How Consumers Can Avoid Surprise Medical Bills

By Consumers for Quality Care, on May 18, 2022

According to Bloomberg, there are several steps consumers can take to avoid paying expensive surprise medical bills.

While the federal No Surprises Act, which went into effect in January 2022, has eliminated many unexpected medical bills, there is still a lack of understanding about how the U.S. insurance system works.

Consumers should first determine how to get health insurance coverage. In the United States, health insurance is usually tied to employment, or Medicaid for eligible low-income individuals. The self-employed can go through the Affordable Care Act health-care marketplace or private companies to select a plan.

Next, consumers need to know what is covered by their insurance plan, including which doctors and hospitals are in-network. The best way to confirm what is covered is to directly ask your provider.

And if a medical bill doesn’t seem to add up, consumers can file a formal appeal with their provider. Information about how to appeal should be on the Explanation of Benefits (EOB) you receive from the insurance provider. Consumers should also inform the hospital billing department to inform them they are disputing their insurer’s decision so the bill isn’t sent to debt collections.

CQC urges all consumers to be proactive and careful when seeking treatment to ensure they are not putting themselves at risk of surprise medical billing. Lawmakers must also do their part and take action to ensure that insurance is actually working for millions across the nation.