rer for a real-time review, the accounting is about 98% accurate, says athenahealth Inc., which provides billing services for doctors’ practices. You should then be able to get a document with the doctor’s charges and the insurer’s coverage decisions.
But if a doctor’s office is using some form of projection or estimate to tot up your out-of-pocket cost, the figure might be off. For one thing, if you are getting a lot of medical care, you may be quickly cutting down what’s still due on a deductible.
If you’re concerned about the accuracy of the charges, you may want to politely ask if you can instead pay most or all of your bill after you get your insurer’s formal explanation of benefits, says Kathleen Stoll, deputy executive director of consumer group Families USA. “It’s easier to be correcting a bill before you’ve paid it than after you’ve paid it,” she says. Cigna Corp. recommends that members pay only about half of their expected bill based on the estimates the insurer provides to doctors, which it says are about 90% accurate.
Of course, that can lead to an awkward conversation. Doctor-practice administrators say they have procedures to defuse tense situations with patients who object to paying or can’t afford the bill. Some offices avoid confrontations by asking for patients’ credit-card numbers before they see the doctor and getting authorization to charge up to a certain sum. Some practices offer discounts to uninsured patients who are able to pay something upfront, or set up long-term payment plans.
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