A mailbox full of medical bills.

A collection notice.

A denied insurance claim.

Mail doesn't get much scarier for a patient still recovering from open-heart surgery or for someone still feeling ill.

But patients in Wyoming and across the United States experience the three - sometimes panic-inducing - occurrences all the time, said Helen Anderson, who works in the billing office at Casper Medical Imaging.

"If you're sick and you don't feel well … then you think, 'I'm only going to get one bill,' and the next day you get 10 bills," she said. "You get panicky."

Health care reform efforts seek to rectify some of these bad medical experiences, but patients don't have to wait for legislation.

If patients have a better understanding of the insurance-claim billing process and follow some simple tips, they can make paying a medical bill less of a headache for themselves and their providers.

Most people "don't have a clue about billing," Anderson said.

Patients think after they leave the doctor's office or hospital, they are "good to go," said Nicole Trott, director of patient financial services at Wyoming Medical Center. However, billing for a service is not as simple as sending a piece of paper to the insurance company.

"There are a lot of steps from A to Z," Trott said.

A patient comes to the hospital or doctor's office, and an employee puts all pertinent information in the office's system to make sure the insurance company receives a thorough claim.

It can be difficult to get the claim right the first time, as every insurance company wants different information and pays differently, but billing offices try to stay on top of all the companies.

It takes an average of 54 days for the hospital to receive payment after a patient is discharged, Trott said.

Anderson and Trott offer some tips to keep patients from "panicking" when they receive 10 bills for one procedure, prevent collection notices from ever reaching their mailboxes and ensure their claims are paid to the fullest.

* Bring insurance card: Providers need to see an insurance card every time a patient visits. Trott said employers change insurance companies frequently and many patients are unaware of their insurance.

Also, many insurance companies have similar names, Anderson said. If a patient says he or she has Banker's health insurance, that could mean Banker's Fidelity, Banker's Health or Banker's Life and Casualty.

"We need to get that information correct," Anderson said, or the claim could be delayed or denied.

* Call insurance company before you have anything done: Even if it's just to have an ingrown fingernail cut, Anderson said to call the insurance company before the procedure. Patients should make sure the procedure is covered and whether they need any preauthorization.

* Ask who the primary insurance company is: Anderson said many people have multiple insurance carriers, and the doctor's office needs to know whom to bill first. Patients also need to inform providers if they were injured in a car accident or at work, because that could change the primary insurance to auto insurance or worker's compensation.

* Fill out all insurance forms: In January every year, insurance companies send beneficiaries questionnaires to complete. Anderson implores people to not throw these away.

* Read explanation of benefits: Also every January, insurance companies send an "explanation of benefits" to each patient. Patients should not throw these away, either. "Many people don't read an explanation of benefits and then they try to blame the provider because the claim didn't get paid," Anderson said.

* Follow up with the insurance company: Patients should call their insurance providers two weeks after an appointment to see if the providers received the claims. The phone number to call will be on the back of an insurance card. "Patients should take responsibility," Anderson said. "If they don't have it on file, call the office."

* Keep in touch with provider: "Patients, they're not asking, 'Why hasn't my claim been paid?'" Trott said. If patients keep in contact with their providers and insurance companies from the beginning, the claims are more likely to be paid correctly and the patients are less likely to go to collections. Anderson said many providers have payment plans to help patients pay claims that aren't paid. "Don't ignore us," Anderson said. "When you ignore us, that is when we send you to collections."

Contact health reporter Allison Rupp at (307) 266-0534 or allison.rupp@trib.com.