Navigating Medical Bills with Catriona & Anne
Today’s episode of Financially Naked: Stories from The Financial Gym, is all about medical bills. Even with insurance, the health care system can be confusing to navigate. Catriona Williams, a Level 2 Certified Financial Trainer, is joined by Financial Gym client Anne Weigand. Anne is here to share her journey with medical bills, tips for navigating the space, and ways you can advocate for yourself while trying to seek medical care.
Podcast Notes
Needing medical care is part of life, but in America, there is a lot of uncertainty when it comes to paying for it. With an endometriosis diagnosis, Anne has first hand experience with the medical billing system and has been advocating for herself the last few years.
It started in 2019 when she had a job that provided health insurance. She found a doctor in her network and scheduled an annual checkup, as preventative checks and routine care were supposed to be covered by the insurance. She even called the doctor’s office before the appointment to confirm the visit would be paid for by them. A few weeks later, she received a $300 bill from the visit.
This led to months of back and forth with the billing department at that office. The bill felt rude, and was a shock and a bummer, as it was unexpected. She was told the first meeting with a physician isn’t technically ‘routine’ which is why it was not covered by her insurance. After four months, the billing manager refused to speak with her, and this caused a lot of frustration, as she did not want this bill to end up in collections. Anne was not trying to get out of paying it, she just wanted to understand why she got a bill at all, when she was told her insurance would cover the visit.
Shortly after, Anne was experiencing issues and got progressively more ill. After doing some of her own research, she saw a women’s wellness doctor but didn’t feel like she was being heard and wanted a second opinion. She wanted to establish care with someone else who could validate her concerns and answer her questions.
Anne was diagnosed with endometriosis and started working with a specialist in late 2019 and into early 2020. This specialist was able to use an MRI to help Anne understand what was happening with her body, before moving forward with surgery.
She was able to schedule the surgery for June of 2020. Even though endometriosis affects other organs and overall health, the surgery is considered elective, so she wasn’t able to have the procedure before then due to covid.
When planning medical care:
Make a plan going in if you can! Sometimes medical issues are sudden and you don’t have time to plan beforehand.
Understand your insurance policy and find providers in your network.
Know the details of your plan. There are things like deductibles and out-of-pocket maximums to keep in mind and ask questions if you’re unsure. Putting in the extra time will help in the long run.
Call the doctor beforehand and ask about the price. Let them know if it’s out of your budget. They may be able to be flexible, and it doesn’t hurt to ask.
Understanding how medical bills work:
When you go to the doctor, they send a bill to your insurance. That bill has a code on it that tells your insurance company what was done with the doctor, so they know what needs to be paid for.
If you are seeing a specialist regularly, learn the billing codes. It will help when sorting through the bills, which can sometimes come months later.
Even if you went to one hospital, bills can come from different places. It’s always good to ask, ‘Who can I expect a bill from?’
It can sometimes take months for bills to be processed through insurance and sent out.
When a bill arrives:
Do not pay the bill in full without questioning it. Question everything!
Always call and confirm the bill is correct. Ask them to go line by line with you and explain the charges in detail.
There could be an error with the bill or an incorrect code.
There may have been a lapse in insurance, and the bill wasn’t sent to the new insurer.
Some hospitals have financial assistance. Apply if it is available. Even if it is denied, there may be other actions that can be taken from there. Anne emailed the CEO directly, and they were able to help her.
If you are working with a billing department, take notes and keep a record of all of the conversations. Email yourself a thread so you have detailed records of the conversation.
Try to be patient and kind with the people on the phone, they’re more likely to be helpful.
When you’re sick or recovering, it can feel like the last thing you want to do, but it is important. At the end of the day, you have to advocate for yourself. There are always options out there, be brave, and ask for help if you need it!
Resources for Endometriosis
An illustrated Story about Endometriosis
Connect with Anne Weigand
Instagram: @anneweigandofficial