Tips:
by Kim R
- Keep yearly files for medical bills, insurance statements (explanation of benefits) and flexible spending statements. SAVE EVERYTHING!
- Know your insurance coverage. Be aware of any annual or lifetime caps on medical coverage.
- Do not automatically pay a medical bill that is sent to you. If the bill is more than you were expecting (as per your deductible and standard co-pay requirements), call the provider AND the insurance company to question the bill. Most insurance companies will initiate a three way call with the medical provider and you to work out any problems. More often than not there is a coding error that is the cause of the problem, and the issue will be resolved without you having to pay more than your standard co-pay.
- Take notes and include the date and names of the people you talk to about any insurance or billing problems. SAVE THESE NOTES.
- Don’t assume your medical providers properly billed your insurance company. Also, don’t assume your insurance company has a good reason to deny coverage on a claim. QUESTION EVERYTHING.
- If you have an HMO make sure you get referrals for all specialists and pre-authorization for any special tests. Referrals will not be applied retrospectively. Request them far in advance of any medical appointments or procedures.
- If you have an HMO, keep copies of all your referrals and stay on top of when your referrals expire. Don’t trust your child’s medical providers to tell you when a new referral is needed. They may not tell you and your insurance company will then require you to pay a larger portion of the medical bill. There is no way to avoid paying this larger portion in the event you forget to request a referral in advance of a medical appointment.
- Don’t assume your insurance company’s requirements will stay the same year after year. To be safe you should check with your insurance company before any major tests or medical procedures. A little bit of time on the phone in advance could save you a lot of money later.
- If your insurance company tells you something that seems inconsistent or too good to be true, it probably is. Trust your instincts. Ask for information to be sent to you in writing and/or call your insurance company and speak with a different representative on another day to ensure the accuracy of any information that seems questionable.
- Consider signing up for a flexible spending account to help pay for out-of-pocket medical expenses.
- If you don’t have flexible spending, keep copies of all medical bills and try to qualify for an itemized deduction on your taxes at the end of the year. Be aware that you cannot deduct medical expenses on your taxes that have been paid or reimbursed through a flexible spending account.
- Be aware that some counties offer family support programs that will help you resolve insurance problems. Some of these programs may also help you pay for a select few medical expenses (such as respite care).
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- Learn about the book that inspired this site, and help your little one to know they are not alone!
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