Medical bill advocates.
A Medical Billing Advocate will save you money, time, and reduce the stress from having to deal with expensive, usually inaccurate bills. Advocates provide a variety of free services to patients, whether they have insurance or not. In general they will negotiate with your health insurer or Medicaid/Medicare to appeal coverage denials, help you with finding errors on your medical bills, or they can also negotiate lower fees and costs. Find a Medical Bill Advocate near you.
There are both private as well as non-profit medical bill advocates. Their services are contingency-based, which means that advocates get paid only when they save you money. In general, there is no risk to try their services. If they do not directly save you money on your medical bills or improve your access to health or dental care, then there is no cost to you.
What are Medical Bill Advocates?
They are trained specialists focused on assisting patients by ensuring they are billed accurately and fairly. A Medical Billing Advocate will also provide information on all of the various health and dental care options available to consumers. They give details on both private insurers or government benefits such as Medicaid, CHIP, Medicaid, Social Security and other programs. They help ensure low-income families, seniors, the uninsured, disabled people and others get all the care they need.
Medical Billing Advocates will review both your medical bills and insurance documents (if you are insured) for errors. In addition to that, they will assist you in better managing your total health care costs including the benefits that you are entitled too.
Most Medical Bill Advocates near you work on a contingent basis. They will typically charge customers about 20 percent to 35 percent of the amount they are able to save their clients on their medical bills. So if the client does not save money, there is no payment due from the client. This greatly reduces the risk to using one of the professionals. As always, shop around for the best offer.
- On average, studies show that medical billing advocates are able to save patients between 15-30% on most health care claims, which an advocate will take a “cut” of those savings. They can also handles claims that are up to three or so years old, so historical research is part of what they do as well.
Services from Medical Bill Advocates near you
As noted, the goal is to both help people save money and get the health, vision, or dental care they are entitled too. This includes families that have no insurance - as even they have the ability to get health, dental, vision and emergency care from a hospital or charity program. The process is extensive.
They will review every medical charge you have to ensure that all the costs are accurate and reasonable. Medical Billing Advocates will also audit, organize, and file all of your documents, bills, statements and tell you who, why, and how much you should pay. This is done in an effort to ensure you do not pay a cent more. They also serve as a “Patient Advocate” to ensure you are treated fairly.
Advocates will negotiate fees, medical debts and bills. A patient may realize that their insurance policy won’t cover certain medical expenses or a surgery, sometimes after the fact. Millions of people completely lack health insurance, or their coverage is very poor or unclear 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, insurance company 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 advocate 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.
Identify billing errors. Per multiple independent surveys, about 90% of medical bills have errors on them. Many of these mistakes are made because you are being charged for services that were never provided to you or the bill is over complicated.
- Countless millions of Americans find their medical bill confusing. It has a baffling list of codes, acronyms, and other difficult to understand jargon. No matter the consumers education level or expertise, or whether they have insurance or not, health care costs are very complicated. It can be even more so when dealing with insurance companies. A medical billing advocate is kind of detective - they are trained to help find mistakes on hospital bills. Or they look at insurance policies, both private and government programs. They can also help families find affordable health insurance plans.
- Advocates near you will wade through these various and complicated charges. After this has been done, they can identify and point out mistakes. An advocate will 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. Click here to read more on specific examples of how advocates have saved money.
Medical advocates will 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. 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 near you is complicated, time-consuming, and frustrating.
- If you need this type of help, 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.
Negotiation for payment plans is sometimes offered. After going through the steps above, some patients just can’t afford the final bill. This is where a payment plan or some form of relief is often a good choice. While some medical bill advocates can also negotiate a payment arrangement for 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 or hospital costs. They deal with doctors, hospitals, and even the government bureaucracy. In general, a specialist will be a skilled professional in negotiating lower hospital and medical bills on your behalf. Read more on medical bill negotiators.
In general, a medical bill advocate is free to use. As they work on a contingency basis, or they are set up as non-profits that provide free consultations and help. Many medical advocates will only charge you based upon what they save you on your bills.
- They will often charge 30 percent of whatever costs they recover. The fact is if an advocate does 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. However, also be sure to get a contract if you use their services.
Free non-profit Medical bill advocates for the the uninsured and low income
There are non-profit medical bill advocate organizations as well. They often help people with no money or income, senior citizens, the disabled or unemployed. Many clients of medical billing advocates are very low income and/or uninsured. Or their current policies are limited. For these individuals it can be even more difficult to pay a costly hospital bills or for dental care. Or maybe the deductible from a doctor, health insurance company or provider is too high. Assistance is offered in these cases as well, often from a non-profit.
Medical advocates near you will call the local hospital billing office asking for help or the doctor. Or they will deal with private insurance companies, or Medicaid/Medicare. Or if the client is uninsured, maybe an advocate will explore any charity programs. All this is done in an effort to help the patient save money. However, there are some steps consumers can take themselves, and read more on hospital bill help.
Patients do have other non-profit options. Medical expenses are some of the easiest types of bills to get help with. This means many non-profits, charities, and other groups will help consumers. While a medical billing advocate can help you save on bills, find billing errors, negotiate, and more, there are other steps you can take, including the following.
- There are national and local charities that help the poor, cancer patients, sick kids and the homeless with medical needs. Locate a charity for help,
- Drug and pharmaceutical companies provide help, often in partnerships with an advocate near you. Learn how to receive free prescription drugs.
Medical bill advocate near you
There are local organizations that may be near you as well as national companies. Both in person or free online consultations are offered, or they take requests over the phone. The end goal is to provide as much access to patients as possible.
- One of the largest non-profit charities in the nation is the Patient Advocate Foundation. They will assist people no matter their age, income, or background. They help low-income or uninsured patients lower their bills, get free medications, access debt relief and more. Learn how to get help the Patient Advocate Foundation.
- 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 on Alliance of Claims Professionals.
- RIP Medical Debt is a national organization that advocates for patient rights. They have a helpline that can help you understand your medical bills and fight unfair charge. They have a team of experienced medical billing advocates who can help you navigate the healthcare system and get the financial help you need.. They advocate for patient rights, including for the poor, disabled, elderly and single moms too. They have a helpline that can help you understand your medical bills, refer you to a local medical billing advocate and fight unfair charge.
- California Medical Billing Advocates (CALMBA): A focus is on patients in California, including those on Medi-Cal, but the advocates can help people in other states too. The organization is a non-profit, California-based organization that helps people fight unfair medical bills. They have a team of experienced advocates who can help you understand your bills, dispute charges, and negotiate with your private or government insurance company. Dial (415) 632-3316.
- Centers for Medicare & Medicaid Services - The government focuses on advocate for people on Medicaid or Medicare. All of the programs are free. CMS has details on advocate, hospital charity programs and other resources, and find a CMS advocate.
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