Understanding Your Medical Bills

Dr Bill Hennessey, expert on healthcare transparency, joins us to discuss medical bill sticker shock and how you can advocate to lower your bills. 

Episode Transcript

Speaker 1 (00:00):
Well, let's talk about your medical bill. Hold on before
you turn the channel. It's help with your medical bill.
This is West Michigan's Morning News. Steve Kelly, I see
Brett Bikita, expert on healthcare transparency. Doctor Bill Hennessy back
on the liveline with us. Doctor, thanks for doing this today.

Speaker 2 (00:18):
Happy to do so. Those darn hospitals are doing things
illegally and they are predatory. But help everyone listen.

Speaker 1 (00:27):
There's a lot of stuff that might not necessarily be untoward.
That's just hard to understand too. I worry the most
about and you know, I have I'm sixty, I have
a wife. We can collaborate on things, but I'm helping
to take care of my mom more and more. She's
getting bills, and my gosh, some of this stuff. Is
it a bill? Is it a notice that the insurance

(00:49):
is going to pay it?

Speaker 2 (00:50):
Right?

Speaker 1 (00:50):
How do you even know?

Speaker 2 (00:53):
Well, it is tough. There are two separate things. You
said there. There is a bill. A hospital can give
you a medical bill that's supposed to represent what they
are charging you for care. Separately, the insurance company, if
it's Blue Shield or Medicare, is supposed to give you
an explanation of benefits. They call it an eob by

(01:15):
acronym just to confuse you. But you're supposed to be
able to look at them and match them up. Supposedly, well,
the insurance companies are going to protect you and tell you, well,
the hospitalill builds you these ten things, but really you
only have to pay for these eight and here's your
real price. They used to do that in the eighties

(01:37):
or nineties. Now the insurance companies are hiding also, and
they're not giving you an explanation of benefit. So but anyway,
those are the two things. In the old days, we'd
match up before we pay the bill.

Speaker 1 (01:50):
What is the best way to advocate for yourself? To
make sure that you're getting the most concise information.

Speaker 2 (02:00):
You have to ask for an itemized bill. I know
that sounds crazy, because anytime we buy anything else in
this world, we see the price tag. So you have
to ask for an itemized bill. That is your federal
right under HIPPAP Privacy Law, Health Insurance Portability Accountability Act.

(02:21):
Your medical record includes your bill. So the first thing
you tell the hospital is I am not going to
pay one dollar. You put it in writing, you send
it to the billing department. I'm not going to pay
one dollar toward my bill until I see and review
an itemized bill with all the billing codes and with
the full names of every care item that you want paid.

(02:45):
And I know it's my right under federal privacy law.
I'm waiting. That's what you have to do to see
an itemized bill in today's world for five seven hundred
hospitals in the US. That's a starting point.

Speaker 3 (03:01):
Doctor. I'm so glad you said that, because you know,
dealing with my parents that have aged and my in
laws who have now passed away, but they had a
lot of medical bills, and I see it myself and
that it's so confusing because of online and maybe they
send you a paper bill, maybe they don't. They give
you a notification and bug you like, hey, you need
to pay this, And that's exactly what my thing is.

(03:21):
First of all, I'm going to wait for the insurance
explanation of benefit, like you said, I watch something in
writing before I'm going to pay anything, because how many
times and it's happened to me where I've paid something
and I've ended up paying twice and then they send
me a check back for a refund because it was
all crossed in the mail.

Speaker 2 (03:40):
It happens far too frequently at a high level. You
want to drag it out. The longer you take to
pay them, the less they're going to expect to get paid.
Hint number two, on average us of A, if you
go inside a hospital, they're only getting thirty cents on
the doll or from their friends at Blue Shield United

(04:02):
signa Netna. So if you had a ten thousand dollar bill,
take your time get an itemized bill. I'm not kidding you.
It could take one or two months to get it,
but that's okay, keep your money in your bank. But
when you get it, your offer is, well, I'm going
to get I could do three thousand, but you know
I want them in monthly payments over the course of

(04:22):
the next year. That's a lot better than a ten
thousand dollars bill up front.

Speaker 1 (04:29):
So how do you I mean that just seems gutsy
for a single you.

Speaker 2 (04:34):
Know, wor right, Yeah, the average person gonna do it.
But yeah, you're right, today's elderly they shouldn't have Medicare recipients.
So those sixty five years shouldn't have to worry about
bills except for the two thousand dollars expense of drugs
on an annual basis. But those of us with a

(04:55):
commercial working age, I mean, geez, you got fifty million
uninsured people. You got about another one hundred million that
have a deductible that's so high they'll never meet it.
They're paying for every dollar they're having insurance, but they're
still paying for all the care. They got a six
thousand dollars deductible. It's ridiculous. But hey, one hundred million
people do qualify also for free and discount of care

(05:17):
under the Affordable Care Act. Nonprofit hospitals benefit almost forty
billion dollars a year by their nonprofit tax status. Now
we know they're the biggest buildings and they have the
prettiest water fountains, and they take your money, and their
CEOs make more money than all three of us combined.
They supost to get back free care. So ask the

(05:38):
financial counselor. If you are in Michigan and you're making
between thirty grand and ninety grand, you're here and get
free care or discount of care at almost every hospital
in Michigan. Ask the financial counselor for a financial assistance application.
Even If you have a five thousand dollars deductible and
you don't want to pay it, ask the financial counselor

(06:00):
for a financial assistance application you.

Speaker 1 (06:04):
We're out of time, but doctor Bill Hennessy will be back,
expert on healthcare transparency. Thank you for your time this morning.

Speaker 2 (06:11):
You're welcome