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Medical practices take note: 3 tips to avoid billing disputes

Hospital billing disputes can have a negative impact on a private practice’s ability to care for their patients. Private practices can reduce the risk of these disputes by putting into place proactive measures. Hospitals and private practices throughout the country have found the following tips have helped to better ensure smooth payment:  

  • Break it down. Communication is arguably the most important step towards reducing the risk of a patient billing dispute. However, the way we communicate can further reduce this risk. Providing a transparent breakdown of the cost and noting where factors could change this estimate can help better ensure an accurate estimate and help the patient prepare for the bill.
  • In network or not? Be clear. Make it very clear if the services received are out-of-network or not. It can help to breakdown each element if possible. For example, provide an explanation if a scheduled surgeon is likely in-network while the anesthesiologist is not.
  • Discuss funding. If the patient cannot cover the costs, discuss other options. A payment plan or alternative insurance coverage may be options to consider.

Ideally, clear communication before the procedure will result in a smooth transition to the patient getting the bill and sending in payment. Unfortunately, this is not always the case. In some situations, the issue that arises may not be with the patient but with a failure of insurance to cover the bill. Medicare or commercial insurance providers may come after the practice and claim overpayment. In these cases, it is best to seek legal counsel experienced in overpayment determinations to better ensure your interests are protected.  

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