How to Read and Understand Your Medical Bill

Nov 16 • 2018
How to Read and Understand Your Medical Bill

Helping Patients Understand Their Medical Bills

At first glance, medical bills seem overwhelming for many patients. Some itemized health care statements include unfamiliar language and service codes. Fortunately, health literacy—the ability to understand basic health information and services—can help patients pay bills and play an active role in managing their health. The next 6 questions will help you ace any health literacy test.

1. What should I expect to see on my medical bill?

According to Shannon Burnham, manager for financial service and assistance at Baptist Medical Group’s Central Business Office, health care bills contain several important elements.

“First and foremost, patients should identify who the bill is from,” said Burnham. “Billing statements also include the date of service—in other words, the day the patient received care in the hospital or physician’s clinic. If they have insurance, they will see the dollar amount that was billed to their insurance, as well as the amount paid by the insurance company and the balance they’re responsible for after insurance.”

However, a different bill is sent to self-pay patients. Self-pay patients are either uninsured or have high-deductible health insurance. According to Burnham, medical statements for self-pay patients will not include billing information for an insurance provider.

“If they’re a self-pay patient, they should see that there is no insurance bill,” said Burnham. “Self-pay patients will know—based upon the bill’s language—that they are responsible for the bill.”

2. How many bills should I receive?

Typically, Baptist’s patients receive two to three paper statements—unless they have opted to receive recurring statements each month.

 “If you don’t make a payment on your first bill, you’ll receive a second bill that serves as a reminder,” said Burnham.”

While multiple paper statements can be convenient, Ron Wachsman, vice president and chief revenue cycle officer at Baptist Memorial Health Care, recognizes that many patients prefer to manage their medical bills online. To make accessing health care information easier for patients, Baptist offers a personalized, secure web portal called Baptist OneCare MyChart.

“We’re in the process of streamlining our communication with patients in MyChart,” said Wachsman. “Our intent is to make it easier for patients to understand and resolve their bills. Patients can access medical records, set up appointment reminders and more. In the future, patients will also receive billing reminders in MyChart. We’ll be rolling out this exciting functionality soon.”

3. What is an explanation of benefits (EOB)?

Insured patients also receive an EOB after their health care provider submits a claim. It is not the same as a medical bill, although it resembles a bill and shows a balance due. Instead, an EOB educates patients about their health care costs and gives them the opportunity to review their services.

“The EOB comes from a patient’s insurance company,” said Burnham. “It tends to have a little more detail than a normal statement. It’s important that patients understand and compare their EOB to their Baptist statement to make sure services have been billed correctly.”

4. How can I pay my medical bill?

According to Wachsman, Baptist’s patients have multiple ways to pay their health care bill.

“Patients can quickly sign into MyChart to make a payment if they don’t need to talk to a person,” said Wachsman. “If they do want to talk to a person, they can call the customer service number on their statement or they can send private, secure messages through MyChart and a customer service representative will answer their questions.”

Traditional payment methods, including payments made by mail and phone, are available for patients who prefer to handle health care expenditures offline.

5. Can I set up a payment plan?

Interest-free payment plans are available for insured and uninsured patients. According to Wachsman, this option provides a convenient, manageable way for patients to resolve their health care bill over time.

Baptist offers payment plans to all patients and additional assistance for patients without insurance,” said Wachsman. “We have representatives that assist uninsured patients—at no cost to them—and help them find coverage, whether it’s through Medicaid or other types of available coverage. If they’re unable to get coverage, Baptist offers a generous discount on their bill to help reduce their balance.”

6. What should I do if I discover a billing error?

The medical billing process involves several entities, from medical billers and coders to various insurance and health care professionals. Despite standardized procedures, billing mistakes—such as inaccurate service codes, wrong plan information and typos—can and do happen.

“If you compare your EOB with your Baptist statement and you find discrepancies, we encourage you to reach out via MyChart or by calling customer service,” said Burnham. “Don’t delay. Don’t say, ‘Maybe I’m looking at it wrong.’ It’s important that you reach out, so we can help you resolve discrepancies and feel confident with the information reflected on your medical bills.”

Learn more about Baptist OneCare MyChart, including how to communicate with doctors, access test results, request prescription refills and manage appointments.