Episode No. 067

The Only Way To Pay A Medical Bill With Dr. Virgie Ellington

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Did you know that nearly 90% of medical bills contain errors? This means that vast majority of Americans have grossly overpaid on medical bills simply due to lack of knowledge.

Dr. Virgie Ellington is an internal medicine physician and medical billing expert who helps patients learn how to advocate for themselves and avoid financial devastation from crushing medical bills, and today she’s sharing three steps to take to ensure you never overpay on a medical bill again!


The Ethics of Medical Debt

Dr. Virgie: “So the story of how I came to… helping people struggling with medical bills — I was a board certified practicing internal medicine physician for many years and then started working in the health insurance industry as an executive… I thought I pretty much knew the US healthcare system from both sides… 360 degrees…I see all the perspectives. But it wasn’t until, Allison, I actually became a patient. And I had to be admitted to the hospital and my hospital roommate was telling me a story about how the year prior she had been in the hospital…she had a representative from the hospital’s billing department come in and trick her into thinking that she had to sign a waiver saying that she would pay the financial bill, whatever the invoices, even though she had insurance…

If you think about the insurance company and companies on one side, and the providers, the health care systems and hospital systems on the other, they’re both trying to get as much resource as they can. So who’s in the middle? And with no knowledge about the system? The American patient. The public, right? So yeah, Alison…the curtain dropped, literally I saw red. I was absolutely enraged. Because I knew that she was a mom who’s on a very modest income… she wasn’t working outside the home at that point because they had two toddler girls who weren’t in preschool yet. And then [her husband] is working in a 24-hour diner, so I knew that she had just signed away the financial future of her and her family. And I was like, ‘You know what, Virgie. Don’t get mad, get to getting and do something!’And that’s how Christian medical debt was born.

A week after that hospital visit where I realized this was going on, I had to go to have lab work done…and I decided to go to this facility that’s affiliated with a hospital that’s in low-income neighborhood. And I came home crying and told my husband…the way this country takes advantage of poor people is just outrageous. It’s a sin…it’s unethical, it’s immoral. And it may not be illegal, but it’s immoral and unethical.. it’s just horrid. And he said, ‘You know what, Virgie? You can do more. You can educate folks.’ So we created a multimedia platform. So there’s a radio show on Voice of America, Ask the Doctor, where we talk a lot about medical debt.”

The #1 Mistake That Can Destroy Your Financial Future

Dr. Virgie: “The number one mistake that people in their 20s and 30s make that can just destroy their financial future forever is going without health insurance. So in our 20s and 30s… we’re feeling good. We’re looking good. We’re in shape, we exercise, we run, we bike, right? And we’re like, ‘You know, I’m good. I don’t have any medical problems. I’m young, I’m healthy, no problem.’ But the problem is, is that it only takes one injury…God forbid you get hit on the bike…young people can still be diagnosed with a serious illness that can destroy your financial future. So I tell people, yes, it’s really hard to try to talk yourself into saying, ‘You know what, I’m going to pay a monthly premium that’s really stretching my budget. I can’t really afford this…I don’t think I’m ever going to use.’ If you’re age 29 and younger, there’s something called catastrophic health insurance or catastrophic health plans that is kind of structured or governed by the ACA, the Affordable Care Act… what that does is, you don’t have these big monthly premiums like you do with regular insurance. But if something, God forbid, happens, an injury or an accident or a serious illness, then you’re covered. Now, let’s say that you have a nasty virus and you can’t get rid of a cough for weeks and weeks, you go to a doctor or urgent care and you’re diagnosed with bronchitis, that is totally not going to be covered. But, you know, you’re not going to be eviscerated. Now, once you turn 29 – 30, you’re going to have to go into the ACA marketplace and just try to find something that is within your budget in terms of the premiums. It’s better than nothing.

The one thing that’s really important is think about what insurance is for. You don’t buy insurance on your electronic products, when they say Oh, would you like to for a low low price? You have a free checkout? Would you like to buy for 499 a month law? No. Insurance, you buy insurance for things that you can’t afford to replace or pay for yourself?”

The Only Way to Pay a Medical Bill

Dr. Virgie: “99% of the American public doesn’t know that there’s only one right way to pay a medical bill… there are three steps to making sure that you don’t overpay a medical bill.”

Step 1: Request an Itemized Bill with CPT Codes

Dr. Virgie: “When you get a bill… nine times out of 10, it’s usually not an accurate bill…An accurate bill is an itemized bill. An itemized bill is a bill with CPT codes. CPT codes are just like bar codes. When you go into a store, every product has one, right? And you swipe it and the price comes up, the description of the product. Same thing with medical care and medical services…when you go in, you’ve gotten a service. So you expect to get a bill that lists the services that you got. And when you get this crazy thing they send you that has no CPT code to be found anywhere on it, you’re gonna call up and say, I need a bill, an itemized bill, please, with CPT codes.”

Step 2: Compare Costs

Dr. Virgie: “Step two, you’re going to take those codes and you’re going to google them. You’re going to plug them in, you’re going to say CPT code 99213. And up will pop the description of the service and you want to make sure that sounds close to what services you think you’re received. And while you’re there googling things, you’re also going to take that CPT code and plug it in to see how much Medicare pays for for that service. Medicare, the CMS Center for Medicare and Medicaid Services, if it’s good enough for the federal government, you know, why would I pay their manufacturer and retail sticker price? Like on a car, you’re not going to pay full price? Right? I start with Medicare, okay, no more than two times anything other than that. Basically, what you should be paying is a fair rate. Okay, so then you’re gonna take those numbers you’ve added up…So this is what Medicare pays for the the inpatient stay, for a room…. And this is what they charged me for. So you’re gonna take all those, stack them up… what Medicare pays for them?

Step 3: Set up a No-Interest Payment Plan That Fits Your Budget

Dr. Virgie: “Call back the billing department. And that’s when you negotiate… You’re going to take that number, and you’re going to say, ‘You know what, this is what I’m able to pay. Can you give me an interest free payment plan?’ Make sure they don’t charge you interest — an interest free payment plan that fits your budget. And it doesn’t matter, Allison, how long it takes. Make sure it fits your budget. Let’s say you have a $20,000 bill that you realize, okay, this is the price that Medicare would pay for it, or no more than two times Medicare, and you’re like, I can only afford $250 a month, that’s all my budget can do. And I’m squeezing every little dime, that’s the best I can do. And you tell them that you know what, I can do this, and I need an interest free payment plan for $250 a month to get this $20,000 bill, and you’re gonna get a response probably like, ‘that’s gonna take forever, that’s going to take years it will take 10 years to pay off’ And you’re like, yeah, I realize that. But this is what I can afford to pay. This is the only thing that’s in my budget. And the reason why you want to stick to your guns and why eventually they’ll accept it, Allison, is because…a little bit of something is better than all of nothing, right? And they’re saving money by not having to chase you down the road, or potentially having to sell it at a discount or for pennies on the dollar to debt collectors and that kind of thing. So those are the three steps. You have to apply it to every single medical bill. Please, please, every single medical bill you get in the future. First, laugh when you see a what they call a bill. They’ll have this big number, and it will say due date by ___. And they’ll have a phone number next to it. And you know, when you call up… ‘Oh, can you tell me what you sent the insurance company? My insurance company? This is a bill I got but how much — I’m unclear with your summary bill here, how much my insurance paid?’ And they say ‘Oh, we can’t give you that information. We don’t know.’ It’s all a lie. Per HIPAA, they have give you access and the right to every single thing affiliated with your medical care, including any bill sent to anybody, anything remotely related to your care. And if you start using HIPAA, ‘as per HIPAA, I would like an itemized bill with CPT codes, as per HIPAA guidelines.’

Dr. Virgie: “We’re humans, you know, we get sick, we get injured, life happens. And we can’t be penalized and have our lives taken from us or future taken from us, our homes, our children’s college savings, because we’re human, because we’re living creatures. Always, always, always stick to your budget…it’s really important to make sure that you have a budget…and I know, Allison, you have a free budgeting class, if you’re just getting started, please, folks, please, take advantage of resources like this a free budgeting class! And then you’ve got this great information, you’re going to be protected and not get taken advantage of with a bill.”

Dr. Virgie Ellington

Links Mentioned:
Crushmedicaldebt.com
Podcast – Ask a Doctor – What Your Doctor Wants You to Know with Dr. Virgie
Book – What Your Doctor Wants You to Know to CRUSH MEDICAL DEBT

Follow Dr. Virgie:
Facebook | Instagram | LinkedIn | Twitter

Resources:
Free Budget Class

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Meet Allison

Allison Baggerly is a blogger, author, influencer, speaker, podcaster, and founder of Inspired Budget, which is proudly a Latinx and women-owned business. A former teacher, Allison blends her talents for teaching with her passion for personal finances to help others learn how to start budgeting and build a life they love.

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