How to Become a Medical Billing Advocate

If you would enjoy a medical billing career but wish to work more on the side of the patients and insurance companies getting billed for medical care, a medical billing advocate position may be ideal for you. Becoming a medical billing advocate is not very difficult and can contain the same education you would receive for a medical billing career within a medical facility. The major difference in your duties is that you won’t be billing patients and filing insurance claims, but acting as a billing consultant that looks over medical bills to ensure there aren’t any unnecessary or mistaken charges or upcoding present. Upcoding is an act that has been found to be fraudulent and consists of patients being billed for a higher level service than was actually received. This is illegal and as a medical billing advocate, you would be pointing out these errors.

Getting a Higher Education

Just like you would attend a medical coding program or related program in order to enter the medical billing specialist position, you would do the same to become a medical billing advocate. You will be responsible for learning appropriate medical terminology and appropriate codes for billing procedures. You will also be trained on the appropriate procedures for pinpointing billing errors and addressing them properly. It is a federal law that all errors must be reported by the physician to the federal regulating agencies, and you will act as the consultant that checks for these errors.

Entering Into the Position

There are many medical coding consulting agencies that offer the position to those that wish to investigate medical bills and billing procedures. Your main role will be inspection of patient bills and decoding to identify any improper charges or upcoding that have occurred. Once the issue is found, the patient as well as the physician is notified and given appropriate details for making the appropriate reporting measures to the correct agency.

Why Become a Medical Coding Advocate

In a world where health care costs are always on the rise, it is important that there are medical coding advocates to ensure that patients are only billed for the services and resources they receive and no more. You will serve as the voice for the patients, and the insurance for the insurance companies that the payments due are necessary and should have been charged. In the event that you are able to identify any type of fraud, you will be able to ensure that the issue is resolved and the patient only charged what should have been from services.

A medical billing advocate holds a key role in the health care industry with a strong influence over the future of this industry. There are organizations that go further to ensure that policies are enacted to provide security to patients from medical billing fraud. Patients may not be able to decipher medical code, so it is up to you to ensure that there haven’t been any mischarged items on a patient’s bill or insurance claim.

Medical Fraud: A Big Dollar Concern

With reports about identity fraud making waves throughout the news media, it’s especially important for those looking at the American health care industry to consider a specific kind of identity fraud that can be especially expensive for victims. Medical fraud is commonly defined as any kind of identity theft that facilitates the use of insurance or medical information which allows for an unauthorized individual to get access to medical insurance, medical care or other services, or that in some cases, allows for false billing or funneling money directly from the victim to the fraud perpetrator. Learning more about it can help you avoid medical bankruptcies or other problems.

The Numbers on Medical Fraud

Although it may be more obscure than other types of fraud, for instance, credit card fraud, some reports estimate that medical identity theft affects almost two million people in America each year, with an overall monetary impact of over $40 billion. Experts also estimate the costs of medical fraud per victim at over $20,000. That means that this kind of fraud can destroy the budgets of many American consumers or families who become victims of this type of identity theft.

Common Scenarios

Experts suggest that some identity thieves pursue medical fraud in order to get insurance coverage through illegitimate means, while others may be looking to get their hands on prescription drugs that they will sell on the black market. But although these kinds of situations can hit consumers or families out of nowhere, other reports suggest that in many cases of medical fraud, there’s a gray area: the victims of these kinds of fraud may have let their family members misuse their medical information or otherwise been complicit in fraudulent claims or other types of identity theft.

Medical fraud is just one way that the average American family can find itself bogged down in medical debt or otherwise trapped in eternal debt cycles. In order to prevent these kinds of nightmare scenarios, it’s important to safeguard identity information and do regular credit checks and basic financial monitoring. You can also get help from third party medical advocates that understand the health care system and how to fight various kinds of financial challenges to make sure that you and your loved ones are not taken advantage of by a system that often generates extremely high costs. Talking to these types of agencies and organizations can help you gain a better idea of how to prevent medical fraud, unfair denials or bills, or any other financial struggle that could have been avoided through good documentation and vigilance. Get the facts and protect yourself against medical fraud and unfair medical debt for a better financial future.

Struggling To Pay Medical Bills?

People all over the U.S. struggle to pay medical bills. The unpaid hospital bills will pile up quickly from an unexpected illness. Due to the lack of medical insurance, you may have received a minimum level of treatment and were discharged with a recommendation of going to see another doctor. How do they expect you to see another doctor when you can’t afford to pay their medical bills?

This is the sad reality of the medical industry in the United States. While the current administration promises a resolution, what do you do in the mean time? There are options, however none are absolute. Americans neglect their own health issues until their body won’t let them anymore and sometimes it is too late by then. Waiting makes the issues worse yet many cannot afford the preventative measures and checkups necessary. Your health should be a priority, but the expense of medical bills sometimes makes that impossible.

Medical assistance is available through state and federal programs for some people. Those that are offered medical insurance through their employer sometimes can’t afford it or they have it and it is not as effective as it should be. The rates of insurance are high, the deductibles are high, the co pays are high and the percentage the insurance covers is low. For those who do have insurance these numbers still equal needing help to pay medical expenses.

Medical advocates can help with unpaid hospital bills; however their assistance is limited too. They can find errors in billing and negotiate the numbers, but in the end you still have to find a way to pay medical bills. When there is nothing left to rob from Peter to pay Paul, it is time to consider a different approach to resolve your medical expenses.

Many have not considered bankruptcy to alleviate the stress and financial burden of medical expenses, however many are forced into bankruptcy due to unpaid hospital bills. When you do not have the means to pay medical bills, consult with a bankruptcy professional to help you make the best financial decision.