Are you paying too much for your medical bills?

When you receive bills from your medical providers, do you really look at them? Do you compare them against the EOBs (Explanation of Benefits) from your insurance company when you receive them? If not, you should. I've talked to several people lately who have paid more than they should have. Some of them weren't fully aware of their coverage while others simply received the bill, assumed that they must have owed it if the bill was sent, and paid their bills like dutiful patients. The truth is that medical billing departments deal with a ton of paperwork and are bound to make mistakes sometimes. Here's what you should know in order to make sure you're not paying too much.

Deductibles

The deductible is the amount you must pay out of pocket each contract period before your insurance company will start paying your bills. Most of the time, each individual has a deductible and the family has a deductible. The family deductible is usually less than the sum of the individual deductibles combined. Ours, for example, is $100 for each individual, but $200 for the family. We have three family members, so not all of us have to meet our individual deductibles. Read through your insurance contract to find out what is and is not subject to the deductible.

Copayments or coinsurance

Your copayment is a flat fee that you must pay when seeing a provider; the copay for a specialist is usually higher than a primary care physician. With coinsurance, you pay a percentage of the allowed amount, typically 15-20 percent. Most offices charge copays and coinsurance fees upfront, as well as deductibles. Again, you need to read your contract to find out which services are subject to these payments. Our son's pediatrician often tries to charge us a copay for his well visits, but I know that well visits are covered at 100 percent and are not subject to the deductible or copayments, so I remind them of this. It saves us $15 per visit, which adds up during a child's first two years.

Allowed amounts

If your physician is a participating provider with your insurance company (and you should definitely find one that is, if at all possible), he or she cannot charge you above the amount that the insurance company allows for the service. For example, if a provider usually charges $100 for Procedure X, but your insurance only allows $60, the provider cannot charge you for the rest. On the other hand, if your provider does not participate in the network, he or she can bill you for the remaining $40.

The moral of the story is to be mindful of your benefits and carefully examine your bills. You don't want to pay more than you actually owe. Do you have any tips on saving when it comes to healthcare? Share them in the comments.

Photo courtesy of Alex Proimos via Flickr.