Medical billing advocates provide a variety of programs as well as services to patients. In general they will negotiate with your insurer to appeal coverage denials, help you with finding errors on your medical bills, or they can also negotiate lower fees and costs. What is offered is always changing and resolving based on the latest trends in the health care industry.
Many of the companies that offer these advocacy services will work directly with your providers on your behalf. While it is possible to find some medical billing advocates that perform all three tasks referenced above equally well, it may be more difficult as because of their background or training. Some may specialize in one area or another and that is the area they have the most success in.
Many medical advocates will only charge you based upon what they save you on your bills. So while some people may say that using their services are costly, as they will often charge 30 percent of whatever costs they recover, the fact is if they do not save you any money then there is no cost to you. So in effect there is no risk in using them as there are no up front costs due.
Also, the initial consultation that you have with a medical advocate should be free, and then be sure to get a contract if you use their services. The experience they provide and 30% continent fee is almost always worth the expertise these advocates can bring you to helping deal with a medical billing issue.
Other option to consider is The Alliance of Claims Assistance Professionals. They also try to tackle to excessive health and dental care costs that families are faced with. This Alliance is another advocate organization that will help you negotiate medical bills as well as tackle excessive health care costs. More.
Advocates can negotiate fees, medical debts and bills.
A patient may realize that their insurance policy won’t cover certain medical expenses. Millions of people completely lack health insurance, or their coverage is very poor in what is covers. Or maybe they just do not have the funds to pay the bill or debt that a provider charges them. When this occurs, a medical billing advocate can usually help you lower your out-of-pocket costs as they can negotiate lower rates directly with your health care provider or hospital.
How is this possible? Well, doctors, dentists and other health care providers accept much less in fees and payments from health insurance companies than they charge individuals. So the most common tactic an advocates will try is to get providers to charge individual patients the same rate they would charge someone with group health insurance coverage. They also will try to negotiate a payment plan, so extending the terms over several months on a client’s behalf.
Per multiple independent surveys, about 90% of bills from medical providers, local doctor offices and hospitals have errors on them. Many of these mistakes are made because you are being charged for services that were never provided to you.
Advocates can wade through these various and complicated charges. After this has been done, they can identify and point out the absurdities and they can ensure the bill is corrected or negotiate more realistic rates. Finding one or more of these billing errors and overcharges is especially helpful for underinsured or uninsured patients who are paying these expenses out of their own pocket and have no assistance from an insurance company.
If you need help with understanding a billing statement and if you think you’re being overcharged, you should search for an advocate who has previously worked in a hospital, insurance company, or billing office. The knowledge and experience that they have from those roles is invaluable.
Appeal denial of coverage.
If your insurance claims or hardship case has been denied for whatever reason, you do have the ability to appeal that decision of the denial. Consumers always have this right, no matter what state they live in. If you do this, you will learn that the appeals process with a provider is complicated, time-consuming, and frustrating.
If you need this type of aid, advocates will handle the appeal for you. They will also negotiate with the insurance company to get the fees covered, hopefully completely paid, and worst case at least partly paid under the insurer’s out-of-network coverage process. Many different steps will be taking in an effort to solve problems with a dental or health insurance policy.
How can you get help with this situation? If you full into this category and need help handling a dispute with your health insurance company, this is one of the common services offered. Patients should try to seek medical billing advocates who have a strong background in insurance claims departments or a lawyer with a strong health care background, as they will usually have the skills you’re looking for to assist.
Like this site?