process to avoid this kind of debt. but before you follow the 3 steps (listed later) here is what you should try first.
Financial aid/assistance
All nonprofit medical care facilities, have to offer a sliding scale, income based, tax, free, payment plan application. this is a federal law. So if they don’t give you one, ask them what is their financial assistance policy?
Even if you have a high income, their formula may decrease or even eradicate the amount you owe. The doctor mentioned a woman who made $150,000 per year and had a $10,000 medical bill white clear. Just because of their formula. 60 to 65% of medical facilities are nonprofit. So this will pertain to them.
If after you went through the financial assistance steps, you were not qualified for some reason or you still have a balance left over, proceed to the steps one through three!
3 Step Process
Step 1:
Find the CPT codes on your bill. The CPT codes are unique codes for each medical service provided. If you don’t see CPT (or CPT/HCPCS) codes, call the billing department and ask for a bill containing the CPT Codes. Don’t ask for an itemized bill.
Step 2:
Google the CPT codes to determine what they mean. Make sure the service sounds like what they provided. Once you determine that, Google how much Medicare pays for that service. (Doesn’t matter if you qualify for Medicare or not!). Medicare is the lowest, most fair retail price that is paid for medical services in the USA. Make sure you’re not being over or upcharged by plugging the CPT codes in once you get the true bill!
Step 3:
Call the provider about the bill stating the bill price and then how much you are able and willing to pay. Once they agree, let them know that you tried every possible way to budget and you can only pay (insert dollar amount) every month. Then ask them who you can speak to to help set up an interest free payment plan for this. You will probably get pushed back but tell them you just want to pay what you actually owe and this is what you can pay. Once they get you to who can help set this up, stick to the number that you said. If you agree to a higher one, and then you miss a payment, they can send you directly to collections.
Keeping a “Battle Journal”
Dedicate a journal to document conversations, names and dates pertaining to your medical bills. This will be helpful for you to keep track and in case a facility sends you to collections.
How to proceed with payment once you determine how much you actually owe, if anything
Don’t use a credit card. Unless you absolutely, positively have to. Once you put the debt on a credit card, you obliterate all federal protections to keep that debt off of your FICO score. Medical payment plans made just for the providers do not show up on the FICO score. If you charge it and you can’t pay off the total on time, interest will add up fast. I know we talked about negotiating credit card, APR‘s, but obviously it’s best not to get to that point if possible.
Nonprofit resources
If, for some reason you get stonewalled, or given the runaround while trying to negotiate your medical debt, here are some resources for you to turn to.
Dollarfor.org:
They will help with your application process for a non-profit medical facility, or if the bill is incorrect, or not in compliance of what Medicare fair price would be.
Thepatientadvocate.org:
They help with all medical bills, not just bills from non-profit facilities. They will help you with almost every step of your case.
There are for-profit companies who will negotiate for you, if insurance will not cover something that deserves to be covered. But try those as a last solution. You want to try financial aid first, and then the three steps after that.
You shouldn’t feel bad for challenging your medical bills. There are many times that facilities charge you unfairly. You may go to the ER and they will try to push you to sign a form before they even offer care. You don’t have to do that. They have to treat you. There are cases that patients are tricked into signing a form to agree to be a balance build. This is a breach of contract between the insurance company and the medical facility, but the insurance company will not always find out about it. If you are at an in network provider and your insurance agrees to pay a certain amount, that is the amount the provider is supposed to accept. They should not come back to you, and have you agree to be balance billed, which means agreeing to be billed the remainder of what they say you owed. balance billing is one of the top five reasons of overcharging. If the facility is in your network, make sure you challenge that.
I have challenged some medical bills without all of this knowledge, and was able to talk down some of the bills. But with this knowledge, you should be able to do a lot more.
I hope you find this in the following links helpful!!
How to Money Episode 716 https://podcasts.apple.com/us/podcast/how-to-money/id1337718773?i=1000626178118
Dr. Virgies website (particularly the step process checklist) https://crushmedicaldebt.com/free-resources/
Nichole's Blog 