Do You Need a Medical Billing Advocate?

Do you have a stack of unpaid medical bills? Not sure if you really owe all that your doctor or hospital bill is claiming you do? Did your insurance cover less than you thought they would? Do you have an elderly relative that has been ill and the bills are piling up?

If you have answered yes to any of these questions, it may be time to consider hiring a medical billing advocate to review your bills to determine if you owe what is being claimed. After all, it is reported that 8 out of every 10 medical bills contain errors, and the majority of patients and consumers have no idea that they are being over-charged for medical services that have been rendered (and sometimes not rendered at all). It’s not unusual for billing advocates to detect data entry errors, unbundling of charges (charging for procedures separately, when they are included in one code) erroneous billing for services never received – honestly, the list is infinite.

If your insurance company rejects a service, the provider may simply send you the bill rather than researching and resubmitting the charges for payment. How would you know if this is the case? How would you know that your insurance should cover the charge? It’s so important to have someone knowledgeable review your bills so that you aren’t placed in a position of feeling coerced into paying medical bills for which you may not even be liable.

Medical Billing Advocates review your bills by combing through them, line by line, and also carefully examining the explanation of benefits from your insurance company. They will subsequently compare the charges to your medical records, to ensure that you did in fact receive the services for which you are being billed. This will leave you with peace of mind, knowing that you are only paying for services that were legitimately rendered, thus eliminating the risk of paying thousands of dollars of medical bills for which you are not responsible.

You can be certain that Medical Billing Advocates have the expertise needed, and thorough knowledge of the codes used and how to read a medical record to determine if all charges are appropriate. Additionally, professionals will know what codes can be billed together, and what codes cannot, and when the provider is required to write off charges that have been billed in error, and when you are actually responsible.

It’s time to be proactive. Remember, it’s within your rights to obtain all the assistance you need, and it’s unnecessary to pay another dollar for which you are not responsible.

Ways to Pay Off Medical Bills If You Don’t Have Healthcare Coverage

The impact of health insurance premiums and treatment costs continues to be a major concern for consumers. In addition, a recent industry survey indicated that 77% of consumers struggled using their health insurance in the past year. While we anticipate what’s to come on the healthcare landscape, here are some ways to reduce and or at least manage your medical costs, with or without insurance.

  1. Speak Up: Let your healthcare provider know how medical costs can impact your personal situation. Most providers provide quality care. Sometimes, this could mean extra costs to you. However, if you plainly explain to your doctor your concerns and are seeking ways to keep them in line while effectively treating your condition, s/he can prepare a treatment plan with this in mind.
  2. Unnecessary Procedures: Understanding your sensitivity to costs, your physician might eliminate less necessary tests or delay tests, if possible, without compromising your situation.
  3. Generic Medications: Costing up to 80% less and just as effective as brand names is a good way to reduce the prices of your prescriptions. There are a number of good resources for this.
  4. Online Research: Do your homework before the procedure to compare costs in your area. Use this information as a guideline. Remember, there are many factors in determining why a procedure costs what it does. In addition, contact your own insurance plan or use their cost estimator tool.
  5. Right Facilities: Urgent care clinics can cost a fraction of hospitals and emergency rooms when it comes to doing procedures, tests or blood tests. These are good for non-emergency care.
  6. Cash Payments: If you can pay cash, ask about cash discounts. It’s less work for the administrative offices.
  7. Payment Plan: Avoid putting a large medical bill on a credit card. Instead, ask if you can pay using a pay plan. Most providers offer this and in some hardship cases, they might even reduce what you owe. Find out what your doctor’s payment options are.
  8. Medical Advocates: For complicated cases, a medical or patient advocate offers services including helping to research treatment options, tracking paperwork and negotiating lower rates. You may have to pay a fee but it can help unravel complex paperwork or lower outstanding medical costs.
  9. Billing Mistakes: Check your explanation of benefit (EOB) statements to make sure they are correct. Compare them to your actual bill. Industry studies suggest many bills contain errors because of incorrect coding and other reasons. Do not hesitate to call the billing department or your insurance plan’s support hotline to get to the bottom of the bill if you suspect it is incorrect or simply want clarification.
  10. Understand Your Medical Insurance: Make sure your insurer is still in your market and that your provider and facility remains in-network. Many consumers are shocked when they receive a bill they thought would be covered by their insurance only to find out the provider or the facility was out of network with their plan.

Hospital Forgives Medical Debt For 90 Year Old

A Colorado hospital forgave over $21,000 in medical debt for a local 90 year resident. Despite all the stories we hear bashing health care providers, a story where a hospital shows compassion is a welcome change of pace.

My client, Liz, owed a local hospital for services received in 2008 as a result of an accident. Liz was not eligible for Medicare, and had private insurance. After admittance to the hospital on an emergency basis, she remained there for rehabilitation treatment. Her claims were paid at out of network level, leaving her with significant balances owed. While she made small monthly payments, she never really understood why she owed all that she did and how she got into this mess.

Liz had no family to help her and lives in downtown Denver. When she called me, she pleaded with me to come down to Denver and meet with her to help her, as she was very confused about all of her medical bills. I made the trip from Loveland to Denver and sat down with her at a local McDonald’s restaurant (she told me her kitchen table in her apartment was not big enough to spread out the papers). She entered the restaurant very slowly, using a wheeled walker. As I spoke with her and looked through all of the piles of bills, I was amazed at how bright and sharp and intelligent her blue eyes were, as she seemed to understand most of what I was saying, and was able to intelligently answer my questions. Needless to say, I was impressed with her and I certainly felt compassion for her circumstances. She wanted to do what was right, and pay her fair share, but the weight of these large bills were more than she could handle.

I wrote a well thought out letter to the hospital, petitioning them to forgive Liz’s debt, and providing a rationale for why I felt that they do this. The amazing thing: I received a prompt reply from them. They agreed to bring all of her accounts out of collection, and reduce them to a zero balance, for both the hospital and for the physicians amounts owed.

What a wonderful outcome and phone call it was for me to call Liz and inform her of this great news. Imagine her relief to no longer have this burden. And, it is encouraging that the hospital administration truly do have a heart.