Claims Assistance Professionals from ACAP advocate on your behalf to help with medical bills.
A Claims Assistant Professional, sometimes called CAP for short, can help save money on medical and hospital bills and also ensure you get the coverage you are entitled too. The fact is that navigating the healthcare system, insurance policies and its confusing billing practices can feel impossible. The Claims Assistance Professionals can help with a number of health and medical needs. These services are often affordable, offered on a income based sliding scale, or free for people in serious financial hardship.
The Alliance of Claims Assistance Professionals (ACAP) is a national nonprofit organization made up of experienced professionals (CAP) who represent as well as advocate for patients. They work directly with individuals to review, correct, and often reduce or eliminate medical bills. Local members of this alliance, called Claims Assistance Professionals (CAPs) are based locations across the U.S. and provide hands-on support.
How do Claims Assistance Professionals help people with medical bills?
Members of the non-profit ACAP address everything from surgeries to Medicare, prescription drug bills or coverage, dental care, and dozens of other health care needs. Claims Professionals offer various forms of help. They include, but are not limited to, the following.
Medical billing errors are extremely common - and costly to patients. Studies have shown that as many as 4 out of 5 hospital bills contain errors, often overcharging patients. For a low to moderate income household already struggling with limited income or no insurance, this can be devastating. Claims Assistance Professionals will request copies of your medical records and itemized bills, then go line-by-line to identify upcoding, duplicate charges, Out-of-network billing mistakes or unbudled services among other mistakes.
Claims Assistant Professional will take the lead on medical debt negotiation and settlements. Many are also trained mediators who can negotiate with your health insurer. If you are uninsured or facing a huge out-of-pocket cost, CAPs can contact hospitals or providers to negotiate discounts or cash-based pricing plans. There are also flat rate settlements for debt, reduction of charges due to financial hardship, payment plans as well as other solutions. Many CAPs can reduce bills by 30 - 80% or more, especially for uninsured patients. Learn more on how to deal with medical debt collectors.
All non-profit hospitals are legally required to offer charity care or financial assistance programs, especially for low-income or uninsured patients. A CAP will help people apply as these programs can be difficult to find or understand. CAPs will determine if you’re eligible, gather supporting documents like pay stubs or benefit letters, complete the application and appeal a denial as well. CAP will help people get access to resources to deal with hospital bill assistance.
Get help with Medicare or Medicaid benefits from the Claims Assistant Professional. Even if you have government insurance like Medicare or Medicaid, you can still be billed improperly or need help navigating the medical system. CAPs will appeal denied claims with Medicare or Medicaid. They will also fight against balance billing or charges Medicare should have covered, correct billing issues with dual eligibility and a CAP will also clarify what a patient can get done from the government benefits.
In addition, CAPs will always ensure that you receive all the private company health insurance benefits to which you are entitled and your plan allows for. It is well known how complicated a doctor or hospital bill can be. Or how difficult a statement of coverage may be to interpret. So they will make sure that your policies to the coverage are accurate, inform you about your options, and manage as well as decipher the endless paperwork and forms. They can help clients find and sign up for free government health insurance plans as well in lieu of a government plan.
For those without health insurance, a Claims Assistant Professional will help you negotiate and save on the costs of medical care from providers. They also help the uninsured deal with past due bills and help with medical debt. The Claims Professional are aware of what a procedure or medication should cost so they will try to ensure you get the lowest price possible. They will also keep you from incurring any unforeseen charges
Find an approved, trusted CAP professional
While a CAP is not always free, and they will charge you for their services (maybe on a contingency basis), they can potentially save you thousands of dollars on your hospital or medical bills. Or an ACAP member can help ensure your insurance company gives you the treatment, medications, or health care coverage that you are entitled too. Claims Assistant Professionals are health care specialists who have a background in medical billing, health insurance, law, or medical care in general.
If you need to deal with the expensive health care system, contact a Claims Assistance Professional to learn about their services. The National Alliance of Claims Assistance Professionals can be reached at (888) 394-5163. You can also ask a local legal aid society for referrals to a Claims Professional, or maybe legal aid will provide help. Or contact your Area Agency on Aging (for seniors) or reach out to disability advocacy groups.
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