Whether you have health insurance or not, a Medical Billing Advocate will save you money, time, and reduce the stress from having to deal with expensive, usually inaccurate medical bills. Their services are contigency-based, which means that they make money only when they save you money. If they do not directly save you money on your medical bills, then there is no cost to you.
What is a Medical Billing Advocate?
They are highly trained specialists focused on assisting patients and consumers by ensuring they are billed accurately. Medical Billing Advocates will review both your medical bills and insurance documents (if you are insured) for errors and they will assist you in better managing your total health care costs and benefits. They will review all different types of medical bills and expenses, and work as your advocate to save you money. Studies show that over 80% of bills have errors, and they can help identify these.
While an advocate can also negotiate a bill, that is not always their main focus as they specialize in finding errors and inconsistencies with your account. However there are other professionals who specialize in negotiating medical and hospital bills. Read more medical bill negotiators.
How will they save me money?
They will review every medical charge you have to ensure that all charges are accurate and reasonable. Medical Billing Advocates will also audit, organize, and file all of your medical documents and bills and tell you who, why, and how much you should pay, and ensure you do not pay a cent more. They serve as a Patient Advocate to ensure you are treated fairly, dispute claims, address billing errors, and file appeals. They may even negotiate the medical bills on your behalf to ensure you have the lowest possible price.
How much can they save?
On average, studies show that medical billing advocates are able to save patients between 15-30% on most health care claims, and sometimes they can save you even more. They can also handles claims that are up to two years old. Click here to read more on specific examples.
How much do medical billing advocates charge?
Medical billing advocates, sometimes also called health care advocates, will typically charge customers about 20 percent to 35 percent of the amount they are able to save their clients on their medical bills. As always, shop around for the best offer.
What other options do I have?
Medical expenses are some of the easiest types of bills to get help with. While a medical billing advocate can help you save on bills, find billing errors, negotiate, and more, there are other steps you can take, such as contacting a charity for help, receive free prescription drugs, and more.
What services are usually offered?
A variety variety of services are offered by advocates. It can include reviewing bills, negotiating, and much more. Each company or professional may have their own list of services available so be sure to fully understand this before entering into an agreement with them. Learn more on the services they offer how they can help.
What if I just need someone to negotiate?
There are specialists who will just negotiate your bills, and some studies show that they have up to an 80% success rate in negotiating lower hospital and medical bills on your behalf. The truth is that whether you receive a bill from your medical provider or insurance company, the bills are oftentimes difficult to understand and patients don't know if they're getting ripped off and being overcharged. Read more on specialists who can negotiate.
A real life story of savings:
Detroit landscaper Steven O'Shea was landscaping a tree when he slipped and fell. As he fell down, right on his chain saw, it severely sliced into his arm. O’Shea says it sliced right up to the bone. It cut through all the muscle, and the tendon.
O'Shea, who is uninsured, received a bill from his medical provider that said his cost was $39,000 for a three-hour operation. He called the hospital billing office asking for help, but didn’t have luck. However, there are some steps consumers can take themselves, and read more on hospital bill help.
Like countless of millions of Americans, O'Shea found his medical bill confusing. It was a baffling list of codes, acronyms, and other difficult to understand jargon. So after a quick Internet search, he found Nora Johnson, who is a medical billing advocate. He entered in a contact with her.
A medical billing advocate is kind of detective, an advocate who is trained to help find mistakes on hospital bills. She found a big mistake on O'Shea's. For people going to a medical provider, there are often two big issues: mistakes and higher than average charges. For those medical bills and statements that are often hundreds of pages long, the errors can be costly and significant. According to a Harvard study, 90 percent of all hospital bills have at least one error.
The hospital repaired only six tendons, but O’Shea was sent a medical bill to pay for nine tendons. That billing mistake cost an extra $11,000 on his bill, said Johnson, of Medical Billing Advocates of America. Johnson says that almost every hospital bill she helped review had an overcharge.
Another example. Consider Joe Manchin's bill. After his recent knee replacement, Manchin says most of his $34,000 medical bill was a list of charges simply labeled "hospital extras." Also, by the way, Manchin was the governor of West Virginia. He also says that nobody can understand what each hospital fee is for. The best accountant in the world can’t possibly understand this, he says.
Nora Johnson, the medical billing advocate, strongly believes that every patient can, and needs to be a watchdog. First, she says, never settle for a summary bill: You need to get an itemized medical bill. Look for fees or charges on procedures doctors did not perform, and then you need to be sure to check for duplicate charges.
Also, for the increasing number of patients without health insurance, a bigger problem is the fact that patients are charged more than insurance companies for the same services. Medical Billing Advocates say that it is probably in the neighborhood of about 70 percent. So what this means is that an uninsured patient may be charged $500 for a service from their doctor or hospital. However an insurance company would only be charged (and need to reimburse the hospital) say $300 for that exact same service.
After Steve O'Shea found a medical billing advocate, serious negotiations began with the Henry Ford Health System, where O’Shea was admitted to. In O'Shea's case, his medical bill advocate, Nora Johnson, found more than $11,000 in errors.
They were charging him twice for some items, such as a nerve repair, O'Shea said. Then the medical bill advocate negotiated a 75 percent discount to get O’Shea’s bill closer to what an insurance company would need to pay. O'Shea ended up paying a little more than $6,300 on his total bill / debt, which is much less than the original charge of $39,000.
O'Shea was obviously very happy to pay the adjusted bill. He said that his doctors did a great job saving his arm and his medical billing advocate did a great job saving his bank account and house.
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