WEBVTT - Avoid & Combat Crushing Medical Debt w/ Dr. Virgie #716 0:00:00.080 --> 0:00:03.040 Welcome to How to Money. I'm Joel and I am Matt, 0:00:03.120 --> 0:00:06.520 and today we're talking how to avoid and combat crushing 0:00:06.559 --> 0:00:09.480 medical debt with doctor Virgie Ellington. 0:00:28.640 --> 0:00:32.400 Deest of the leading cause of personal bankruptcy is you 0:00:32.479 --> 0:00:36.760 guessed it, medical bills. So when a singular expense like 0:00:36.760 --> 0:00:39.400 this is such a blight on our personal finances, you 0:00:39.440 --> 0:00:41.120 better believe that we're going to spend a minute on 0:00:41.400 --> 0:00:44.960 how we can not only eliminate medical debt, but just 0:00:45.040 --> 0:00:47.400 avoid it in the first place. So here are some 0:00:47.400 --> 0:00:51.840 some more sobering statistics. And estimated one hundred million Americans 0:00:51.840 --> 0:00:55.000 have amassed nearly two hundred billion dollars in medical debt, 0:00:55.240 --> 0:00:57.960 and nearly one in five adults have medical debt that 0:00:58.040 --> 0:01:00.400 is currently in collections. This is according to us study 0:01:00.920 --> 0:01:03.840 by the Journal of the American Medical Association. And that 0:01:04.040 --> 0:01:07.399 is why we're happy to have doctor Virgie Bright Ellington 0:01:07.480 --> 0:01:11.440 joining us today on the pod. She obviously, I said doctor, 0:01:11.480 --> 0:01:15.119 so she's an insider and her book Crushed Medical Debt. 0:01:15.240 --> 0:01:16.880 It outlines the steps that we need to take to 0:01:17.000 --> 0:01:19.640 ensure that we're not paying money that we don't owe 0:01:20.080 --> 0:01:23.600 so we can avoid becoming one of those statistics. I 0:01:23.640 --> 0:01:25.640 just mentioned earlier. So doctor Virgie, thank you so much 0:01:25.640 --> 0:01:27.040 for joining us today on the podcast. 0:01:27.440 --> 0:01:29.520 You know what, thank you so much for having me guys. 0:01:29.560 --> 0:01:31.600 It's awesome talking with you. Yeah. 0:01:31.680 --> 0:01:34.679 No, we're really excited for this conversation because I think 0:01:34.680 --> 0:01:37.040 a lot of people might say bull ring, but Matt 0:01:37.120 --> 0:01:40.800 just highlighted so many rings. Yes, it's like money. 0:01:40.800 --> 0:01:42.280 It is not boring exactly. 0:01:42.520 --> 0:01:44.520 And we like money, and we like keeping money in 0:01:44.600 --> 0:01:45.720 our pockets, and this we want. 0:01:45.600 --> 0:01:46.440 To keep your money. 0:01:46.720 --> 0:01:49.800 Yes, this is a place where we get separated from 0:01:49.800 --> 0:01:52.000 our money. So it's really important to talk about. But 0:01:52.280 --> 0:01:54.280 the first question we have for everybody who comes on 0:01:54.320 --> 0:01:56.760 the show is Matt and I we like to splurge 0:01:57.000 --> 0:01:58.480 a little bit into here and now on a couple 0:01:58.560 --> 0:02:01.080 things we enjoy. One of those things is craft beer, 0:02:01.200 --> 0:02:03.240 even though I know you're a doctor and you might 0:02:03.280 --> 0:02:06.240 say it's not the ideal choice, right, but that is 0:02:06.280 --> 0:02:09.160 something we do enjoy. And moderation. What is that thing 0:02:09.200 --> 0:02:10.960 you like to splour John in the here? Now? What 0:02:10.960 --> 0:02:13.000 do you spend more money on in your personal life 0:02:13.040 --> 0:02:15.240 while you're also still making wise choices for the future. 0:02:15.960 --> 0:02:19.600 I have to tell you, guys, it is sushi and 0:02:19.600 --> 0:02:21.440 It's one of those things that sneaks up on you. 0:02:21.440 --> 0:02:23.840 You write with any addiction, you don't realize you trouble 0:02:23.960 --> 0:02:27.000 until something happens right is just matched in your face. 0:02:27.440 --> 0:02:30.440 And I am just so thrilled and fortunate that my 0:02:30.520 --> 0:02:34.600 favorite sushi place delivers and I'm just like doing my thing. 0:02:34.760 --> 0:02:38.120 And then the day after Black Friday, so the day 0:02:38.120 --> 0:02:43.000 after Thanksgiving one year, I order my sushi usual thing 0:02:43.520 --> 0:02:45.920 and the guy, you know, just really sweet, you know, 0:02:46.280 --> 0:02:49.799 kind guy with his usual smile, has in one hand 0:02:50.040 --> 0:02:53.079 the sushi bag and then the other hand a big 0:02:53.200 --> 0:02:57.400 giant bottle of sake. And it hit me. I was like, 0:02:57.600 --> 0:03:00.520 I spend so much money with these folks, just like 0:03:00.880 --> 0:03:02.840 they're like, okay, we're going to get in on, you know, 0:03:02.880 --> 0:03:06.919 giving our best customers a big giant pressure. And that's 0:03:06.919 --> 0:03:08.680 when I figured out, you know what, Virgie, you have 0:03:08.760 --> 0:03:13.160 a problem. We're spending too much with a lot of 0:03:13.160 --> 0:03:14.000 money on sushi. 0:03:14.760 --> 0:03:17.760 Okay, then quick follow up. Do you like the the 0:03:17.800 --> 0:03:20.040 different roles that they make, you know, with the different ingredients, 0:03:20.120 --> 0:03:23.200 or do you like the super fresh, high end cutting 0:03:23.240 --> 0:03:25.680 meat there just on that perfectly formed piece of rice? 0:03:26.120 --> 0:03:31.440 You know what? I really I'm pretty predictable. I really 0:03:31.560 --> 0:03:37.080 enjoy the salmon, that fresh salmon surrounded by carbs. You know, 0:03:37.120 --> 0:03:41.280 there's just nothing like pure white rice carbs. It's also 0:03:41.480 --> 0:03:44.440 a little bit of extra fat that mouth feel with 0:03:44.480 --> 0:03:47.760 the avocados. So my thing right when I'm trying to 0:03:47.800 --> 0:03:50.200 be healthy and be a good girl is the salmon 0:03:50.200 --> 0:03:54.400 avocado role. But when I am being a bad girl, 0:03:54.800 --> 0:03:58.760 I always have to get this shrimped tempearl with it fry. 0:03:59.200 --> 0:04:01.560 Oh yeah, be that so that's. 0:04:01.440 --> 0:04:04.240 Me they again, these guys have my order down cold. 0:04:04.280 --> 0:04:06.680 I love it. Yeah, that's so good. Speaking of that 0:04:06.760 --> 0:04:08.640 rice that those cars, I've been trying to talk Joel 0:04:08.680 --> 0:04:11.960 into getting the high end rice that they sell at Costco. 0:04:12.000 --> 0:04:15.000 It's like three times the price of the cheaper stuff. 0:04:15.000 --> 0:04:16.320 But it's so much. But when you buy a back 0:04:16.360 --> 0:04:18.960 in Costco, it's still last year, five years. You're still 0:04:19.560 --> 0:04:21.120 exactly all. 0:04:21.160 --> 0:04:23.960 Right, doctor Virgie. Let's let's kind of dive into talking 0:04:23.960 --> 0:04:28.160 about medical debt, and you know, like here on the podcast, 0:04:28.600 --> 0:04:30.000 like I don't think there's much reason for us to 0:04:30.040 --> 0:04:34.080 talk necessarily about like policy shortcomings and how this impacts 0:04:34.120 --> 0:04:37.080 millions of folks across the country quite untimately, every year. 0:04:37.120 --> 0:04:40.600 But given the lack of political will and output and 0:04:40.720 --> 0:04:43.720 changes we've seen oftentimes seen that we were just left 0:04:43.720 --> 0:04:47.080 to advocate for ourselves. Is that your experience and what 0:04:47.120 --> 0:04:49.080 you've seen working with patients, This. 0:04:49.200 --> 0:04:54.159 Is the problem, guys. The issue is is that in 0:04:54.200 --> 0:04:59.080 the United States, in order to have medical financial literacy, 0:04:59.720 --> 0:05:03.360 you it's just it's really really people feel like it's 0:05:03.400 --> 0:05:06.680 impossible to have. But in the United States, you have 0:05:06.800 --> 0:05:11.680 to have medical financial literacy in order to have financial stability, period, 0:05:12.080 --> 0:05:16.600 because most Americans, even those of us with fabulous insurance, 0:05:17.040 --> 0:05:20.400 are just one accident or serious illness away from a 0:05:20.440 --> 0:05:25.560 lifetime of debt or worse. And so people think, well, 0:05:25.800 --> 0:05:29.440 we don't have any other choice. You know that we're 0:05:29.520 --> 0:05:32.360 just stuck with this system, and it's an expensive system, 0:05:32.360 --> 0:05:35.480 and it is what it is. No, that's the bad news. 0:05:35.800 --> 0:05:38.320 The good news is, no, it doesn't have to be 0:05:38.480 --> 0:05:40.880 this way. It doesn't have to be that way. So, no, 0:05:41.440 --> 0:05:45.560 we have control over not getting taken advantage of. We 0:05:45.680 --> 0:05:50.080 have control over not becoming victims to predatory billing. We 0:05:50.200 --> 0:05:52.440 just don't know it. Ninety nine point nine percent of 0:05:52.480 --> 0:05:53.400 us don't know it. 0:05:53.920 --> 0:05:56.240 I feel like we've all talked to somebody who says 0:05:56.480 --> 0:05:59.440 I avoided going in to seek medical care because I 0:05:59.520 --> 0:06:02.240 was worried about the financial repercussions of going in to 0:06:02.240 --> 0:06:04.320 see the doctor or going to the hospital. And so 0:06:04.480 --> 0:06:08.760 people will avoid getting the medical care they need sometimes 0:06:08.839 --> 0:06:13.400 because they're scared of the financial outcome, which says a lot, right. 0:06:13.440 --> 0:06:15.640 I mean, that's kind of scary stuff that people won't 0:06:15.680 --> 0:06:18.200 get what they need, they won't see someone who can 0:06:18.200 --> 0:06:19.839 help them with their problem because they're worried about how 0:06:19.920 --> 0:06:20.640 much it's going to cost. 0:06:21.080 --> 0:06:22.880 You know, you guys are talking about the statistics at 0:06:22.920 --> 0:06:27.039 the beginning the top of our conversation, and what's really 0:06:27.080 --> 0:06:31.440 really sad and heartbreaking is scary, is that there's direct 0:06:31.480 --> 0:06:36.240 relationship between having medical bills meaning medical debt meaning it's 0:06:36.279 --> 0:06:38.200 a bill that you can't pay off in total at 0:06:38.200 --> 0:06:43.200 the end of the month, and life span. So people 0:06:43.279 --> 0:06:46.080 put off to your point, people put off getting care 0:06:46.279 --> 0:06:48.280 because they can't afford it. They're afraid of the bill, 0:06:48.600 --> 0:06:51.560 and something that could have been preventative maybe before the 0:06:51.640 --> 0:06:55.880 issue started, or like screening type stuff or something that 0:06:56.000 --> 0:06:59.479 was small gets really really huge and it's really expensive 0:06:59.520 --> 0:07:03.640 and or can shorten your life. So it's real there 0:07:03.720 --> 0:07:06.720 is a lot of statistics that bear this out, that 0:07:06.960 --> 0:07:09.520 the American life span actually is shortened by debt. 0:07:10.040 --> 0:07:12.440 Well, and I mean that everybody's heard of the phrase 0:07:12.680 --> 0:07:15.640 that an ounce of prevention is worth a pound of care. 0:07:15.520 --> 0:07:17.280 Right, if we just would And I always say, you know, 0:07:17.320 --> 0:07:19.320 I tell my family this all the time. I say, 0:07:19.760 --> 0:07:22.000 you know, not a pound of care. I say, worth 0:07:22.080 --> 0:07:26.680 more than ten pounds of care. Ounce of prevention is 0:07:26.720 --> 0:07:29.200 worth more than ten pounds of cure. It's just I 0:07:29.200 --> 0:07:33.120 can't even begin to tell you believe that it's a 0:07:33.160 --> 0:07:36.720 big deal. And you know, the student debt. I saw 0:07:36.720 --> 0:07:39.080 you guys are talking about that the other week. The 0:07:39.120 --> 0:07:42.880 student debt or student loan pause is ending, you know, 0:07:42.880 --> 0:07:45.920 at the end of this month, so basically all of 0:07:45.960 --> 0:07:48.960 the payments are now due again as of October first. 0:07:49.480 --> 0:07:51.960 There's a study that came out last week that showed 0:07:52.360 --> 0:07:58.120 those folks with student debt have lower health outcomes and 0:07:58.400 --> 0:08:03.560 higher essentially medical more medical problems, and actually end up 0:08:03.560 --> 0:08:06.720 having more medical bills because they're cutting back on other 0:08:06.800 --> 0:08:09.960 things trying to make those student debt payments. So there's 0:08:09.960 --> 0:08:16.240 a direct relationship between debt and destroyed families, destroyed lives, 0:08:16.320 --> 0:08:18.720 and financial futures. 0:08:18.560 --> 0:08:21.040 Sure, and foregoing some of that care. That would be 0:08:21.320 --> 0:08:24.240 the classic example of being cheap versus frugal, which we. 0:08:24.240 --> 0:08:29.480 Talk penny wise pound for sure exactly. 0:08:29.800 --> 0:08:32.839 Okay, So what you kind of I mean, you launched 0:08:32.880 --> 0:08:34.240 into your book right like right out of the gate, 0:08:34.280 --> 0:08:36.480 you kind of give some different case studies, and you 0:08:36.640 --> 0:08:41.160 gave one where you were documenting basically signing an agreement 0:08:41.280 --> 0:08:45.680 for these services before there was any services being provided. 0:08:46.080 --> 0:08:49.080 So how common is this tactic? And you know, is 0:08:49.080 --> 0:08:52.080 there a chance that if you are faced with one 0:08:52.080 --> 0:08:53.480 of those and it feels like you're being pressured to 0:08:53.480 --> 0:08:55.040 pay that, is there a chance that you would potentially 0:08:55.040 --> 0:08:57.760 not receive care, you know, were you to actually refuse 0:08:57.760 --> 0:08:59.440 signing one of those questions? How does that work? 0:08:59.760 --> 0:09:02.240 You know? And I laugh. I always say this. I 0:09:02.280 --> 0:09:04.680 laugh so I don't cry. And that's how I got 0:09:04.679 --> 0:09:09.960 into this work really literally was I had been a 0:09:10.679 --> 0:09:13.840 internal medicine physician for god knows how many years, and 0:09:13.920 --> 0:09:17.200 I was a health insurance executive, which gave me a 0:09:17.200 --> 0:09:21.000 complete three hundred and sixty degree total view of the 0:09:21.120 --> 0:09:24.640 US healthcare system and how it works, or so I thought, 0:09:25.120 --> 0:09:29.040 until I became a patient and met Mia, my hospital roommate, 0:09:29.120 --> 0:09:32.520 who told me she had been tripped into signing a 0:09:32.679 --> 0:09:36.199 bill or agreement I should say to pay a bill 0:09:37.120 --> 0:09:40.320 that I was pretty sure she didn't owe, but I 0:09:40.400 --> 0:09:43.560 was definitely sure it was putting her and her family 0:09:43.559 --> 0:09:47.360 into a lifetime of debt. The thing is is that 0:09:48.200 --> 0:09:51.480 in an emergency situation, when you go into an emergency room, no, 0:09:51.559 --> 0:09:53.840 you don't have to agree, you don't have to sign anything. 0:09:54.559 --> 0:09:57.840 The care has to be provided to you until you 0:09:57.920 --> 0:10:01.240 are stabilized. Once you're stabilized, they can ship you out 0:10:01.240 --> 0:10:04.000 to someplace else that gives charity care or free care, 0:10:04.920 --> 0:10:08.400 that kind of thing. My point to her was when 0:10:08.440 --> 0:10:10.720 I was talking with her, she was telling me the 0:10:10.720 --> 0:10:12.720 story about the last time she had been in the 0:10:12.760 --> 0:10:16.439 hospital the year prior, and it was for the same thing. 0:10:16.520 --> 0:10:18.480 She was being worked up, something happened, and they were 0:10:18.480 --> 0:10:21.040 concerned doing these tests on her and kept her for 0:10:21.040 --> 0:10:23.079 a week doing all these tests because they were concerned 0:10:23.080 --> 0:10:26.480 that she was having a rare reaction of rare something. 0:10:27.200 --> 0:10:31.200 And she was telling me that she was really concerned 0:10:31.200 --> 0:10:34.400 about what this is going to cost this current hospitalization 0:10:34.960 --> 0:10:37.800 because and she told me the story about yeah, when 0:10:37.840 --> 0:10:41.120 this happened to me a year ago. One of the 0:10:41.160 --> 0:10:45.920 hospital representatives came in and said, hey, before you can leave, 0:10:46.480 --> 0:10:50.360 you need to sign this, and she explained, well, I 0:10:50.440 --> 0:10:52.360 had insurance, I don't know what they were asking me 0:10:52.400 --> 0:10:55.080 to sign. And guysa she was telling me the story, 0:10:55.120 --> 0:10:58.959 I realized, oh my gosh, they tricked her into believing 0:10:59.640 --> 0:11:04.000 that she had to sign to agree to be balance built. 0:11:04.040 --> 0:11:06.360 And what that means is that if you have insurance, 0:11:06.920 --> 0:11:10.720 if your provider a hospital in this case, is in 0:11:11.040 --> 0:11:14.559 network with your insurance, it means they accept your insurance, 0:11:15.160 --> 0:11:19.560 they have to take whatever the insurance pays them for 0:11:19.640 --> 0:11:23.439 the services that they provide. So let's say that the 0:11:23.640 --> 0:11:27.760 usual care for a service or service, the price for 0:11:27.840 --> 0:11:31.240 a service that they offer is one hundred dollars. But 0:11:31.360 --> 0:11:33.280 the insurance company says, well, if you want to be 0:11:33.320 --> 0:11:36.080 a network with us and have access to our millions, 0:11:36.160 --> 0:11:38.959 hundreds of thousands to millions of patients, then you know 0:11:39.080 --> 0:11:41.040 you're going to have to accept this as payment and 0:11:41.080 --> 0:11:44.920 full and we only pay like ten dollars for this service. 0:11:45.640 --> 0:11:50.640 So that is a contract with between the provider with 0:11:50.920 --> 0:11:55.120 the insurance company saying what they're going to take for 0:11:55.400 --> 0:12:01.520 their members. For this particular insurance company as payment in full. 0:12:01.800 --> 0:12:05.600 Balance billing is going back and saying, hey, yeah, you 0:12:05.640 --> 0:12:08.880 know that service is reprovided for you. Your insurance only 0:12:08.920 --> 0:12:11.400 paid ten dollars. We charge one hundred, so you owe 0:12:11.480 --> 0:12:12.360 us ninety dollars. 0:12:13.320 --> 0:12:16.280 That's breaking balance that agreement right with the insurance company. 0:12:16.400 --> 0:12:21.440 That is essentially contract fraud because the person who is 0:12:21.520 --> 0:12:26.600 agreed to the agreed the party that's been affected negatively 0:12:27.040 --> 0:12:31.360 didn't sign a contract with them. The patients don't know that, hey, 0:12:31.600 --> 0:12:34.800 this is balance billing. This is this is essentially contract 0:12:34.840 --> 0:12:37.600 fraud between the insurance company and the provider. 0:12:38.440 --> 0:12:41.920 To talk to me about also just medical billing errors, 0:12:42.080 --> 0:12:44.720 and there's I think you said in your book that 0:12:45.080 --> 0:12:48.160 estimates are that ninety percent of medical bills contain errors. 0:12:48.360 --> 0:12:50.439 So balance billing is an issue, but so is that 0:12:50.920 --> 0:12:54.200 And so if we have insurance, are they finding and 0:12:54.200 --> 0:12:57.840 pushing back against the errant bills that we're getting and 0:12:57.880 --> 0:12:59.520 how can we find them in contest them if the 0:12:59.520 --> 0:13:00.880 insurance isn't doing it. 0:13:00.800 --> 0:13:03.480 For us, well, the insurance company isn't going to know 0:13:03.520 --> 0:13:06.079 that you're being balanced bill. Think about it. That's why 0:13:06.320 --> 0:13:10.120 the providers are so ubiquitous and feel comfortable doing it, 0:13:10.160 --> 0:13:11.920 because how is the insurance company going to know that 0:13:12.640 --> 0:13:16.720 their provider that their network with balance built the patient, right, 0:13:16.760 --> 0:13:19.520 They're never going to know. The insurance company isn't going 0:13:19.520 --> 0:13:23.079 to see the bill that the provider sent you. That's 0:13:23.120 --> 0:13:26.880 why it's so it's such an ubiquitous problem. Yes, to 0:13:26.920 --> 0:13:30.920 answer your question, there are studies that say minimum eighty percent, 0:13:31.080 --> 0:13:35.720 but up to ninety percent of all medical bills generated 0:13:35.760 --> 0:13:39.920 in the United States have errors. And if you can imagine, guys, 0:13:39.960 --> 0:13:42.640 they're not going to be in the favor of the patient, right, 0:13:42.679 --> 0:13:44.640 They're going to be in the favor of the provider 0:13:44.720 --> 0:13:49.720 and or the insurance company if you have insurance. So, yes, 0:13:49.840 --> 0:13:53.080 it's a real thing. But this is a caveat, I say, 0:13:53.360 --> 0:13:56.200 And in my experience, what I've seen is that these 0:13:56.280 --> 0:14:01.200 quote unquote mistakes aren't really mistakes. I'm being generous by 0:14:01.320 --> 0:14:03.920 calling the mistakes. And one of the top five mistakes 0:14:03.960 --> 0:14:08.080 I talk about is balance billing. So the balance billing 0:14:08.200 --> 0:14:12.559 we just discussed is one of the top five reasons 0:14:12.600 --> 0:14:15.760 that eighty to ninety percent of us have been overcharged 0:14:16.240 --> 0:14:17.240 with our medical care. 0:14:17.559 --> 0:14:19.440 So it's not in oops, it's intentional. 0:14:19.880 --> 0:14:22.480 Yeah, So let's say that we call you on it. 0:14:22.520 --> 0:14:25.760 You know, we get this bill, Hey, you owe us 0:14:25.880 --> 0:14:28.760 ninety dollars for that service that we charge one hundred 0:14:28.800 --> 0:14:32.120 dollars for, but your insurance only pays ten. If I 0:14:32.200 --> 0:14:35.080 call them up and say, hey, I'm looking I got 0:14:35.080 --> 0:14:37.280 this bill from you guys, and I'm looking at this, 0:14:37.440 --> 0:14:40.480 and it says that you're in network with my provider, 0:14:40.520 --> 0:14:43.560 and I call with my insurance company. Rather, I call 0:14:43.680 --> 0:14:46.120 my insurance company and they say, yes, you are in 0:14:46.200 --> 0:14:49.680 network with them. By definition, in network means that you'll 0:14:49.680 --> 0:14:52.360 take whatever they pay as payment in full for the 0:14:52.400 --> 0:14:57.000 services that you that they cover. Okay, so where's this 0:14:57.080 --> 0:15:01.360 ninety dollars coming from? This is I don't understand. And 0:15:01.400 --> 0:15:04.400 they'll say, oh, gosh, you know what, our mistake, just 0:15:04.480 --> 0:15:05.360 disregard them. 0:15:06.520 --> 0:15:08.880 Yeah, I didn't realize how big of an issue that was. 0:15:09.040 --> 0:15:10.920 Balance billing. But in your book you talk about some 0:15:10.960 --> 0:15:12.840 of the other common errors, and we're going to discuss 0:15:12.880 --> 0:15:15.240 some of the ways that we can discover those errors, 0:15:15.240 --> 0:15:21.520 and we will get some of that right after this break. 0:15:27.160 --> 0:15:29.040 All right, we're back from the break. We're still talking 0:15:29.080 --> 0:15:31.760 about crushing medical debt, how to avoid it with doctor 0:15:31.840 --> 0:15:36.160 Virgie Ellington and doctor Virgie. We're talking about the bill 0:15:36.200 --> 0:15:38.920 you receive. Sometimes it's a balance bill that you should 0:15:38.920 --> 0:15:41.040 have never received in the first place. And so the 0:15:41.080 --> 0:15:42.680 way to combat that is to call and be like, hey, 0:15:43.000 --> 0:15:47.000 call them out on their fake oops. Right, But let's 0:15:47.000 --> 0:15:49.560 talk about some other stuff too, Like when we get 0:15:49.600 --> 0:15:52.680 a bill that we do owe that the insurance doesn't 0:15:52.720 --> 0:15:55.160 fully cover, Well, one, how do we know that it 0:15:55.560 --> 0:15:57.440 is something that isn't fully taken care of by the 0:15:57.520 --> 0:15:59.520 insurance company that we do actually owe, and then how 0:15:59.560 --> 0:16:01.400 do we get to the bottom of Like you talk 0:16:01.440 --> 0:16:03.880 about medical billing codes and it feels like it's this 0:16:03.960 --> 0:16:06.600 completely new language that we have to learn if we 0:16:06.640 --> 0:16:09.880 want to learn how to fight back against medical bills 0:16:10.560 --> 0:16:14.240 in general, Like, how can we know what that system 0:16:14.360 --> 0:16:16.360 entails and learn how to fight back against it. 0:16:16.960 --> 0:16:19.840 Yeah, So the way to figure this all out and 0:16:19.920 --> 0:16:21.600 to not have to think, oh my gosh, what I 0:16:21.640 --> 0:16:23.880 do now? What I do? What do I do and 0:16:23.880 --> 0:16:27.520 not get overwhelmed is just understand there's only one right 0:16:27.600 --> 0:16:31.560 way to pay any medical bill, and it involves three 0:16:31.600 --> 0:16:38.640 simple steps. Step one, the key is CPT codes. CPT 0:16:38.840 --> 0:16:42.600 codes are to medical services what bar codes are to 0:16:42.960 --> 0:16:46.480 products in a retail store. So every medical service you 0:16:46.480 --> 0:16:48.720 can think of getting in the United States has its 0:16:48.720 --> 0:16:56.200 own unique CPT code. So every test, every operation, procedure, outpatient, 0:16:56.320 --> 0:16:59.120 doctor visit, anything you can think of has its own 0:16:59.200 --> 0:17:03.440 unique CEP codes. And that is the currency that is 0:17:03.480 --> 0:17:06.480 saying okay, this is the service that was provided. This 0:17:06.520 --> 0:17:12.639 is the common language between providers and payers. So if 0:17:12.760 --> 0:17:16.480 you want to make sure that you're not getting overcharged, 0:17:16.920 --> 0:17:21.040 get the CPT codes, meaning call the provider and ask 0:17:21.200 --> 0:17:25.240 for a real bill with quote unquote CPT. 0:17:24.840 --> 0:17:27.280 Codes, and that's is that typically known as the itemized 0:17:27.320 --> 0:17:29.119 bill as well, So that's. 0:17:29.640 --> 0:17:34.440 The language is played with. It's a game. So an 0:17:34.480 --> 0:17:36.959 itemized bill. They'll say, yeah, sure, I'll send you an 0:17:36.960 --> 0:17:39.760 item We'll send you an itemized bill and it'll have 0:17:39.840 --> 0:17:42.480 all kinds of details of the things that they they're 0:17:42.600 --> 0:17:45.560 charging you for the services you received, but they don't 0:17:45.600 --> 0:17:49.520 have any CPT codes assigned to them. CPT codes are 0:17:49.600 --> 0:17:53.520 usually about or usually five digits and at the top 0:17:53.560 --> 0:17:56.639 of every bill if you scan it and it doesn't 0:17:56.680 --> 0:17:59.760 have something at the top that says CPT or c 0:18:00.080 --> 0:18:04.280 PT slash kicks picks hcpcs, which is a subtype of 0:18:04.680 --> 0:18:08.919 CPT code, then it's not a real bill. There is 0:18:09.040 --> 0:18:14.680 no insurance organization company in the country period that will 0:18:14.720 --> 0:18:19.240 accept a bill that doesn't have CPT codes. Fly do 0:18:19.600 --> 0:18:25.119 providers send insurance companies different bills, then they send patients 0:18:25.480 --> 0:18:27.760 ninety nine points, I'd say nine times out of ten. 0:18:28.080 --> 0:18:31.320 There are some hospitals that will send a real bill 0:18:31.359 --> 0:18:34.320 the first time without having a call back and request one. 0:18:34.960 --> 0:18:36.399 But if you call them and say I need an 0:18:36.440 --> 0:18:39.720 itemize bill, they'll say, yeah, sure, and it makes them 0:18:39.800 --> 0:18:42.159 very happy. They'll send you a very long list of 0:18:42.480 --> 0:18:44.840 something that even says they'll have codes at the top 0:18:44.960 --> 0:18:48.080 or service codes at the top, and it means nothing. 0:18:48.160 --> 0:18:48.520 Guys. 0:18:48.600 --> 0:18:52.679 It's language that's internal to that organization or to that 0:18:52.800 --> 0:18:57.040 medical system. It is not a CPT code. That is 0:18:57.200 --> 0:19:01.439 the common language that the providers and payers in the 0:19:01.520 --> 0:19:04.800 United States speak for paying for medical care. 0:19:05.200 --> 0:19:07.600 Okay, So once we have those CPT codes for a 0:19:07.600 --> 0:19:09.399 lot of people, it's going to feel like reading Latin, 0:19:09.560 --> 0:19:11.840 going back to high school looking at a dead language 0:19:11.840 --> 0:19:14.199 sort of thing. So what do we do with that 0:19:14.240 --> 0:19:15.640 information once we have it in hand? 0:19:15.840 --> 0:19:18.960 So, yeah, now you finally have your bill, the real 0:19:19.040 --> 0:19:22.600 bill that has CPT codes. And step two, you're going 0:19:22.640 --> 0:19:24.879 to take each of those codes and you're going to 0:19:24.960 --> 0:19:29.120 google what Medicare pays for each of those services. You're 0:19:29.119 --> 0:19:31.840 actually why you're googling. You're doing two things. You're going 0:19:31.920 --> 0:19:34.240 to plug in and let's use an example. I like 0:19:34.280 --> 0:19:38.000 to use a lot CPT nine ninety two one three, 0:19:38.000 --> 0:19:41.479 and that describes a type of outpatient office visit. You 0:19:41.480 --> 0:19:44.760 plug that in, you do an Internet search, Google it, 0:19:45.280 --> 0:19:50.280 and up will pop some descriptions of that code. And 0:19:50.359 --> 0:19:52.919 what you're doing is basically just making sure it sounds 0:19:53.000 --> 0:19:55.960 roughly like the services you believe that you were provider, 0:19:56.000 --> 0:19:58.040 that you were told by your physician that you were 0:19:58.080 --> 0:20:02.320 provided great, and while you're there, you're going to find 0:20:02.440 --> 0:20:08.679 what Medicare pays for that CPT code, for each CPT 0:20:08.880 --> 0:20:13.639 code for which you're being charged now Medicare. The reaction 0:20:13.760 --> 0:20:18.760 I get Joel and Matt often is that people will say, well, Medicare, 0:20:19.520 --> 0:20:23.119 that's for old people. That has nothing to do with me, 0:20:23.840 --> 0:20:27.159 and I say, well, yeah it does, because Medicare is 0:20:27.359 --> 0:20:30.679 the lowest, most fair retail price that is paid for 0:20:30.760 --> 0:20:34.760 medical services in the United States period. So that's the 0:20:34.840 --> 0:20:38.520 number you're looking for. That's the fair retail price you're 0:20:38.560 --> 0:20:41.480 looking to pay. That's the price that shows you're not 0:20:41.640 --> 0:20:47.119 being overcharged, overcharged, or upcharge. For instance, let's say you know, 0:20:47.320 --> 0:20:49.480 God forbid, you had to go into the emergency room. 0:20:50.280 --> 0:20:54.320 You're away a couple hours away skiing and you fell 0:20:54.480 --> 0:20:57.280 broke your arm. Go to the nearest emergency room and 0:20:57.280 --> 0:20:59.200 they're like, you know what they did the X rays. 0:20:59.400 --> 0:21:03.400 You're going to need this set surgically. We'll call the 0:21:03.560 --> 0:21:06.800 orthopedis closer to your home. You can go home. I'll 0:21:07.040 --> 0:21:09.520 just put you in a sling here until you can 0:21:09.560 --> 0:21:13.080 have surgery tomorrow or the day after near your home 0:21:13.119 --> 0:21:15.880 with a provider near your home, or who's a network 0:21:16.119 --> 0:21:19.760 with your insurance if you have insurance. So you go, 0:21:19.960 --> 0:21:23.480 you go home, you get the surgery at the orthopedis 0:21:23.680 --> 0:21:26.800 closest to your home, and a month later, you get 0:21:26.840 --> 0:21:31.560 a bill and you from the emergency room right when 0:21:31.560 --> 0:21:34.960 you're on vacation, and you look at it and you're like, well, 0:21:35.119 --> 0:21:37.400 well no, there's no CPT codes here, So you call. 0:21:37.560 --> 0:21:41.399 You finally get a real bill that has CPT codes 0:21:41.400 --> 0:21:44.359 and you plug them in and one of the CPT 0:21:44.520 --> 0:21:51.520 codes says humoral fracture intervention. So it sounds like well, 0:21:51.560 --> 0:21:54.480 I don't know what humorous is, but fracture it sounds 0:21:54.480 --> 0:21:58.480 like something broken. Okay, But intervention, well, all they did 0:21:58.600 --> 0:22:01.359 was put it in a sling. No, they didn't do 0:22:01.400 --> 0:22:05.320 an intervention. That's an up charge. There is a CPT 0:22:05.520 --> 0:22:08.480 code I'm sure for a sling if they're going to 0:22:08.560 --> 0:22:10.959 charge you for that, but they need to delineate that 0:22:11.040 --> 0:22:13.840 in the CPT codes. They should not charge you for 0:22:15.040 --> 0:22:18.760 fracture intervention. The intervention you had was at your home. 0:22:19.160 --> 0:22:21.159 It was not in the emergency room. So that is 0:22:21.200 --> 0:22:23.439 getting up charged. That's why you're going to take in 0:22:23.520 --> 0:22:27.000 step two. Those CPT codes you work so hard to get. 0:22:27.000 --> 0:22:30.280