Have you been surprised by a medical bill from a doctor, hospital or another health care provider? Or confused by an “explanation of benefits” document from your insurance company?
Take these steps to try to resolve the problem:
- Call your insurance company to find out what the problem is and how it may be fixed. The phone number for customer service should be on the back of your insurance card.
- If you are being billed because your claim (your medical service or equipment) was denied by the insurance company, ask the insurance company why it was denied.
- Check your insurance plan or handbook to see if the service you received is a covered service, an excluded service that is not covered, or if your insurance company requires a prior authorization or any other steps before it will cover the service.
- Call your provider—the doctor’s office, hospital, etc.—to see if they gave the insurer the right information or if they can help fix the problem. The provider may be able to supply more information to show why the service should be covered.
- Check your appeal rights and deadline. Annual reports from the insurance companies show that people who appeal have a very good chance of winning the appeal. Read our section on Appeals to find out more.
- If your problem involves two or more insurance companies, read our section on Coordination of Benefits.
Patient Financial Assistance
Every hospital in Vermont has a patient financial assistance program. If you have hospital bills that you are unable to pay due to financial hardship, call your hospital and ask how to apply.
Apply as soon possible because each hospital has deadlines. The programs also have income limits.
If you have medical bills that you can’t pay, read our web page about Medical Debt.
If your medical bill is turned over to a collection agency, you have a right to tell the collection agency to stop calling you. See our Medical Debt page for the details.