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Billions Spent On Fake Healthcare, How Can Consumers Protect Themselves?

National healthcare spending increased 7.5% year over year in 2023 to $4.9 trillion, or $14,570 per person, according to data recently released by the Centers for Medicare and Medicaid Services. The 7.5% rise represented a much faster pace of growth than the 4.6% increase in 2022.

A 2023 report provided by the Institute of Medicine, “unnecessary services” contributed $210 billion to healthcare costs, emerging as the primary contributor to wasteful spending. In other words, unnecessary expenditures on overuse range from 10 to 30 percent of total healthcare spending.

According to a 2022 Consumer Financial Protection Bureau report, consumers lose $88 billion per year on inaccurate medical bills. A number that is likely to be higher now as health care costs continue to increase.

Healthcare billing and claims expert Scott Speranza, CEO of Health Lock, says Americans are paying billions for health care they never even received.

Speranza tells Florida Daily there are tips consumers should follow when they receive a bill.

Don’t pay the first bill you receive from your provider. The first bill you receive is often not final. Insurance adjustments, discounts, and corrections may still need to be applied. Paying too soon can lock you into charges that might later be adjusted or negotiated.

Always compare your bill with the Explanation of Benefits (EOB) from your insurance provider. The EOB outlines what your insurance covered and what you may owe. Look for discrepancies between the EOB and the bill. If you notice any, request an itemized statement from your provider which can make it easier to identify errors. After errors are corrected by your provider, contact your insurer to make sure the claim has been processed correctly.

Don’t be afraid to ask for a discount. Providers today would rather offer a discount and get paid sooner than wait for insurance payments. Ask about payment plans or hardship discounts if you’re unable to pay the full amount upfront.

Speranza points out some interesting stats on the health industry.

HealthCare.gov Issuers Denied 19% Of In-Network Claims In 2023. In all, insurers reported on 49 million denied in-network claims at the plan level for the 2023 coverage year.

45% of insured, working-age adults reported receiving a medical bill or being charged a copayment in the past year for a service they thought should have been free or covered by their insurance and less than half of those reporting billing errors said they challenged them. Lack of awareness about their right to challenge a bill was the most common reason, particularly among younger people and those with low incomes.

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