Heads Up: Keep a Close Eye on Your Medical Bills

Whenever you visit your doctor, have a test or procedure, or receive any other healthcare service, the service is assigned a code. That code tells your health plan carrier the type of service you received and the dollar amount due to the healthcare provider.

Changes to the medical claims coding systems have recently taken effect. As a result, doctors and healthcare facilities may experience some growing pains as they become familiar with these changes over the coming months.

What This Means for You

Most likely, these changes will have no effect on you. That is because health plan carriers and providers have been preparing for them for some time. However, it is always good practice to check your bills and Explanations of Benefits (EOBs) carefully for errors.

In particular, keep an eye out for a few issues that might result from these changes:

• Payment Delays. It may take longer than usual for your carrier to pay its part of the bill. In turn, your provider may send you a bill for more than your share of the cost because the bill does not reflect your carrier's correct share.
• Approval Delays. Certain services require pre-approval from your carrier. Pre-approvals may be delayed if your provider miscodes the service.
• Coding Errors. If your provider uses the wrong code, you could receive a bill for services that don't reflect the services you actually received.

What You Can Do

If you experience a delay or spot what might be an error on your bill or EOB, contact your health plan carrier promptly. You can find your carrier's contact information on your member ID card or in the Contacts Information section.