Tips To Effectively Manage Hospital Bills

Hospitalisation is generally physically depressing, and can turn into a financial tragedy if you’re not well prepared. Lately,medical care is so expensive and has made access to quality health care a luxury, and even then, the quality is arguable.

While you can’t predict sickness or accidents, there are certain things you can do before and after hospitalisation that help you greatly reduce your medical expenses.

1. Get a medical cover: I can’t emphasise this nearly enough. When you’re healthy, a medical cover may seem like an unnecessary expense, but an accident,1 week’s hospitalization and maybe surgery is all that needs to happen, and you find yourself with a Kshs 1 million plus hole to fill.

Insurance could also sometimes be the difference between life and death. In an accident situation for example, victims are typically taken to Kenyatta Hospital, where sadly if your injuries are serious, you are more likely to succumb to them. With a medical cover, your insurer is able to evacuate you to a better hospital. I experienced this once, when I bled for 20 minutes in the car at the Kenyatta Hospital Accident & Emergency, because the nurses told the wellwisher who had brought us to hospital that he had to find a gurney and wheel us in so we could be attended to. I had insurance so I asked him to take us to Nairobi Hospital, and thank God for that because otherwise I wouldn’t be alive to tell this story. So yeah, spend some money on a good medical cover today, it could save your life.

2. Read the fine print: We have all heard of stories where someone gets sick, and the insurance company refuses to pay the bill or pays less than the person signed up for because of a detail in the insurance policy.

When buying insurance, ignore what the salesman tells you about the cover, and insist on reading the policy document yourself before signing up. There are always special conditions that you should be aware of. For example, most insurance companies exclude pre-existing conditions (health issues you had before signing up), others split the cover amount into two, half for accident related bills, and the other half medical bills. Make sure you are aware of all this before signing up, ask as many questions as you need to.

The other thing, never conceal a medical condition you have when signing up for insurance coverage. If you do and it comes up later, it could void your cover. Insurance contracts operate on outmost good faith (uberrimae fidei) which means that they assume that all material facts relating to the contract have been disclosed by both parties.

3. When hospitalised, be proactive about your bill; Whether the insurance company is paying for you or not, it’s important to constantly check (or have someone check) your bill during your hospitalization, and query anything that doesn’t make sense before discharge. I recommend that you do this every day: itemised hospital bills are extremely detailed, and you may not have the presence of mind or time to study pages and pages of items when you’re getting discharged. Hospitals are known to charge for procedures they haven’t carried out, especially if your doctor had slotted it in then changed his mind, so be careful.

4. Negotiate on fees: Most hospitals consider the doctors independent contractors and expect them to charge their fees directly to the patient. And while insurance companies have negotiated rates with doctors, these are sometimes higher than the market rate because the insurance company takes some time to pay the doctor.

When you realize your cover is running out (or even if it isn’t), it helps to speak to the doctor and agree on a discounted rate on fees.

Where it’s a planned procedure for example child birth, ALWAYS negotiate with all the doctors that will treat you and your child. Doctors are human, in some extreme cases they may even waive part of their fees., when your cover runs out (or is almost running out).

5. If your cover runs out, negotiate for a payment plan:I’ve had the experience of insurance cover running out while in hospital, and it wasn’t very pleasant. The insurance company realized that my cover was almost running out, and they called my next of kin to let her know that they wouldn’t be paying my bill. It was a crazy story but at the end of the day, the insurance company settled the bill with the agreement that if it exceeded my cover, I would reimburse them.

The other option is to negotiate with your employer, for him to pay your bill, then you pay it off slowly.

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