Helping Sarah Kliff Solve Her Medical Bill Issue

Former WaPo Wonkblog health policy writer Sarah Kliff is a huge proponent of Obamacare and the expansion of health insurance. She's also been a recipient of excellent employer sponsored insurance benefits. Sarah has a problem. Here is what she tweeted:

2/20 at 11:27am
Sarah Kliff ‏@sarahkliff
Received today an $820 medical bill that I was not expecting nor can I decipher because American health care.
 
2/20 at 11:35am
Sarah Kliff ‏@sarahkliff

I've never tried to negotiate down a medical bill before, but excited for this new personal and professional adventure! 

Sarah, please allow me to help you out.

First, you can't blame the American health care system as the reason for not being able to understand the bill. It's probably an issue with the coding - the little thing called ICD-9 soon to be ICD-10 that you wrote about just a week ago. If the coding was incorrect then the insurance company might have pended the claim until additional information was received.

 

Second, since the bill came from the provider my guess is that the $840 probably is retail charges. Having insurance provides you with a discount on the service. There are a few other things that could have caused you to receive the bill.

• Could it be that the service isn't covered under your plan?
• Could it be that you went to a non-network provider?
• Could it be because your plan has a deductible that you haven't met yet? 

You need to find an EOB that matches up to the bill you received. You should also review your SBC to make sure that the healthcare service was covered under the plan. 

These are the questions a professional advisor would be asking you. From there we would take your bill and your EOB and work with your provider and insurance company to have the claim fixed. It is NOT an easy process - something I'm sure you are finding out.