HOSUTON – Protection starts with asking questions before getting services from medical providers, hospitals or labs.
1. Ask if the medical provider is in your insurance provider's network or out?
It's important to know because insurance companies negotiate the maximum prices they'll pay for medical services, tests and hospitalizations ahead of time. If the provider isn't in network, and those price caps aren't in place, you could get a shock when you open the bill.
2. Get an estimate of costs
Insurance companies and health care providers have up to 10 days to provide estimates, because of that estimates may not be available for all medical situations, especially emergency medical care.
3. Comparison shop.
Average costs for different medical procedures can be found by using the Texas Department of Insurance's, Texas Health Costs website. The site lets you search by zip code as well as medical service or procedure.
4. Ask for an itemized statement of services
Texas law requires providers to give you an itemized statement if you ask for it.
5. If you do get a surprise big bill from an out-of-network provider, call to ask if it will accept a lower amount
If that doesn't work you can request mediation for many medical bills over $500 through the Texas Department of Insurance. The Agency boasts a better than 90% success rate in lowering bills through mediation.
For more information on surprise medical billing check out the Texas Department of Insurance's Surprise Medical Bills website here.
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