Picking back up on the topic of health care for 2017, we continue this week with suggestions from AARP to help all of us to become more empowered consumers. Let's begin with hospital savings.
Obviously, we don't have a choice when an emergency occurs; whether by personal vehicle or ambulance, we travel to the closest facility. On the other hand, elective surgery or treatment for a chronic condition calls for negotiation — now.
Make an appointment with the hospital's ombudsman. I advise sitting down with the officer at each local hospital to determine the least-costly fees.
If you haven't negotiated, don't be surprised if you're hit with a mind-blowing hospital bill. Don't panic yet. If the bill is a summary, ask for a detailed one. Once the detailed bill is in your hands, scrutinize closely and look for obvious mistakes.
Since studies show that at least half of all hospitals send out erroneous billing statements, it's in the patient's best interest to go over it with a fine tooth comb.
It's not unusual for billing errors to occur in the operating room, specifically regarding rates. For example, someone can be billed anywhere from $60 to $200 per minute depending on the operation. Imagine going through an hours-long surgery at $200 per minute. It's imperative to confirm you're paying the correct rate for the correct procedure. Always question what appears to be exorbitantly priced items, such as $30 for Tylenol or box of tissues.
Double billing can be the culprit. For instance, a "surgical kit and tray" may appear in one spot and a few entries later a "knife and other instruments" is charged. This is double billing, and it's illegal.
A call to the billing department should take care of any honest errors. However, if the charges aren't quickly dropped after calls and correspondence, it may be time to hire a health-care advocate.
One of the fastest-growing industries around, these folks find mistakes and advocate on your behalf to get rid of them. The typical hourly fee is about $100, which is one-third of the discount collected for the patient. Advocates claim to find enough errors to cut a big bill by 10 to 50 percent.
To find a nearby advocate, check the Alliance of Claim's Assistance Professionals at claims.org. According to AARP, the top three advocates are Patty Stone 650-323-0216/stoneortsupport.com), Pat Palmer (855-203-7058/billadvocates.com), and Katalin Goencz (203-569-7610/medbillsassist.com).
And, finally, insurance savings may be somewhat less of a bugaboo than we might think. Those of us on Medicare or who have employers who offer health insurance sleep a bit easier at night. But for those who partake of the ACA (Affordable Care Act or "Obamacare"), shopping around can yield an enormous financial difference. (A note here: Medicare recipients also should shop around to save money or improve benefits. Visit Medicare.gov/find-a-plan.)
Even though we don't know what's going to happen with the ACA under the new administration, the current suggestions still apply for the time being.
Investigate "Simple Choice" plans that offer two biggies:
- They cover basic services without a deductible and, according to AARP, make apples-to-apples comparisons among all plans, including bronze, silver and gold.
- These plans feature relatively low co-payments for basic services, rather than having to meet a deductible before the insurance company pays.
And, finally, never choose a low-or-no-premium plan. While you may think you're saving money, that is not the case. Insurance companies always find a way to savage prospective savings that look good at face value. Whether by jacking up deductions or cutting down or cutting out benefits we depend on, these folks eventually come out on top leaving the insured — us — the biggest losers.
Contact Ellen Phillips at firstname.lastname@example.org.