General Article

When It’s Time to Pay for Your Hospital Stay

When you’re having a medical emergency, the last thing you’re thinking about is how you’re going to pay for it. You need care, stat, and no other thoughts apply. But once the health crisis is over, you may find a financial crisis looming. Here are a few ways to get organized and prepared as those bills start rolling in.

Know What Your Insurance Pays For

You’ve probably scanned your benefits list and seen that your insurance pays a large percentage of hospitalization expenses. However, since hospital stays can cost tens of thousands of dollars, your small remaining percentage will be way more than a $20 copay. You’ll need to be prepared to blow your full out-of-pocket maximum at once. That may take some financial planning and sacrifice.

Examine Your EOBs

All through a patient’s stay, a hospital’s chargemaster management makes note of every test, every procedure, every specialist. Those services will be individually priced, invoiced, and sent to your insurer—which, in turn, will send you an Explanation of Benefits showing what was charged, what it paid (often thanks to prior negotiation with the provider), and what if anything you owe. Look these documents over as soon as they arrive and contact your insurer if anything looks wrong.

Manage Your Case

Compare every bill that comes in with your insurer’s EOB. If a provider claims you owe something your insurer says you don’t, it’s time to get on the phone. You may have to have several chats with your insurance company and the provider to work out codes and correctness, but eventually, things should work out in your favor. Clip every EOB to the bills it addresses and keep notes of all conversations attached.

Hospitalization is traumatic enough without the ensuing months of billing woes. But with a little organization, you may be able to keep the financial side effects from being worse than the medical ones.