On April 18, 2011 I received a medical bill for $99.92 from our hospital in Minnesota. It was a bill for services rendered on May 5, 2010. Yes, you read that correctly. The bill arrived almost a full year after the services were rendered. The bill stated that payment needed to be made in full by May 13, 2011.
Now I consider myself to be a reasonable person. If I buy something or use a service, I pay for it promptly and in full. I also feel that it is reasonable to expect some time to pass while the insurance company and the hospital decide who is paying for what. However, I do not feel that it is reasonable to expect a patient to budget for expenses when bills can be received up to a year after the fact. In fact, as I later found out, they can bill me for expenses up to 14 months later!
So I wrote a letter of appeal.
I actually end up writing letters of appeal for most medical expenses I incur, because there are often mistakes in the medical billing process. In almost every case my bill is reduced, and in many cases it is eliminated. As it is often said, “The squeaky wheel gets the grease.”
If you are going to write a letter of appeal, you will need to keep a few things in mind:
1. PLAN AHEAD. Speak with your insurance company, your hospital, your doctor, or any other necessary parties before you incur expenses to be sure that what you need is covered by your insurance.
2. CALL AHEAD. After you incur medical expenses, call these same people again to clarify points in your insurance policy and billing.
3. BE PROFESSIONAL. The information about how to appeal your bill is usually printed on the back of your bill. Use a formal letter format with complete addresses at the beginning and end of your letter. Type and print your letter. Include your contact information beneath your hand-written signature. Double-check your spelling and grammar.
4. BE DETAILED AND ACCURATE. Review your bill, and use exact dates, charges, descriptions, account numbers, and invoice numbers. If you spoke to someone on the phone, record the date and time of that conversation and what was said. If there are any special circumstances (discontinuation of coverage, financial difficulty) explain the situation concisely.
5. BE RESPECTFUL. This is not a place for whining, bitter diatribes, and name-calling. Be polite. State your case, point by point. Then move on. Thank your reader for their time.
6. FOLLOW-UP. The appeal process will generally delay the paying of your bill. Don’t let this delay allow you to forget to pay the bill! Call occasionally to check on the processing of your appeal. When a decision is reached, if you still disagree with the outcome, appeal the bill again. If you are satisfied, pay the bill promptly.
7. DOCUMENT YOUR APPEAL. Keep a copy of your letter and any transactions for your records.
So what happened? When I called the hospital a couple weeks after I appealed my bill, I spoke with a secretary. She pulled out my file, and then put me on hold while she spoke to her supervisor. When she returned to the phone, she informed me that her supervisor had “decided to write off the balance as a consideration for the inconvenience it had caused me.” I saved $99.92 for writing a one-page letter of appeal. Success!