Medical Billing and What You Don’t Know

Medical Billing and What You Don’t Know

Medical billing is a lot more involved than you think. So, if you think all you do is hand over your insurance card you better think again & read this. Now.

Medical Billing and What You Don’t Know is the title of this article. The “What You Don’t Know” will probably come as a huge eye opener. And a huge eye opener to a majority of readers at that. Believe me, when I say what you don’t know about hospital billing is important.

Because, it is very important.

Medical billing is something that holds some potentially expensive pitfalls. This article covers two of them. Not in detail but sufficiently so you won’t fall into their traps.

Medical Billing and What You Don't Know

We all have experienced what seems like a mountain of forms you have to fill out when you go to a clinic, urgent care, hospital or doctor’s office for the first time. The problem is we don’t read all of them. We just fillin the boxes and sign or initial on the marked lines.

A Quick Personal Experience

So, I had occasion to use the services of a clinic I have never used prior to the morning learned this neat lesson. Like all clinics they give the new patient anywhere from 4 to 6 pages and/or forms to complete. It’s the usual stuff. Name, address, phone number, email, contact person, types of medication you are using and primary care physician. As well as a list of medical conditions you check if you have that particular condition or conditions.

Which is why most people believe the only requirement is to present their insurance card and the clinic does the rest. No surprises, right? The first surprise however for most of us is the block labeled social security number. Most people simply fill it in. I never give them my number. And I do give them my insurance cards.

Ahhh, but wait, there is a surprise. Read the forms and you will see the burden is actually on you. They list it as your responsibility for making sure the provider is paid by the insurance company. 

Wait a minute, did I just say what I think I said?

Your insurance cards have all the necessary numbers for the clinic to be reimbursed. They do not require your social security number. In fact, if they do have it, they must have a social security number safeguard policy in place and give you a copy of that document upon request.

This is required by a provision in USC 42. USC isn’t the University of Southern California in this case, it is the United States Code. This is going to serve as the first piece of the medical billing and what you don’t know. Moreover, it is packing a whammy that surprises, if not shocks and befuddles, most patients.

The second piece of the medical billing shock story is something called courtesy. Yep, good old fashioned courtesy. How can courtesy be something you don’t know? You’re courteous to everybody.

Easy. Like so many of us, you didn’t read the medical billing form. You simply initialed and signed on the marked lines and assumed your handing over your insurance cards was all that was necessary. Once again, like so many of us do and have done. In almost every case that is correct. However, in some cases, the patient not only has to deal with the illness but the insurance payment process.

It works like this. If you had read the medical billing form you most likely would have seen words to the effect:

*This clinic bills your insurance out of courtesy to you. You’re responsible for payment and any follow up necessary to complete the payment.*

What?

You read that right. Surprise, Surprise!!

You are responsible because there are no laws that shift the responsibility on to the clinic to attempt to collect the money owed. Hence, the clinic is providing a courtesy to the patient. They do it because they want to get paid as soon as possible. That part isn’t a surprise, right?

Hard to believe in this day and age no law like that exists but true. That is one aspect not talked about in the current health care debates. It would seem like if you paid your premiums and your coverage is in force and you gave the front desk clerk your cards your part should be over.

Like I said, in most cases, that is the end of the story. The clinic’s insurance manager submits the forms to the company and the clinic waits for payment. You do not know if or when the payment will be made but you did your part. At least according to how it has always worked in the past.

This is the second medical billing. And what you don’t know that could potentially raise its ugly head and cause you a heartache. Pay attention to the forms. So you can ask questions while you are standing at the front desk.

Trust me, you will sleep way better if you do.



Senior Outreach Ministries achieves it’s objectives with the capital we’ve either earned or received from donors. The Proud 2 B A Senior Ribbon for example. Donate $5, get a ribbon and help us help a hungry Senior Citizen in need. All proceeds remain in the Ministries to be used per our mission statement. We are a volunteer church. No one receives a salary or wage. Please help us help less fortunate hungry Seniors. We never have and never will ask the government for grants, funds or hand outs. Thank You in advance.

Hospital Billing and Senior Citizens

Hospital Billing and Senior Citizens

Hospital billing & senior citizens generally know each other quite well. Even though torture isn’t on the list of resources for seniors.

In fact, hospital billing is a one of those items none of us ever want to face. For a variety of reasons. Bills from the hospital can be enough to mess with your health and wellness, for one. Being a senior, however, can be great.

I had open heart surgery in 2006. Which made me a member of the hospital billing & senior citizens demographic.

I myself was fortunate, fortunately. In the fact I had great medical coverage commonly called health insurance. Aside from paying the paltry few dollars called a deductible, I didn’t have to worry about hospital billing, and I went my merry way.

Other hospital billing & senior citizens aren’t or weren’t as fortunate. They either didn’t have health insurance or were under-insured. They faced or are facing the menace of old age, hospital billing.

In a moment I will point you to a site that goes into great detail on the inner workings of hospital billing & senior citizens. The site belongs to an actual practicing doctor. I spoke with him on February 14, 2019. And, I told him my intention.

Hospital Billing Can Be Tricky Business

He said by all means point your audience to my site. Let them learn as much as they can about what’s actually being perpetrated in the health provision and hospital billing realm.

I like that. A doctor willing to tell us the inside facts. His name is Dr. David Belk. He’s in Alameda, CA. His site is listed below.

BTW, I receive NO compensation from him for this referral.

But before I let you go I need to say a few words about this hodge podge called hospital billing. The law requires you to receive what is almost universally called an Explanation of Benefits (EOB). Sometimes it is called a Summary of Patient Services or an Account Detail. Regardless, this form has all of the services the hospital is charging you for.

Pay attention to this form. You can dispute every charge on that form. You probably won’t because almost all of them are actual procedures/medications/actions you received.

But, not all of them. My EOB looked like a small ebook of charges. The list was lengthy. If your procedure wasn’t/isn’t as drastic as mine yours will be shorter.

PAY ATTENTION to this form.

OK, click the link below and go explore Dr Belk’s site.

https://truecostofhealthcare.org

Senior Outreach Ministries achieves it’s objectives with the capital we’ve either earned or received from donors. The Proud 2 B A Senior Ribbon for example. Donate $5, get a ribbon and help us help a hungry Senior Citizen in need. All proceeds remain in the Ministries to be used per our mission statement. We are a volunteer church. No one receives a salary or wage. Please help us help less fortunate hungry Seniors. We never have and never will ask the government for grants, funds or hand outs. Thank You in advance.