5 Tips for Interpreting Medical Bills

Updated on October 5, 2021

It’s not always easy to understand medical bills. Sometimes, the terms are difficult to decipher, and it can be hard to tell what you’re being charged for. This blog post will provide five tips that will help make understanding your hospital bill easier!

1. Understand what codes mean

You don’t need a degree in medical coding to figure out the coding on the bills. Generally, some of the codes will be a number and then another set of numbers. These are typically associated with services or procedures that you received from your doctor or hospital.

Codes are also used for different equipment and supplies that a patient might receive during their visit. The type of service you receive is often included on your bill, so you don’t need to know the codes.

2. Know your deductible and co-payments for each plan you have

Many times, a person will have more than one plan that covers medical expenses. It’s important to be aware of how much you need to pay at the time of service or when receiving your bill from the hospital or doctor.

For example, if you go in for an office visit with your primary care physician and make a payment on-site, you can expect to pay a co-payment. Depending on your insurance plan and deductible, the amount of this payment will vary from person to person.

If you go in for an emergency room visit or stay overnight at a hospital, likely, there won’t be any additional fees since they are considered emergencies. However, if you are admitted to the hospital and don’t have many procedures like lab work done, your stay may be considered outpatient. This means that it will not be covered by an emergency room visit or overnight fee, so there might be additional charges associated with this type of service.

3. Review the Explanation of Benefits (EOB) carefully to make sure all charges are accurate  

Sometimes, the EOB and the medical bill will not match up. It is important to understand that this could be for various reasons, such as incorrect coding or billing for services that haven’t been performed yet.

If you see discrepancies between your insurance claim and your medical bills, it’s best to contact both parties right away to look into the issue and find a resolution.

4. Contact a health care advocate if you can’t understand what’s going on with your bill or if something seems wrong

In some situations, a simple misunderstanding can turn into a big problem. This is why it’s important to have someone on your side who understands the medical billing process and can help you navigate any potential issues that might arise during this time.

If something seems off or incorrect about your bill, don’t be afraid to reach out for assistance. It’s better to be safe than sorry when it comes to your money and health.

The last piece of advice is to remember that you don’t have full control over what happens with your bill, but some people can help if needed. Take the time now while everything is calm, organized, and in front of you so you can get the process started early before things become complicated.

5. Get help from family members, friends, or others who may be able to assist when it comes time to negotiate payment plans

If you can’t decipher your medical bills on your own, don’t be afraid to ask for help. Several different resources can assist with this type of information including Medicare and Medicaid.

It’s important to note that even if you do have insurance or access to some sort of assistance program like these two, not all medical bills are covered. It will depend on your policy and the type of service you received, which is why it’s important to start this process early if needed.

Remember that there are several different steps in the billing process, so understanding what they all mean can be tricky. However, by following these simple tips, you should understand your medical or hospice billing and what you can expect to pay.

The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.