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What Questions to Ask Before & During Your Visit

Before the Visit

Network and Billing Confirmation

Key details to confirm:

  • Who will bill for the visit

  • If each billing group is in-network

  • If there were any outside groups involved

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Location and Preventing Facility Fees

Key details to confirm:

  • Where the service will be performed

  • If a facility fee will be charged

  • If one could receive medically equivalent care at a lower-cost facility

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Prior Authorization and Referrals

Key details to confirm:

  • If prior authorization is needed

  • If a referral is needed

  • Who submits the paperwork

  • How could a person know if the approval was confirmed

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Billing Codes

Key details to confirm:

  • Expected CPT codes

  • If the service is preventative or diagnostic

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Cost Estimates

Key requests to include:

  • Ask for a written estimate

  • Ask that all expected services be included in the estimate

  • If uninsured or self-pay:

  • “I am uninsured/self-pay, could you provide me with a Good Faith Estimate in writing that includes all expected services before I schedule anything?”

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During the Visit

Extra Services

Key details to include (when additional tests, imaging, or services or suggested):

  • If these extra services are medically needed

  • If there are alternatives that are less costly

  • If it will raise the amount owed out-of-pocket

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Medication

Key details to ask:

  • Generic availability

  • If location impacts the price of the drugs

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