The United States is in a time of transition. Anxiety over changes in health insurance and paying medical bills is rising as the Senate took steps to repeal “Obamacare” and the administration made an executive order about health care on January 20th, 2017. Advice from a medical bill advocate on how to lower health costs on any plan is needed now more than ever!
Some of the rights and protections of Affordable Care Act policies are coverage for people with pre-existing conditions, dependent coverage to age 26, an annual out-of-pocket limit: capping the amount individuals are expected to pay each year, prohibit annual and lifetime limits: stopping coverage from being cut off from use, as well as, prevention services without cost sharing: giving people access to preventative care. These benefits make it difficult to replace “Obamacare”. Without a replacement to ensure that services continue to be subsidized and the self-insured continue to be insured the market may become unstable. Any instability in the market and coverage would be unfortunate because as the ACA has matured the preventative services market has expanded, improving early detection and healthier living.
Medicaid expanded under the ACA. Usage information about service habits and illnesses have increased. While working with the government, the San Francisco startup NUNA has taken the data of the Nation’s 74 million Medicaid patients and developed a cloud-computing database. With this data the ability to track illnesses and service usage has improved the preventative care services that insurance carriers encourage, medical professionals advise and patients benefit from. The Act has caused the development of higher value care over rewarding volume of services paid out.
Some of the high volume care services provide for: technological innovations that make services more patient-centered, alternative financing to allow for payment flexibility, core metrics for measuring collective progress and aligning providers and payers, as well as increase collaborative efforts to connect health with social services improving health outcomes at the community level. These developments are reshaping the system to better care for people and cost everyone less in long term health care.
Avoid getting ripped off by insurers, medical providers and the government with advice from a medical billing consultant, who helps lower medical bills by spotting overcharges by providers, under-reimbursements by insurers, and inappropriate denials by insurers and government employees. As the ACA has encouraged medical professionals to collaborate and increase value care to decrease medical costs, the benefits align with the following:
10 tips to reduce medical bills under any health care plan.
1. Record the doctors seen and the procedures received so you can check them against any bills.
2. Keep a copy of your medical records to share with doctors so they are seeing a complete history during your visit.
3. Send a new doctor a copy or authorize a copy of your medical records to be sent before your initial visit so your first visit can accomplish more than a basic intake.
4. Utilize preventative care services that are cheaper than treating major health risks that are left untreated.
5. Schedule as many tests and procedures as possible during a visit to decrease the need for multiple visit costs.
6. Make sure tests and procedures are not unnecessarily duplicated by practitioners. Have doctors communicate with one another.
7. Never pay a hospital bill before leaving the hospital.
8. Compare the bill with your service records and the Explanation of Benefits from your insurance provider.
9. If you don’t understand something on a bill, make sure to call the hospital billing department and ask.
10. Do not be afraid to ask questions and to advocate for your care.
These are just some of the tips that can be found in “Solved! Curing Your Medical insurance Problems,” along with how to challenge an incorrect or inflated medical bill, questions to ask after a suspected hospital over-charge, Medicare considerations and more.
“How the ACA Will Change the Health Care Delivery System,” National Academy of Sciences, 27 Aug 2014.
Adria Goldman Gross, “Solved! Curing Your Medical Insurance Problems: Advice from MedWise Insurance Advocacy”(Outskirts Press, 2015).
Thomas Kaplan and Robert Pear, “Senate Takes Major Step Toward Repealing Health Care Law,” The New York Times, 12 Jan. 2017.
Steve Lohr, “Medicaid’s Data Gets an Internet-Era Makeover,” New York Times, 9 Jan. 2017.