Trying to Cut Your Medical Bills? Medical Billing Advocates

[MHCGirl]

If you have been ill, you already know that medical bills are almost impossible for most people to understand. At best, medical bills are totally confusing; at worst, bills are a babble of medical jargon, billing codes, and benefits footnotes. What choice is there but to give up trying to understand the bill and a) pay it, or b) hide?

It may seem like a hopeless situation, but if you are buried under a mountain of incomprehensible medical bills, we have another resource that you may not have tried yet: medical billing advocates.

What is a Medical Billing Advocate?

Medical billing advocates are professionals who specialize in helping patients wade through the medical billing paperwork and negotiate their medical bills. It is a cottage industry that has developed in the wake of spiraling health insurance premiums and medical costs. Generally, medical billing advocate can help you save on your medical bills one of three ways:

Spotting Medical Billing Mistakes and Errors. Some surveys estimate that as many as 9 out of every 10 medical bills have one of more errors, and those errors often include billing for medical services that were never preformed. A medical billing advocate who is experienced in billing errors can spot these mistakes as well other errors that can cost you money, like overcharges and charges for more expensive procedures than were performed. Medical billing advocates who specialize in billing mistakes and errors often come from a medical billing background and know the costly errors that are likely to occur on medical bills, as well as how to negotiate overcharges like obscene charges for aspirin or tissue.

Appealing Denials of Health Insurance Claims. Even though patients have every right to appeal any denial of a health insurance claim, the process can be long, frustrating and extremely confusing. Some medical billing advocates specialize in fighting claim denials for patients, handling the appeals process and negotiating health insurance denials with insurance carriers. Even when medical billing advocates are unable to get health insurance claims paid in full, many advocates are still often able to get some kind of partial coverage for their patients.

Negotiating with Hospitals, Doctors and Other Medical Providers. If there are no substantial medical billing errors and all health insurance appeals are exhausted, medical billing advocates can still help you negotiate directly with doctors and hospitals to get your medical bills cut, sometimes cut by a lot. Doctors and hospitals almost always charge insurance companies much less than they do to uninsured patients for the same procedure, so medical billing advocates are often able to get medical bills cut to at least health insurance rates, and then can get their clients on some kind of manageable payment plan.

Sounds Great! What Is a Medical Billing Advocate Going to Cost Me?

All this help does not come cheap, but it’s undoubtedly well worth it if you have had an illness or medical emergency with major bills. Medical billing advocates usually charge 30% of whatever they are able to recover or $100 per hour or more. Initial consultations are usually free, followed by a contract which should list all fees to be charged for services.

What Else Do I Need to Know About Medical Billing Advocates?

Before you rush out to hire a medical billing advocate to help you with your medical bills, keep in mind that it’s important that you choose your advocate carefully. Unfortunately, because the medical billing advocacy profession is still very new, there is no standard education or certification which qualifies someone to be a medical billing advocate.

Your best bet is to try to find an advocate with a strong background in the area in which you need help. The Medical Billing Advocates of America lists advocates in different states on their website, along with their specialties. However, please note that these are only medical billing advocates who have completed coursework with the organization.

For the Medical Billing Advocates of America, visit their website at http://www.billadvocates.com.