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Four steps to fight high medical expenses

Four steps to fight high medical expenses (contd)

2. Ask the right questions

"Will you take my insurance?" isn't enough to head off an out-of-network charge.
"When you're making an appointment, don't ask if you're covered under your plan," said McClanahan. "Everyone will take your insurance."
Your doctor's office may accept your insurance, but that won't spare you from a surprise bill weeks later if he or she is out of your network, McClanahan said.
The correct question for your doctor's receptionist is, "Are you in my network?"
Be sure to document who gave you the answer and the date so that you're prepared to fight back if you get a bill that says otherwise, McClanahan said.
Speak up when your doctor recommends tests and prescriptions. Ask questions such as: "Is the testing facility in-network?" or "Are the doctors evaluating the tests in-network?"
Don't be shy about asking your doctor for an explanation if he or she recommends that you undergo a test. Learn more about the test and find out how the results will affect the approach to treatment.
"If they can't provide a clear answer, ask, 'Is this test really necessary?'" McClanahan said.
Finally, curb costs on prescriptions by asking whether your medication is covered under your plan and if a cheaper version is available.
Sometimes it's cheaper to pay cash for your medication than to claim it on your insurance, McClanahan said.
She suggested digging up drug price information on and comparison shop.
"Know the benefits and risks, how long will you be on medication, and what are the alternatives to the medication prescribed," McClanahan said.

3. Keep records

Maintain a health-care log so that you're equipped to fight back in the event of a dispute with your insurer. Keep track of any communications you have with your insurance company and your doctor.
If needed, hire an expert to act as your advocate, McClanahan said. She suggested reaching out to the Alliance of Claims Assistance Professionals.

4. Call your regulator

If balance billing is illegal in your state and you receive a massive out-of-network bill, be sure to reach out to your doctor first, as it may be an error. Pull in your insurer to help.
If neither your doctor nor your insurer will help you address the bill, then it's time to contact the regulators, said McClanahan.
That means you should reach out to your state medical board and your state's insurance department.
If your insurance plan is self-funded — one in which your employer assumes the financial risk for providing your health-care benefits — then you should contact the U.S. Labor Department's Employee Benefits Security Administration.
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