Patients should ask questions to reduce health care costs

Oct 6 2009

Medical bills can be very complicated and, in some cases, they can also be inaccurate or incomplete. California's Office of the Patient Advocate is encouraging all Californians to ask for clarification if they do not understand their medical bill. Start by asking your doctor's office to explain any charges that you are being asked to pay -- many billing problems are solved this way. If there are still questions, health insurance plan members should call their health plan for further explanation and to ensure that the bill reflects the correct payment contribution from their health insurance. Taking the time to understand your medical bill can save you money while helping you get the most out of your health care.

"Patients have a right to receive accurate information about their medical bills and the charges they are responsible for paying," said Sandra Perez, director, Office of the Patient Advocate. "If any part of your bill is confusing or if you see something that you would like clarified, ask about it. Asking questions about your medical bill can ensure that the payments from your health insurance company are accurate and that you are paying only what is necessary."

The Office of the Patient Advocate provides tools and tips on how you can best understand your medical bill, such as asking for a list of fees so you will get a sense of what you will have to pay before you go to the doctor. The Office of the Patient Advocate also provides information on how health insurance works and tips on how to spend money wisely when it comes to health care. For more tips and information about how to navigate through health care costs, please visit www.opa.ca.gov.

If you've already talked to your doctor's office and your health insurance plan and you still disagree with your medical bill, the next step is to file a formal complaint with your health plan. If you're not satisfied with your health plan's decision, contact the Help Center at the Department of Managed Health Care at 1-888-466-2219 or www.HealthHelp.ca.gov. The Department of Managed Health Care makes sure that health plans follow the law and address member complaints on time, and its Help Center can help you with your complaint.

Health care plays an important role in the lives of all Californians. The Office of the Patient Advocate seeks to provide Californians with the information and tools needed to make informed health care decisions and get the most out of their health insurance plan. In addition to free educational materials, the Office of the Patient Advocate releases an annual health care quality report card rating the largest health insurance plans and doctors' medical groups in the state on quality of care and patient satisfaction as rated by members of the plan. There are also easy links to report cards on hospitals, nursing homes, PPOs, Medi-Cal, Medicare, and Healthy Families.