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Step 1
Request an itemized statement from the medical billing company. This may take a few days to receive in the mail. Be sure to indicate the date of service or a billing period as some insurance companies take longer to process a claim and the processing date could differ from the actual date of treatment. If you went in for a doctor's visit in January, request an itemized billing statement from January through March.
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Step 2
Review your itemized billing statement paying attention to each line item. There should be a transaction listed for each charge after insurance has paid. If you have no insurance filed, you will need to focus on the items listed as billed. Any medical codes used should also show a description of what each code means.
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Step 3
Look at each date of service separately. Most visits will list the physician's name first then the date of service.
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Step 4
Record each charge you are disputing on a separate piece of paper linking it to the date of service in question. Pay attention to large charges like x-rays or lipid panels if you did know you didn't have these services performed; these are the first you will want to include in your dispute as they are easy to spot. Next look for the smaller items like dosages of medicine.
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Step 5
Inspect more closely any panels for which you are billed. These might be duplicated if they are charged separately then as a bundle. For instance, you will not typically have two EKGs done on the same visit, so make sure you aren't charged for one EKG then charged again for one under a bundle such as "cardiac screening tests."
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Step 6
Compose a letter to dispute all charges in question to the medical billing company. Indicate your findings, request that your bill be reviewed and ask that the billing company send you a corrected billing statement.
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Step 7
Create a separate letter to your insurance company detailing the same information. They should be more than happy to pursue this matter with the medical billing company since they were probably paid twice for something or paid for services that were not rendered at all by your doctor.
Comments
debbiejohnson said
on 10/20/2009 I personally am upset with a recent visit to my Doctor. I made an appointment for routine physical. The doctor ordered a mammogram, blood work,etc.. which is the norm for a physical. I was questioned the routine questions about past history, all the multitude of questions they ask, including depression and smoking and I mentioned, every once in a while, I have experienced depression, and I also mentioned I recently started smoking and would like to quit. I was prescribed Chantix and then they (the office girl) scheduled another day for a pap smear. I thought it was strange to schedule that for another day, but ok. I received the bill from my insurance stating I came to the doctor regarding a "Sickness" and the "sickness" is not covered, and apparently the reason for the scheduling of the pap smear on a different day was to bill me for a physical on the day I arrived for that. Fortun...
momcobb said
on 7/9/2009 How can you know if a service was provided if the patient was unconscious and a spouse or friend was not there? (My husband was in the hospital on a ventilator and they wouldn't let me stay with him.) Also, they kept him in the ER because they didn't have a bed in ICU and sent down an ICU nurse just for him. Should I have to pay extra for the nurse because they didn't have a bed? I want to pay my bill, but I want to be billed fairly. Any help? Thanks!
karakerkhof said
on 10/2/2008 How are calls more effective? Is there a specific "tone" a customer uses that is more convincing? Please let me know how calls are more effective than letters.
dav2008 said
on 2/19/2008 Although one can send letters to the medical insurance company, as a previous worker with an insurance company, I have discovered calls are quicker and more effective.