Claims Assistance Professionals advocate on your behalf.

A Claims Assistant Professional, sometimes called CAP for short, can help you reduce and save money on medical and hospital bills by finding errors in your bill, assist with negotiating or disputing the charges on your account, and they can help you in dealing with your health insurance company by getting them to pay for expenses that they initially refused to pay. The Alliance of Claims Assistance Professionals can help you with finding a CAP or medical billing advocate near you. While a CAP is not 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.

Claims Assistant Professionals are health care specialists who have a background in medical billing, health insurance, law, or medical care in general. Many are also trained mediators who can negotiate with your health insurer to appeal coverage denials, they can dispute the charges on your bill, find billing errors, and generally work on your behalf to get you lower fees. The hundreds or thousands of dollars you could save in medical bills makes the CAP service worthwhile. In particular many will only charge you if they save you money, so they will operate on a contingency basis.

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 (512) 394-0008.

Exactly what services are offered by Claims Assistant Professionas

They will advocate for you with your health insurance company, doctor and/or health care providers. Most of these professionals have years of experience in the health care industry. They may have a background in insurance and filing medical claims, and a CAP is always your champion and will have your best interests in mind. They will assist you as needed with resolving problems, facilitate claims payment, ensure your bill is accurate, save you money, and deal with medical debt collectors.





In addition, CAPs will always ensure that you receive all the 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. So they will make sure that your bills are accurate, inform you about your options, and manage as well as decipher the endless paperwork and forms.

And for those without health insurance, a Claims Assistant Professional will help you negotiate and save on the costs of medical care from providers. They 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.

Some of the other services offered include :

  • Negotiate medical bills, providers' fees for uninsured patients and other procedures
  • They will challenge denials of claims by your health insurance company
  • Get access to resources to deal with hospital bill assistance
  • Organize health insurance paperwork
  • Audit hospital and provider charges
  • Negotiate with providers on patient balances and any unpaid medical debts on your account
  • Closely review hospital and medical bills and determine proper payment
  • Track insurance claims to ensure they are accurately processed and paid for
  • File various types of insurance claims on your behalf, including long term care, medical, HSA, FSA
  • Assist with choices of plans during employer open enrollment
  • Provide information on free medications, including those from Pfizer and Eli Lilly
  • Contact both insurance companies and providers to resolve claim and billing problems
  • Assist in selecting Medicare Part D drug plans and Medicare supplement plans
  • Provide information on insurance benefits and other health care options





By Jon McNamara

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