How to Read a Negotiated Medical Bill
When you receive a medical bill, chances are it has passed through your health insurance provider. If so, you may see some different numbers on the bill. If the bill has been negotiated between the health care provider and the health insurance company, dollar amounts for a total due may be changed dramatically. Here is how to read your negotiated medical bill.
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Instructions
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Look at the estimated costs of care. These costs should be itemized on one section of your bill. These reflect the values the provider had assigned to each service.
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Now look at the total amount that the provider has charged to the health insurance company. This will be reflected either directly or as the logical result of the total that is due to yourself and what has been paid.
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Subtract the total paid (and what is yet to be paid) from the total of the provider's line-item bill. There you have the amount that has been negotiated away by bulk contracts between the provider and the insurer.
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Assess the amount that is due to yourself and make sure it is in keeping with the provisions of your plan. If the insurer only paid a minimal sum, they may be obligated to pay more according to your medical insurance plan.
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Call the insurer directly with any questions. The insurer's representatives must respond to appeals from policy holders. Make a detailed inquiry about how the bill was negotiated and what it means for you.
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Tips & Warnings
For non-policy holders, the health care provider will attempt to charge the entire bill, which in many cases is 700-800% higher than if it had been negotiated. In some cases, an individual can negotiate payment with the provider. However they will never be able to cut deals the way the insurance companies can. The bottom line of the negotiated bill is that policyholders profit big-time.
