Today’s post is from Becky Gonzalez, COO and head of billing for MNCOME.
I’ve seen a few articles about medical billing, cost, and price transparency online lately. Fortunately, a lot of the issues out there don’t relate to MNCOME. Our charges are pretty transparent. Even still, no matter who your bill comes from problems can arise when you are not aware of who pays for what–and usually you won’t know that until your bill arrives.
To help make it easier to prepare for and better understand the costs you are responsible for, I’ve put together some tips.
Take the time to read your health plan guide. It will save you lots of wasted time and anguish. Some key terms to look for along with explanations for your plan:
- Co-insurance: a percentage of each bill that’s your responsibility
- Co-pay: what you must pay at the time of each doctor visit
- Deductible: the amount you pay until it’s time for the insurance plan to cover charges
And some key questions to find answers to in your guide:
- Do you need a referral submitted to your insurance by your primary care provider before seeing a specialist?
- Are there certain things your plan simply will not cover?
Knowing and understanding these things ahead of time removes the surprise when you get your bill. There’s more, though. This business about your doctor being “in-network” and “out-of-network” gives all of us a migraine, and it’s getting more complicated every year. Some facts:
- Physicians and clinics may petition to be included in a particular network, but it’s the health plan’s network review committee that ultimately decides.
- MNCOME is included in most networks, but some individual plans have narrow options in exchange for reduced premiums.
- Getting care “out-of-network” will cost you more, but sometimes it’s worth it.
- MNCOME will consider adjusting what you owe if your plan does not include us.
Be sure to set up an online account with your health plan so you can track medical visits, their charges and what your plan is going to do about them. You will also find in your online account any forms you need to help you work with your plan. This includes filing an appeal of any decisions to deny coverage – yes! You can argue with your health plan. You can also track your deductible so you’ll know when you’ve met it and the insurance plan should start paying.
Open, review and answer all correspondence from your health plan and MNCOME. So often patients get charged the full amount of their bills because they haven’t told their health plan if they have other coverage. If you have questions about your bill, call us immediately and ask.
(Tip: MNCOME and Medtox are separate. MNCOME bills you for care. Medtox bills you for processing your labs.)
Ask us about payment plans if you cannot pay your bill all at once. You set the amount. All we ask is that you make payments regularly.
If you have any other billing questions, please write me at firstname.lastname@example.org.