GRAND RAPIDS, Mich — For over a decade, health advocates have been trying to push people like you and me to become consumers of their own health care, to stop relying on insurance companies and health care facilities to take care of things because we think that's the only option.
It's not fun digging through medical bills, but if you take the time to look into what you're buying, you may be surprised how you much you can save on that knee replacement.
The good news is that you don't have to do this alone.
Marshall Allen is a veteran health care journalist who's dedicated part of his career to dissecting the health care system to help people get fairly priced medical bills.
"Never pay the first bill until you have checked that bill to make sure that it's accurate," Allen said, "and to make sure that it's priced in a way that's fair to you, not exploitative of you."
In his book Never Pay the First Bill: And other ways to fight the health care system and win, he gives easy-to-follow advice on how to make sure you're paying a fair price.
Your first step is to ask for an itemized bill.
"When you get that itemized bill where it breaks down each of the individual charges, then you can check those prices," he said.
Once you have those prices, Allen says you'll want to use the website Fairhealthconsumer.org, a national nonprofit that checks consumer prices for health care, to compare those prices. This website compares over 36 billion claim records from all types of insurance providers including Medicare and Medicaid.
You can type in your procedure to compare prices.
"(The itemized bill) would be the kind of bill that you should contest. Other times on the itemized bill, you'll see that they've included charges for things that did not even occur. That's very common," Allen said. "So it is a very complicated system. And on the billing side, it incentivizes overcharging, because everything they bill for they're going to try and get paid for. So you have to check and make sure that the billing codes are accurate and depicting what actually happened."
Then comes the hard part: Making that phone call to your provider's billing department and advocating for yourself.
Allen says it is within your legal right to negotiate for a lower price if you have the evidence that you are being overcharged. If they're not willing to negotiate, Allen says take them to small claims court.
"And then when you file that case, now, that medical provider is accountable in our justice system for the way they're treating patients," he said. "And they have to hire an attorney usually at a cost of hundreds of dollars an hour to defend this case that might only be worth a few hundred dollars or a few thousand dollars. It's not worth their time to continue their abusive practices."
In the end, you have to learn the system and advocate for yourself. Remember you are the consumer and you deserve to know the price you are paying for your healthcare is fair.
You can follow Marshall Allen on Twitter to see the dozens of people he's helped get a fair price for their medical bills.
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