Grease the Wheels – Important Resources for Avoiding Overpaying for Hospital Bills - Zupnick Associates

(by Elton Mwangi)

Learning the tricks to avoid overpaying hospital bills can come in handy for not only you, but your employees as well. For instance, one of your best employees is moody today. Why? 

They went to see a doctor some time back and have just received a shocking medical bill. They don’t understand why. They have the best health insurance; you offered it.

Two reasons could have led to this tragedy:

  • Errors in medical billing
  • Failure to understand the insurance policy

Hospitals are not immune to mistakes. In fact, 80% of medical bills have errors, which significantly impacts wrongful billing.

Employees may also receive health services from physicians outside the carrier’s network expecting their health insurance to cover everything.

Let’s see how these can be averted.

Tips for Employees to Avoid Overpaying for Hospital Bills

Review the Health Insurance Plan

How can employees avoid surprise medical bills? The first step is to review their health insurance coverage by going through the handbook they got from their insurer. They can also learn about the policy online.

This avoids unexpected out-of-pocket expenses and costly prescriptions for medications not covered by their health insurance. 

Review the Explanation of Benefits

If the health care provider sends your employee their medical bill, they shouldn’t pay before checking the explanation of benefits (EOB). What’s an EOB, you ask?

It’s nothing fancy. It’s a document the insurance carrier sends to the insured detailing the following:

  • Service description
  • Cost of health care provided
  • Medical billing code
  • Amount reimbursed by the insurer
  • Amount owed to the health care provider under patient responsibility

Leverage In-network Providers

Employees who are not careful with the health care provider they visit run the risk of paying complete medical costs out of pocket. The costs are also likely to be inflated.

Nevertheless, the solution is as simple as login into their online health insurance account. They must then find their health insurance plan’s in-network health care providers. These are a network of physicians, hospitals, and other health care providers featured in the carrier’s network.

Depending on the health plan, using in-network providers ensures full or partial coverage of the service as well as negotiated rates.

Get an Itemized Bill

Employees shouldn’t accept medical bills showing only a lump sum they should pay. Why is this so? Let’s say the physician ordered a test that was then canceled. Your employee may be accidentally charged for this service, and they can only determine this if they have a detailed medical bill.

So, they should request an itemized bill and compare it to the EOB.

How Employers Can Help Their Employees Avoid Overpaying for Hospital Bills

Connect Workers with a Billing Advocate

Billing errors result in high medical costs. In fact, out of the over 80% of medical bills with errors, almost 33% of the cases have considerably overstated medical costs. That’s where a billing advocate comes in.

They help your staff by:

  • Reviewing bills for accuracy
  • Disputing inaccurate charges with health care providers
  • Negotiating cost reduction when a worker faces high medical bills

Provide Specialty Pharmacy Services

Expensive medications result in high medical bills. Think of hepatitis C, HIV, nerve pain, and cancer medications; they cost a pretty penny.

What’s more, they can be five times more expensive if administered in a hospital outpatient clinic instead of a physician’s office.

Therefore, specialty pharmacy services are ideal for advising employees on the most cost-effective setting for administering medication and if they are getting the most appropriate medication.

Offer HSA and FSA 

The employee’s health insurance can only pay for so much. When it comes to prescription costs, out-of-network care, deductibles, and copays, Healthcare Spending Accounts (HSAs) and Flexible Spending Accounts (FSAs) are a big boost.

This money is tax-free. For instance, a staff member can contribute up to $2,700 annually in tax-free dollars for an FSA, saving about $670 if they’re in the 25% tax bracket.

What’s more, you can match your employee’s contribution in an HSA, offering them more ammunition to deal with out-of-pocket medical costs.


A small error in medical bills and a lack of knowledge and expertise can cause workers to drown in inflated medical bills. It’s your duty as the employer to empower them with the proper knowledge, right experts, and sufficient financial resources to deal with their healthcare costs.

Do you want happy employees? Low absenteeism? High productivity? You know what to do; give employees the right tools. Contact Zupnick & Associates if you need help.

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