Friday, July 10, 2009

Question EOB Payments

As we age, most Baby Boomers will incur ever increasing medical bills. If you're under 65, then you can't qualify for Medicare, so at best you're still liable for probably 15% to 20% of preferred providers' bills and even more for other doctors outside of your medical network.

I've incurred thousands in medical bills over the past year and have had to fight the insurance company because they would not pay a "reasonable rate" for non-provider doctors.

I recently read that this is a common practice in the health insurance industry. They have been using an outdated database that overcharges patients for seeing doctors outside their insurance network; in turn, costing us billions of dollars for payments the meidcal insurer should have made.

That inaccurate database is run by Ingenix which in January agreed to pay over $350 million to settle allegations that it intentionally kept rates low. Many independent insurers used Ingenix to determine a typical average cost for care outside their network, thus subjecting over 100 million Americans to excessive costs for their portion of the bill.

I can't tell you the countless hours I've spent in the past year fighting with my insurance company. It really makes me furious that so many of us Boomers have paid medical insurance premiums for years, only to have to then argue with the provider to get a fair and equitable payment when we need a specialist!

It's your don't hesitate to challenge your insurance company's calculation of what you owe on your EOB(Explanation of Benefits).

No comments: