“You’re not supposed to get a bill for coronavirus tests. But as anyone who’s ever gotten a surprise medical bill can tell you, just because you’re not expecting to be charged doesn’t mean you won’t be. So what can you do to make sure you’re not stuck holding the tab?
“First, keep in mind that testing and care relating to diagnosing the coronavirus is covered by recent legislation. The Families First Coronavirus Response Act provides that all COVID-19 testing be covered by either the patient’s insurer or the government. The CARES Act expands on that and requires that health plans reimburse providers for related services, even if they’re out of the patient’s plan network.
“So don’t avoid getting medical care if you’re worried about costs, advised Caitlin Donovan, a spokesperson for the nonprofit >Patient Advocate Foundation.
Find out much more at Source: >What to Do if You Get a Bill for Your Coronavirus Test
“Do your research before seeking care. The first way to avoid charges is to make sure you’re following directions. That means looking up restrictions for testing centers (some may require an order from a physician) once you >find what’s available near you. If you have insurance, the best time to find out what’s covered is before you’re sick—but with high demand and long wait times by phone, we’re going to guess you haven’t done that.
“If you don’t feel well, check your insurance carrier’s website first—most have special coronavirus information pages. Taking a screenshot of those pages or printing them can help you if you need to file an appeal later on. If you need help getting information, you can enlist a friend or family member to help you.
“Don’t rush to pay any bills. If you’re being tested for the coronavirus, you shouldn’t have to pay a copay or coinsurance. But if you get a bill after your visit, >don’t pay right away. Wait until your explanation of benefits (EOB) comes by mail or electronically. Once you receive that statement, you’ll know your insurance carrier has processed your claim and you can compare it to your billing statement.
“If you’re hospitalized for COVID-19 and worry about paying the bill, here are some tips:
Don’t pay the bill right away
“You should delay before you pay,” Donovan said. “Things are changing so rapidly on a daily basis. Just because you get a bill today doesn’t mean that some legislation might pass that might mean you don’t have to pay that bill.”
“Examine the bill carefully
If anything strikes you as odd, or if you’re being billed for a treatment you don’t remember receiving, call your provider and ask about that part of your bill. Mistakes are common, and often involve a provider billing a patient directly instead of submitting a claim to an insurance carrier, Donovan said. “Even just typos can add costs to your bill,” she said.
“Look at your ‘explanation of benefits’
An “explanation of benefits” can look a lot like a medical bill, but it’s actually a statement that explains what your insurance will be covering and how much you’ll be expected to pay. The amount listed on the EOB should be the same as the one listed on the bill — if it’s not, there’s been a mistake, Donovan said.
“Know the law
Under the CARES Act, hospitals that receive federal relief funding are supposed to sign an agreement pledging not to charge patients surprise bills for coronavirus treatment. It’s worth calling and pointing this out to a hospital billing office if you get a surprise bill, Pollitz said.
“Make the case that an out-of-network bill should be counted as in-network
If you get a surprise bill that’s out-of-network, call your insurance company and ask for it to be counted as an in-network procedure, Donovan recommended. “I think you have a very strong argument to appeal to your insurer that it should be counted as in-network,” Donovan said. “There are so many extenuating circumstances going on right now.” If a phone call doesn’t work, you can appeal in writing. The Patient Advocate Foundation has an online guide to the process with sample appeal letters.
“Consider paying off the bill over time
If your final bill is too big for your budget, sit down and evaluate your finances and see how much you can afford to pay up front. Many hospitals offer financial aid programs that let patients pay off bills gradually. “No hospital expects you to have thousands of dollars on hand — very few people do,” Donovan said. “Letting them know you intend to pay the bill and entering a payment plan might be the least stressful way to handle that situation.”
“Call and ask for a break
“Given that there seem to be a lot of providers and insurers who are making the extra effort to be helpful now, if you get an out-of-network bill, it’s worth it to call the billing office,” Pollitz said. “It’s worthwhile trying to ask if they could reconsider, because times are tough now for everybody.”