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What you can do to understand costs of your health care, before and after a procedure
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Financial Navigator Monica Morales visits with a patient at the Northeast Georgia Medical Center. - photo by Scott Rogers

Health care can be stressful enough medically. Financially, the toll can be too much to bear. Here’s a breakdown of what to do before and after a procedure, according to area health care professionals.

Before the procedure
  • Check with the doctor’s office, hospital and other providers about cost estimates. For example, patients can get Northeast Georgia Health System estimates by calling the Patient Access Service Center at 770-219-7678.

  • If possible, determine if all services are in-network. Emergency department doctors, anesthesiologists, radiologists and pathologists negotiate their own contracts with the health system, and your insurance plans might not be one they accept.

  • Check with insurance companies to see if certain services are covered and at what expense, taking into account copays, deductibles and other amounts.

After the procedure
  • Watch for an explanation of benefits, or EOB, from the insurance company, listing the charges and most importantly, the patient’s responsibility. One thing to note is how much the provider charges and how much the insurer will pay for the service. If you have a copay, the insurer will cover the difference, if there is one; if you don’t have a copay, such as with a high-deductible health plan, you have to pay the full cost up to your deductible.

  • Check costs outlined in the EOB against the research you’ve done, and call customer service as needed.

  • Take note of the amounts you’re responsible for and agree with — that will give you a head’s up about bills to come in your mailbox, and you can prepare financially.

  • When the bills arrive, carefully study them and, like with the EOB, compare charges to what you have been quoted. Again, if any questions, don’t hesitate to call the doctor’s office or hospital. It’s always best to address them head-on, talking with the office and working out a repayment plan as needed. The hospital’s financial counselors can be reached at 770-219-1898.

Lives on the line

This special weeklong series explores how cost and bureaucracy stand between local residents and their health care. Times reporters pored through the latest Community Needs Health Assessment, conducted numerous interviews with those in the local health care industry and those affected by it and examined the latest efforts by state government and politicians to remedy problems in our health care system. Read other stories in the series at gainesvilletimes.com/livesontheline.

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