Unexpected Medical Bills
There are many reasons you may receive a medical bill you were not expecting. For example:
- You received a service from a healthcare provider who is not an “The group of doctors, hospitals, pharmacies, and other health care providers who have agreed to provide care to members of your health insurance plan. Your health plan will usually cover more of the cost of these providers.” provider, meaning that the provider is not included in your A type of insurance that pays for some or all of your medical expenses.
- You received a service that is not a “Covered Benefit,” meaning that it is not covered by your health insurance plan.
- You did not obtain a proper A referral is an order from your doctor for you to see another kind of doctor or get a medical service. You often need a referral for your health plan to cover the care. from the Indian Health Service (IHS) through A program that pays for medical services that are not available at Indian Health Service or Tribal facilities. Used to be called Contract Health. (PRC) to get care from a non-IHS provider.
- You did not notify PRC within 72 hours of receiving emergency services.
- You were a victim of identity theft, meaning that someone else used your private identifying information.
- There was an error in the billing process, for example, your health insurance wasn’t billed.
- There was an error in processing payment, for example, a computer glitch.
How To Resolve Unexpected Medical Bills
Resolving an unexpected bill can be time-consuming and difficult. Follow these steps, and if you need more help, you can talk to someone at the New Mexico Aging and Disability Resource Center or call (800) 432-2080 or TTY (505) 476-4937.
Bill Paying Assistance
If you need help paying a medical bill, call your healthcare provider. Most providers have a Patient Financial Services office, where you can speak to someone about financial assistance or setting up a payment plan.
If you are eligible and signed up for A joint federal and state program that helps with medical costs for some people with limited income and resources., they will pay for medical care that you received in the three months prior to your application, as long as your income was not substantially higher in those three months. The easiest way to find out whether you qualify for coverage, to apply, and to get help with the Medicaid form, is to contact the Benefits Coordinator at your local IHS or Tribal clinic. You can also get help from a BeWell NM Healthcare Navigator for Native Americans at (855) 241-8137.
If you have The federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant)., contact the New Mexico Aging and Disability Resource Center at (800) 432-2080 or TTY (505) 476-4937 for counseling and information.
You may want to have the following information handy to help determine your eligibility when speaking with Patient Financial Services:
- The personal information of the person who received or will receive care
- Identification card or driver’s license
- A federal program that provides retirement, disability, and survivor benefits. Most Social Security benefits are based on taxes that you paid on your wages while working. card
- Insurance cards
- Discharge forms
- Proof of residence
- Proof of income, such as a pay stub, income tax return, or bank statements