StefB's dashboard

Hi Stef B,

That's a really touch question. Knowing whether or not charges are legitimate and if they should be disputed is often dependent on the insurance you have (if any) and the reason you went to see the doctor. There are of course obvious things to look out for such as duplicate charges. Other than that medical billing is anything but straight forward and easy to understand.

We have a partnership with a company called Medical Bill Review Services which helps people manage their claims and dispute irrelevant charges. If you would like Patsy's contact information I would be more than happy to send that your direction. Feel free to email me at kwelty@changehealthcare.com.

We are also coming out with a new version of the change:healthcare site in February. It will be much more helpful in allowing you to determine what other people we typically billed for a certain procedure or health issue as well as what other people ended up paying.

If you have any other questions please feel free to contact me.

Thanks!

Well StefB insurances are anything but standard and simple. Typical HMO and PPO plans will cover about 80% of a persons cost. This generally depends on the procedure being done and the deductible the person has on their plan, and whether or not they have met that deductible. If you have not met your deductible the 8% may only be a discount right now.

Also you may want to double check on whether or not you are seeing in-network or out of network physicians.

If your typical medical needs have been office visits with your primary care physician and exams ordered by them, insurance would typically cover more than 8% of the cost.

It can never hurt to call them and ask them to explain why they are only reimbursing a small percent. You may want to makes notes on the conversation in the journal section.

If you still have questions please email me at kwelty@changehealthcare.com and I will give you a call to help you further. It would be my pleasure.

Happy Holidays!

what if my insurance reimbursement is much lower than the average?
I see that other MBM users' insurance pays about 83% and mine is only 8%. Should I call them and if so, what do I say?