How to Resolve Medical Billing Problems

The medical billing field is notorious for being difficult to navigate. Billers and patients alike face various issues when it comes to submitting and receiving bills—but nothing is worse than finding an incorrect medical bill with your name on it. The first thing to understand is that an incorrect bill doesn’t mean you’ll have to pay the wrong amount, and it doesn’t mean the problem is insurmountable. However, it does mean that you may need to gear up for a lengthy journey to your bill’s resolution. We took a look at what you should do if you find yourself in this situation. 

Look Over Your Bill and Explanation of Benefits (EOB)

The first piece of information you’ll receive after your appointment is your explanation of benefits. This is essentially just a document that states the amount billed by your provider, your plan discounts, the amount covered by the insurance company, and the amount you’ll owe. Once you receive your bill, it’s important to compare it to the EOB, making sure the two are identical. If even one number is off, you know there’s likely an error somewhere. 

Request a Detailed Bill 

After you’ve determined that you received an incorrect bill, you need to request a detailed bill through the medical billing department listed on your bill. This bill should list everything including the date and time, billing codes, description of the service received, total price, insurance coverage, and amount due. Find the billing code listed on the detailed bill and compare it to the one on your original bill. If the two don’t match up, you’ve found your error. 

Contact Your Provider’s Billing Department

Now it’s time to contact your provider’s office, more specifically, the billing department. Let them know that you’ve found an issue you’d like to dispute, and at that point, you’ll probably be told that their team will look into the issue, and in the meantime, your bill will be put on hold. 

Submit an Appeal With Your Insurance Company

If you want to take it a step further, you can submit an appeal with your insurance company. If there’s a chance the insurance company may have overpaid, you can bet they’ll be looking into the issue immediately. Insurance doesn’t want to pay a penny more than they have to, so this is a great way to get the issue quickly sorted. 

Explore New Possibilities With NY Medicaid Billing Software

Billing medical claims without a proper cloud-based Medicaid billing software hurts both the billing practice and the patient. If you’re an office that’s still billing manually, it’s time to upgrade and make a difference for everyone involved. Book your free BillPro demo today to learn more!