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Health Care Reform:

Health Insurance & Affordable Care Act

Your Guide to Health Insurance Paperwork

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7. How can you check to see if you're being billed correctly?

First, see if you got an EOB from your insurance company about the services in your medical provider's bill. This is very important, because some doctors and medical facilities will send you a bill before your insurance company has paid them. 

These early bills show the full amount you're being charged, not just your share of the cost. You don't have to pay these early bills, but some people do so by mistake. You only have to pay after your insurance company has paid its share.

If you get an EOB from your insurance company, you should hold it side-by-side with the bill to compare:

  • The dates of the medical care
  • The services the provider is billing for
  • The amount the insurance company has agreed to pay
  • The amount you owe

8. What if you have questions about a bill?

Call your health care provider's office if you have questions about the dates of your medical care or the description of the services or care.

Call your insurance company with any questions about payment. For instance, you might want to find out why your insurance didn't cover a charge or paid only part of the amount.

9. How can you fight a bill?

You have the right to appeal any decision by your health insurance company. The Affordable Care Act also requires that health plans provide an internal appeals process. This lets you challenge claims that your insurer rejected. You also can find out more about why they were rejected.

If your internal appeal is denied, you might have the right to an independent external review. Ask your insurance company about this. Or, call the U.S. Department of Health and Human Services at (877) 549-8152.

Keep copies of all your bills and EOBs. Also keep any letters from your provider or your insurance company about a dispute. Write down the name and phone number of every person you talk with about your bill. Include the date of the conversation. These records will be very helpful when it comes time to argue your case.

10. Where can you get help fighting a bill?

Some states have consumer assistance programs within the state insurance office. You can go to the National Association of Insurance Commissioners to find out what help is available in your state. You also can get information and assistance about fighting a medical bill from:

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