Consumer Investigator Sasha Jones is hitting the streets of South Florida to find out what questions you are burning to know the answers to.
In our series Consumer Corner, NBC6 Responds takes your money questions to the experts.
Each week, we will feature a different consumer question.
Consumer: Brian
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Question: “How do I dispute a medical bill?”
Expert: Patrick Sullivan, Attorney with the law firm of Lubell Rosen
Answer:
Responds
Responding to every consumer complaint
When it comes to medical debt, there are ways to estimate your out-of-pocket costs ahead of time. You can call your insurance company for an estimate of your out-of-pocket expenses for things like copayments, coinsurance, or deductibles.
But if you don’t have insurance, you can request a good faith estimate.
“Hospitals have to have pricing transparency on their websites, so you can go in and see their chargemaster, which it’s a fee schedule of charges,” Sullivan explained. “If you don’t have insurance, you can contact the provider and they are supposed to give you a quote for how much those services will cost.”
Attorney Patrick Sullivan says new state and federal laws give you the right to receive a good faith estimate if you don’t have insurance.
The estimate will explain how much your medical care will cost. You should try to have your estimate at least one day before your medical service.
But if you receive a bill that is $400 or more than your good faith estimate, you can dispute it.
“If you get the services and it is more than $400 above what they quote you there are steps you can take with CMS to lodge a complaint,” Sullivan said.
Sullivan says you can file a complaint with the Centers for Medicare and Medicaid Services, known as CMS. You can call 1-800-985-3059or file a complaint online.
Keep in mind, Florida law prohibits surprise billing in emergency situations. The law also requires hospitals to post on their website the health plans they are in-network with and let you know if you could be seen by an out-of-network practitioner.
