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Medical Bills • 4 minute read

How To Read Your Medical Bills

How To Read Your Medical Bills
By Kristina James
Published by Ruby

Ruby's online tools and app helps you organize your medical bills and save money.

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A visit to the hospital or doctor means a bill in the mail later. Yet as common as that experience is for most of us, 72% of Americans struggle to understand their medical bills. In this article, we will break down how to read your medical bills so you can ensure that you are not overpaying or falling victim to fraud.

 

Medical bills explained

MedicalBillingAndCoding.org created a list of things included in medical bills, along with a quick explanation of each:

 

Statement Date

The date your healthcare provider printed the bill.

  • A healthcare provider is someone or something that provides a medical service, like a physician, hospital, or physical therapist.

 

Account Number

The number the healthcare provider uses to identify you as a patient and the services you received.

  • If you have questions regarding your bill and balance, you need to provide this number when contacting your healthcare provider’s billing office.
  • Account numbers are also typically used when you pay for a bill online.

 

Service Date

A column listing the dates you received each medical service.

 

Description

A short phrase that explains the service or supplies you received.

 

Charges

The full price of the services or supplies you received before insurance is factored in.

 

Billed Charges

Same as above except this section clarifies that the charges have been billed.

  • Billed charges are either paid by you, your insurance provider, or a combination of the two.
  • Whether the bill goes to you or your insurance provider depends on the makeup of your individual insurance plan.
  • A key factor in your plan is the deductible. A deductible is the amount of money needed to be spent on medical treatment within a given year in order for your insurance company to assist you with payments.
  • If you have not met your yearly deductible, you will be responsible for paying your medical bill—not your insurance provider.

 

Adjustment

The amount the healthcare provider has agreed not to charge.

  • In an article by Healthgrades, healthcare providers and insurance companies work together to come to an agreement on this discount, making services more affordable for patients.

 

Insurance Payments

The amount your health insurance provider has already paid.

 

Patient Payments

The amount the patient has already paid.

  • If you have not made any payments yet, this will read as zero.

 

Balance/ Amount Due

The amount currently owed to the healthcare provider.

  • If your insurance is applied to your bill but there is still a balance remaining, you are responsible for paying that balance.

 

Payable To

The organization you should write and send check payments to.

 

 

Behind the scenes

You may be wondering: Why are medical bills so complicated? The reason is in the process insurance and healthcare providers use to formulate your bill.

Harvard Business School professors Robert Kaplan and Michael Porter stated in the New York Times that healthcare costs are assigned “based on what [healthcare providers] charge, not on the actual costs of the resources, like personnel and equipment used to care for the patient.” Essentially, the cost of service is determined by factors pertaining to your healthcare provider (facility capacity, supply and demand, staffing, among others), which providers use to negotiate the cost with your insurance company. This reasoning explains the medical bill mysteries, like why the same treatment costs more at one hospital than another.

 

 

When in doubt, double-check

Medical terminology can be intimidating and leave you feeling stranded when reviewing medical bills. VeryWell Health advises checking a medical dictionary to make sure the treatments on your bill accurately reflect your medical condition. If they do not match, it is possible that a medical coder (an individual who prepares your medical bill) made an error that could cost you or your insurance provider extra money.

Your billing error could also be caused by upcoding, which is when a healthcare provider charges you for services you did not receive with the goal of being paid more money. Or in an even worst-case scenario, the charge may come as a result of someone fraudulently using your identity and can lead to other issues down the road. If your medical bill has an error, you can contact the healthcare provider’s billing office to clear things up. Whatever the reason, checking your bill’s validity can save money and protect you in the long-term.

Are you prepared?

Whether you go in for a standard procedure or experience a medical emergency, making a trip to the hospital can be nerve-racking. It is often easier to cope during stressful times when you are prepared, and Ruby can help. With the Medical Information Kit, you can store important documents, medical information, and even your hospital bills in one location. Get started on yours today.

For more information on how to be be prepared for any health emergency, take a look at Medical Emergencies: Planning for the Unexpected.

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