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Surprise Medical Billing Can Cost You
When it comes to surprises, an unexpected medical bill that isn't covered by your insurance is one of the worst kind. But that's the experience of 57 percent of patients. And these uncovered medical bills are so costly that they are the reason for two-thirds of bankruptcies in America today, according to the Kaiser Family Foundation.

Where Surprise Billing Happens
You are most likely to receive a surprise medical bill if you are admitted to an ER, check into a hospital for treatment, or seek care at a freestanding Urgent Care. And that's true even though you may have verified ahead of time that the facility is covered by your insurance. The problem happens when an out-of-network provider - such as an anesthesiologist, radiologist or some other specialist - treats you. 
Only afterwards will you discover that these providers were out-of-network, when your insurance company refuses to pay any or all of their bill. Instead, you're on the hook for something called "balance billing." And the rates can be exorbitant, often many times greater than an insurance company would have paid, even for the simplest of procedures and care.

Congress has been trying to come up with a solution to these surprise medical billings. One piece of legislation would subject these bills to "benchmarking," a process that requires insurers to pay out-of-network providers the median in-network negotiated rate for that service based on what's common in your community. 

Of course, that approach will dramatically reduce the profits of those providers now largely responsible for generating these surprise bills, usually big private-equity firms.  It hasn't been in their interest to negotiate a reduced fee with insurance carriers. Instead, by remaining outside the system as out-of-network providers they're able to charge however much they want. That's why they are so opposed to the  benchmarking approach to solving the surprise medical billing crisis.

Instead, they are pushing an alternative legislative approach Congress is considering, called "Independent Dispute Resolution," which requires patient and provider to submit competing proposals to an independent arbitrator.

There's a lot of money at stake in this medical care debate, which explains why many of us throughout the country are being subjected to dramatic television ads portending rampant closures of hospitals, doctor shortages, even drastic cuts to Medicare and Medicaid if either of these proposed legislative solutions passes into law.

Protect Yourself
Unless and until Congress acts, it's incumbent on us to protect ourselves. So consider these tips:

Mistakes happen all the time, with errors occurring in about eight out of 10 hospital bills. So check them over carefully. If charges seem too high, ask to have each service itemized.
 
If you've confirmed that a medical charge is subject to "balance billing" and is your responsibility, try negotiating a lower fee. It will help your case if you can cite the in-network cost for the care provided. Ask the provider if they're willing to accept this rate.

If you strike out in negotiations, you might be able to appeal the bill with your insurance provider. But in the meantime, to keep the bill from being sent to collections, make sure you reach out to the care provider to let him or her know you're disputing it. 

If you're ultimately unsuccessful in negotiating a bill down to a manageable level, ask for a payment plan that you can afford. 
 

 

September/October  2019

 



In the meantime, if the topics covered in this newsletter raises issues or concerns you may have about your own financial strategies, we'd love to hear from you!


Hal Schwartz
DMG Financial Advisors Group
Chief Investment Officer
Managing Partner
 


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A Mixed Bag of Economic indicators
Let's take a quick look at some of the indicators you may be hearing about and what these could potentially mean for the future.

Gross domestic product (GDP)
There are a series of trouble spots that could suppress fourth quarter GDP. For example, China's economy is slowing down and the Chinese US  trade war is impacting our own exports. These indicators, among others, have many predicting slow growth for the fourth quarter.
 
Purchasing Managers' Index
The holiday shopping season is approaching, a time when consumer spending often lifts many sectors. It's possible that the PMI  may trend upward for the next few months. Pay attention to October's PMI, as it  may be a good indicator of how the economy  at the end of the year will fare.

 
Federal Deficit
The federal deficit is expected to end the fiscal year at $1 trillion, a level,  though not without precedent, is certainly one that causes concern.

 
Unemployment Rate
The tightening of  immigration - both legal and illegal - has made it increasingly difficult for employers to find workers for open positions. That makes it even more likely that  unemployment will remain low, barring a major economic downturn.
 
New Job Creation
With holiday seasonal hiring about to begin, it' s likely that new jobs cr eated  will tick up con siderably. If not, it's a sign of concern for the health of the economy.

Inflation
With this year's rate remaining below the 2.0 percent benchmark of a healthy economy, it's definitely an indicator to watch carefully over the next few months as the holiday season begins. 
 
Wage Growth
With the tight labor market and seasonal hiring about to hit high gear, wage growth may tick upwards toward the end of the year. If not, it's cause for concern.
 
Net Wage Growth
Though wages may rise a bit as we approach the holidays, so might the cost of goods and services, as consumers start shopping more, making likely that net wage growth will remain steady. 
 

 



Spooky Octobers 
During the first two days of this October, the Dow Jones Industrial Average was down over 750 points, joining a long history of rough Octobers for the financial markets over the years.

But here's something interesting to note: Out of the 14 biggest market drops during the first three days of October over the last 100 years, 12 of those years saw big increases in the market for the balance of the month . . . and then the rest of the year. 

Taking the contrarian view, you could almost say it's a good thing when there's a market drop in during the first three days of October. For instance, in 1998, during the worst October 1st in history, the market fell 3.01 percent but rallied to +11.38 percent for the month and ended the year at +24.62 percent! 

Who knows what the balance of the year will portend, however. It could be a trick or a treat!


 


Visit Us Online
Our website has lots of resources and timely information about financial products and strategies that may help you meet a wide range of your goals for yourself, your loved ones and your family.

Check us out online at dmgadvisorgroup.com


 
Copyright 2019. DMG Advisor Group LLC. Main office:  7114 West Jefferson Ave., Suite 305, Lakewood, Colorado  80235 800-983-4448, 303-470-5664.  Securities and advisory services offered through Stephen A. Kohn & Associates, Ltd., (SAKL) member FINRA/SIPC/MSRB. SAKL is separately owned and other entities and/or marketing names, products or services referenced here are independent of SAKL.  Neither SAKL, nor its representatives, offer tax or legal advice. Visit us online at dmgadvisorgroup.com


Federal income tax laws are complex and subject to change. The information in this newsletter is based on current interpretations of the law and is not guaranteed. Neither the company nor its representatives give legal or tax advice. Please consult your attorney or tax advisor for answers to specific questions. To best serve you, we need to be kept current on your personal situation.  Please let us know if you have any changes in your financial status including employment changes, raises, promotions, change of objectives, or in your personal status such as marriage, divorce, birth of a dependent, or change of address.