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.

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.

Medical Bill Help: Compare Healthcare Costs Before Proceeding With Treatment

The costs of medical and health care services have been rising steadily for many years, and American consumers are feeling the pinch in a big way. Many American individuals and families are now facing extremely high medical debts, some of them for fairly routine or minor health care procedures or treatments. With the private insurance system looking to offset costs, and very little in the way of a safety net for consumers, medical bankruptcy threatens many thousands of families each year.

Now, medical advocates are telling American patients to go a step further than many of them are accustomed to: new guidelines from experts in the industry suggest that consumers should be asking medical providers about how much a certain procedure, treatment or even a consultation may cost before they ever step in the door of the medical office.

Barriers to Asking Questions About Healthcare Services

In prior times, most patients were not used to asking their doctors what something would cost – there was a kind of intuitive understanding that since medical care is something that nobody wants to skimp on, it’s not a situation where prices can be negotiated. Over time, that led up to a system where insurance plans, largely those provided by group employers, covered major costs, leaving a patient with a straightforward co-pay or deductible that would represent their total financial responsibility.

These days, even a group plan doesn’t protect the average consumer from receiving extremely expensive medical bills after getting nearly any kind of health care service. Larger co-pays, larger deductibles and co-insurance mean looming costs for many Americans as medical costs continue to skyrocket and other issues like deceptive out of network charging leave many patients with much more debt than they thought they were going to incur when they arrived at a hospital or other facility.

Can Americans Shop for Health Care?

What new reports are showing is that the best way to shop around for health care is to ask your insurance company. Most of the efforts at cataloging the various rates that different providers charge for services are done by big insurers like CIGNA, Anthem Blue Cross, and other multi-state insurance companies. Patients can also ask their insurance company which providers have a contractual plan that forces them to charge a certain set price for a given medical service.

Over time, this trend will probably continue, to the point where American patients routinely ask their insurance company to help them shop. For most enrolled members, the insurance company has a vested interest in that person getting the cheapest medical care possible. While these kinds of partnerships between private insurers and individual patients can help both parties to rack up less medical debt for the same kinds of treatments and procedures, there’s also a great need for more patient education, where consumer advocates are standing in for states and the federal government when it comes to providing fixes for a problem that is challenging the majority of American families today.