medical_billing_statement_web.jpgAP Business Writer

NEW YORK — Few things make me feel as clueless as a bill from my doctor's office.

I don't recognize the abbreviations or understand the jargon. I can't tell when I'm being charged too much. And there's no screen on the wall, at least not at my doctor's office, tallying the cost of each extra test I agree to or question I ask.

But, even if you have health insurance, as I do, medical bills can spiral quickly, eating up savings or, in extreme cases, leading to bankruptcy. Here are ways to protect yourself throughout the process.

• Choosing doctors and hospitals: Even people who studiously comparison-shop for their digital camera or winter coat don't always realize they should do the same for medical services. Prices can vary significantly.

If you're thinking you needn't comparison shop because you have insurance, think again. Many insurance plans will still hold you responsible for a portion of the bill in addition to the deductible. And don't assume that choosing a doctor who's in your insurance company's network will solve the problem: Their prices can vary too.

You need to call each doctor's office or hospital you might visit to learn what they charge. The Healthcare Blue Book website, which is free to consumers, can help you figure out what prices might be reasonable. It collects information about the fees doctors accept from insurance companies.

If you're uninsured, ask about a “self-pay” discount. Doctors often charge less to patients who have to pay out of pocket but they generally don't advertise this.

• At your visit: Tell your doctor you need to watch what you spend. He or she may not know the exact cost of each procedure or whether your insurance covers it but will know the relative value of each test ordered. Maybe the doctor can hold off on a few for a couple of months until certain you need them. Or, if you need surgery, maybe your doctor can do it at an outpatient facility instead of a hospital.

It's also important to make sure you've followed your insurance company's paperwork procedures, no matter how ridiculous you think they are.

• The bill: In most cases, you won't see any tally of prices until your insurance company sends you a document listing what the doctor or hospital charged, how much the insurance company paid and what's left for you to cover.

It's a good idea to ask for a line-item bill from your doctor's office or the hospital so you know exactly what you're being charged for. Check for glaring errors: Are the medicines listed on the bill the ones you actually received? Is there lab work listed on a day when you didn't have blood drawn? It's easy for a billing office to accidentally key in “11” instead of “1” and charge you for 10 extra pills or to transpose a few digits in a code and charge you for an injection when you really just got counseling.

• The appeal: If you believe you've been charged for something your insurance company should cover, contact the company first. If it still denies your claim, you have the right, under the new health care reform laws, to ask for an independent organization to review your claim. If your health insurer tries to deny you this external review, contact your state insurance commissioner's office.

Other state agencies also can help you. Check the “Consumer Assistance Program Locator” on the nonprofit Families USA's home page or, a website managed by the U.S. Department of Health and Human Services.

Some for-profit companies also will scour your medical bills for errors and try to get the charges lowered. But these companies will keep a portion of any savings they recover for you, sometimes as much as 35 percent.

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