The medical billing error from hell
When Saideh Browne had an emergency appendectomy in the summer of 2012, she had no idea it would raise the cost of a car loan three years later.
The 44-year-old personal trainer from New York recently visited a dealership to buy a new Honda Accord and discovered her credit score had been dinged by two lingering medical bills for $770 that had gone to collection.
Browne says she did not purposefully ignore the bills, nor did she shirk them because she could not pay. Like many other people, she got caught in an endless loop of indecipherable paperwork between the many providers involved in her care and the insurance company. The amounts due and the reasons listed for the charges kept shifting. Browne did not want to pay a wrong bill and never see the money again.
“I’m an astute consumer, but it gets confusing,” Browne laments. “You don’t know what bill is what.”
Almost 50 percent of medical bills have errors, according to government data studied by NerdWallet, which has a medical bill review service.
“It’s quite staggering,” says Christina LaMontagne, a general manager for NerdWallet. “Probably all of us have been mis-billed on a medical service.”
That includes LaMontagne, who recently received a medical bill she did not understand that was due in 30 days. Her first recommendation to consumers: ask for an itemized statement.
Therein lies the dilemma for most consumers.
“There are cobwebs in the system,” LaMontagne says.
So what is a consumer to do? Here are the three steps to keep your credit healthy:
1. Communicate immediately, in writing
You can pick up the phone to call your provider and the insurance company, but you need documentation, says LaMontagne. The doctor and insurance company need to respond back to you in writing, or you have grounds for appeal because you were not properly notified.
Disputing a charge should stop the clock, but there is no guarantee your unpaid bill will not be sent to collection.
The average time a provider will carry a bill is usually 120 days, which is how long Medicare providers are required to wait, says Chad Mulvany, director of healthcare finance policy for the Healthcare Financial Management Association, a trade group for hospitals.
LaMontagne says significant anecdotal evidence exists that more bills are being sent to a collections agency after 90 days, so the transition to collection could be quick.
1. Get outside help
If you are getting nowhere with your provider, turn to your state insurance commission.
You can also hire a bill resolution company, such as NerdWallet Health or Medical Billing Advocates of America, which charge either a flat fee or take a percentage of the savings you achieve.
Some workplace human resources departments also offer assistance, or at least can run interference with insurance companies.
Expert help is important because many collection agencies prey on consumer fear and tend to go away quickly if confronted by somebody who knows the law, says Pat Palmer, president of Medical Billing Advocates.
For instance, collection agencies are not supposed to be familiar with your medical details. So the first thing Palmer does for clients is call and ask about the charges. If the agents know what the bills are for, she tells them they have violated medical privacy laws. “You never hear from them again,” Palmer says.
3. Negotiate a payment plan
Most medical providers want to close out your account. Setting up a payment plan could get the monkey off your back, says Healthcare Financial Management’s Mulvany.
Most of all, paying something allows you to move forward, says credit expert Beverly Harzog, author of “The Debt Escape Plan.”
“If you don’t take care of it, it’s going to drag you down,” Harzog says.
That is exactly what Browne has done, setting up a payment plan for the unexplained bills.
“At this point, I just want it to go away,” she says.