Articles- Medical Bills, Health Insurance and Pregnancy Medical Costs

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Six Steps to Understanding Your Pregnancy Medical Costs

by Melissa Hernandez

Pregnancy medical costs and insurance can be confusing. If you know the terminology it can help ease your anxiety, so you can rest easier after giving birth.

Becoming single or divorced during a pregnancy may be daunting enough. Then come the bills. Lots of them. First you receive a bill for a pregnancy test and then an ultrasound you may or may not remember having. After the baby is born, you'll receive the hospital bill also. How do you know what you should pay or if your doctor's office or hospital is charging you the correct amount?

1. Look over your statement the doctor sends you. Most of your visits and appointments should be on your personal calendar. Check your statement against your calendar to make sure every item is on a date you actually saw the physician. Remember too, that the physician may send some items out to a separate lab (you will receive a separate bill for these items). You may also receive separate bills for ultrasounds, amniocentesis, fetal non-stress testing and blood draws.

2. Compare your "Explanation of Benefits" (called an EOB) to the bill you receive from your doctor or medical facility. Make sure the patient responsibility section matches what you are being charged for each date of service. When medical services are submitted to your insurance company; this will usually generate an EOB which should list each service and how much your insurance paid. This
EOB will show your responsibility, as well.

3. Check your EOB - It is also a good idea to check your EOB to make sure the insurance is billed for the services you actually had done. If the EOB shows multiple services, make sure you had all services done. Call your doctors office or their billing service for an explanation of the items charged if there is anything you don't understand or don't remember having done. If there are any errors, insist that they be removed from your bill and corrected with your insurance company.

4. Make sure your insurance has processed your claim properly. If you have a plan that is supposed to pay 80% of the allowed charges, make sure they have paid 80%. If the insurance has paid your claim incorrectly, ask them to reprocess your claim. The more you understand your plan, the better off you are. If you have a deductible and a co-insurance, look into those terms and fully understand them. Knowing what you will be responsible for ahead of time lessens the shock and allows you to plan BEFORE your bill arrives.

5. Once you receive a medical bill, deal with it as soon as feasible. Little bills quickly add up. Large bills need to be paid or arrangements made as quickly as possible. If you receive a large bill you know you cannot pay all at once, call the medical facility and arrange an acceptable payment arrangement. If you are single, recently divorced or widowed; tell the office your situation and ask if you can make payments. If you make an arrangement, get it in writing and stick to it. If for any reason you are unable to make one of your payments, contact the office immediately.

6. Ask for discounts - If you are truly hard-pressed financially and are overwhelmed by the amount of medical costs: ask the office if they will give you a discount. You cannot get what you do not ask for. Depending on your insurance (or lack of it), the office may be willing to cut you a break. (Please note that some offices, depending on their contract with your insurance company may not legally be able to do so). Many medical bills are sent to a collection agency over the patient's procrastination or failure to make a call to ask for arrangements. Most offices do not want your account to be sent to a collection agency and are usually happy to make an arrangement for you.

Make your pregnancy, birth experience and baby your number one focus. Understanding your medical coverage and dealing with bills directly is the best plan for cutting financial stress.

~Melissa Hernandez lives in San Luis Obispo county with her husband, 3 children and chihuahua. She has been in the administrative medical field for over 10 years and is a medical biller and writer.