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New Guide Helps Patients to Avoid Unexpected Medical Bills

November 07, 2018

The American Hospital Association (AHA) has partnered with the Healthcare Financial Management Association and America's Health Insurance Plans to develop a new consumer guide to help patients ask the right questions to avoid paying more than expected for health care services.

HAP joins the AHA in its belief that patients and their families should be protected from the financial burdens of unexpected medical bills. And, although insurers are in the best position to help patients understand what is considered in network or out of network, the guide is designed to help patients navigate a sometimes complicated health care delivery and payment system.

Available in English and Spanish, the guide offers several tips and questions patients can ask when scheduling care in advance to find out whether a health care provider is in network, such as:

  • Ask what providers are in your health plan’s network
  • Ask how your health plan covers care from a provider who is not in network
  • When you need to get a service, check again with both your provider and the health plan to make sure that the provider is in the network
  • If you need to see a specialist health care professional, also check to make sure that the specialist is in the network
  • If you need to have a procedure, ask where it will take place
  • Ask who else might be involved in your procedure
  • Give yourself plenty of time
  • Write down all the information you receive
  • If you think you received an incorrect medical bill, or question the amount of the bill, seek help

The guide also offers steps patients can take to lessen their chance of receiving a balance bill during an emergency medical situation, when patients don’t have time to take the same steps that they would if they could plan in advance.

HAP joins the AHA in encouraging Pennsylvania hospitals to make the guide publicly available to patients as they prepare for their care.

For additional information, contact Jolene Calla, Esquire, HAP’s vice president, health care finance and insurance, or Laura Stevens Kent, HAP’s vice president, federal legislative advocacy.

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