How to Avoid Surprise Medical Bills

Surprise billing is a major problem that has led many others and may lead you to bankruptcy. You might think that having great insurance plans will keep you safe, but that is not always the case. Read on to learn how you can avoid the common pitfalls that can lead you to a financially ruining surprise bill.

Research Your Coverage Before Visits


Most insurance plans will cover 100% of your preventive care, but using new technologies may not be covered by your plan. New screening methods such as 3D mammography may result in out-of-pocket charges for you. You must call your insurer to find out which services and tests are covered by your plan before any tests or procedures are done. You can also get pre-authorization from your insurance companies to make things easier.


Always Stay In-Network


Call your insurer and medical office to check that your doctor and procedure is in your plan’s network. Check first how much the out of pocket charges you will incur if the providers are not in your insurance provider’s network. Always strive to get your procedures and doctor visits done in-network to avoid additional charges.

Another thing to watch out for is your hospital. Be sure to confirm that your hospital or care facility is also within your insurance provider’s network. Also, double-check that your doctor or provider is also in-network. It is common to find a hospital in your insurance company’s network, but not all doctors or providers from in-network hospitals belong to your insurance provider’s network.

Anesthesiologists/ radiologists and lab tests are the most common reasons for your surprise bills. Be sure to double-check that all your providers, facilities, and tests are done in-network to avoid surprise bills.


Be Careful of Provider Directories


You’ll find that provider directories are often unreliable. It has been reported that more than half of provider directories contain wrong information that can mislead you. Information such as numbers, addresses, and being in-network have been found to be incorrect in these directories many times, which may lead you to a surprise bill. It is important that you talk to your healthcare provider and insurance company to confirm that your provider and facility are in-network.


Compare Prices


Healthcare is not really an area you want to be frugal, but there are places that offer the same quality of care at varying prices. Routine blood tests have vastly different costs depending on your area. You must search the internet to compare the costs of tests and cares within different ZIP codes. Look for the actual costs instead of the averages to know exactly what you have to pay.

Make Preparations


Make these preparations to lower your risk of surprise medical bills.


  • List down the nearest Emergency Rooms within your area. Next, determine which ones are covered by your plan’s network. When calling an ambulance ask them to take you to a hospital within your insurance plan’s network. Please note that there are no guarantees where an ambulance will take you but it can increase the chances of sending you to the in-network hospital.
  • You need a hospital that employs its own emergency physicians instead of contractors. Emergency rooms that employ their own emergency physicians are more likely in your insurance provider’s network.
  • Make sure that your insurance plan covers an ambulance. Also, make sure that the ambulance is within your insurance provider’s network. Calling an ambulance while uninsured or out of network can cost you a lot.

You must prepare for emergencies to prevent surprise bills.

Facility Fees


Hospitals or other big facilities will often charge you for space and equipment. A bandage and some ointment can get you a bill worth hundreds of dollars in these facilities. Visiting a doctor from these places can also trigger a facility fee you must pay.

In a non-emergency, you should ask first if the place charges a facility fee. You can try to find a new place that has no fees to lower your bill.


In the end, you have to be cognizant of the many details in your insurance plans, medical bills, and prepare accordingly. Doing your research, staying in-network, being cautious of provider directories, comparing prices, making preparations, and watching out for facility fees may keep you from bankruptcy due to medical bills.


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