Intro
Have you ever struggled to understand medical bills? Most people do! Medical billing is a complex procedure that even nurses and doctors can find confusing. So what about an ordinary human being? You can also get stuck with billing invoices as they contain a lot of codes, procedures, and treatments done, and whatnot! So, what to do?
Medical Bill Advocates of America is here to help you. These advocates can help you if you don’t figure out your medical bills. They tell us about the bills and solve the problems we have with insurers.
The services of these advocates do not end here! Below is the complete guide to help you explore teeny-tiny details of these hospital bill advocates. So, let’s get into it!
Who are Medical Billing Advocates?
The professionals who help patients and attendants understand medical bills are actually medical billing advocates. In other words, they make bills readable and understandable, as the medical terms used can’t be familiar to everyone. Here’s how:
- The medical bill advocates of America first read the medical bills to make sure they are completely correct. They spot small and big mistakes and make sure no unfair charges are added.
- In the next step, if the patient demands a discount or if they want advocates to talk to insurance companies to pay and lower the amount. The advocates make real efforts to get discounts for patients.
- Billing advocates elaborate on copays and deductibles to the patients and guide them about insurance policies and billing rules.
- If a patient still has queries, they answer them politely.
In America, medical bills can be confusing for a layman; hence, these advocates make sure you pay only for the services you get. Medical Bill Advocates of America work independently, and they can also charge a small fee for this.
What are the Four Kinds of Errors in Your Medical Bills?
No guesswork and no unnecessary extras.
There are four possible kinds of errors occurring in hospital bills, and medical bill advocates of America fix them all. The errors are as follows:
1. Math Discrepancies
Some medical bills have math mistakes in them. For instance, the cost of the services given isn’t added up correctly, and sometimes the price may not match the total amount charged. The advocates readily spot these types of mistakes. That’s how:
“The subtotal is $50 higher than the charges listed above.”
2. Charges Not Matching The Medical Record
Another error occurs when the bills contain those services that were never given to the patient or mentioned in the patient’s record. Let us explain it with an example:
An IV fee is added to the bill, but the nurse has mentioned that no IV was given, or sometimes a medicine may be charged when no medicine was given to the patient.
These are some serious mistakes, as bills and medications don’t match. That’s how advocates spot this mistake:
Nexium 40 mg was charged, but on the discharge summary, it’s mentioned that “no medications administered.”
3. Duplicate Line Items
When a procedure or service is charged twice on the same bill and the same date, advocates spot it immediately and mention it in this way:
“Autopsy charged twice in one visit.”
4. Unbundled Charges
It means sometimes hospitals and providers charge for the services or items one by one separately. For example, lab tests, including small tests, are charged separately, while they should be billed collectively. Or basic room supplies are charged separately when they should be added to the room fee.
In other words, being charged extra for even small items, such as the simplest things like gauze or routine bloodwork. This error can be spotted as:
“Seven metabolic tests were billed separately instead of using one combined CPT 80053 code.”
These errors are checked clearly and are flagged if there’s any serious mistake. The advocates check the dollar impact and the clear reason behind each error. Medical billing advocates send a dispute letter with the disputed charges and the codes used to the hospital.
Medical Billing Advocate vs Patient Advocate
Although medical billing advocates and patient advocates both work to support patients, they still differ from each other. For example:
| Medical Billing Advocates | Patient Advocates |
| They focus on medical bills and payment issues. | They make sure patients get proper and quality care and support. |
| They review bills, find errors, and fix overcharges. | They help you to decide your treatment plans and give your healthcare guidance. |
| They negotiate with insurance companies and providers. | They help patients understand what insurance coverage is and how to use it. |
| Their work is to provide financial support only. | They can provide emotional, medical, and system navigation support. |
| They make sure bills are correct and fairly charged. | They take care of the medical care a patient gets. |
In other words, medical bill advocates of America handle bills only, while patient advocates support patients in all sectors of healthcare, like care, treatment decisions, emotional support, and system guidance.
Pros of Hiring Medical Claim Assistance (Advocates)
According to a survey, 9 out of 10 bills from hospitals and clinics contain errors and can affect the actual payment that healthcare receives. What if you can’t afford medical bills? What if they contain errors? And you have a deadline to clear your bills. This can panic you all of a sudden.
So, the best decision is to go to Medical Bill Advocates of America. They are present in the hospital you went to, or you can also hire someone else. Hiring them can be beneficial. Let us convince you in the following way:
Handle Insurance Claims Issues:
What if your insurance claim gets denied? Nothing to be worried about! There’s a simple solution: billing advocates motivate you to appeal, submit documents, and ask for flexibility.
In addition, if you have any doubts about the insurance coverage plan, they will make it clear to you. They also tell you if your claim is covered under your plan or not.
Save You Money:
They not only help you understand what you are not getting. In fact, they can instantly spot overcharged bills and make sure you don’t pay extra. What’s the best part? They talk with insurance companies on your behalf to get you discounts.
Save Your Time:
We understand that a sick person can not handle billing disputes or may be stressed out after watching their bills. That’s why we suggest you hire an advocate. They can handle everything, such as negotiating with doctors, insurers, and hospitals. This way, it saves your time.
Know About Consumer Protection Laws:
Not every person knows what consumer protection law is. And nobody knows when they get sick. Hence, medical bill advocates of America are well familiar with these laws related to medical billing. They know how to protect you from anything illegal, such as surprise billing or balance billing.
Let us explain it in a better way:
Let’s suppose you take your medical services from an out-of-network doctor, and now you are between the insurance payer and the provider’s charges. This can give you a surprise bill that means you are charged for what you haven’t used. Here, medical bill advocacy services help you out.
Provide Support:
Medical Bill Advocates of America understands your medical and financial situation. They consider whatever you are going through. This way, they can easily make a plan as per your financial needs and ensure no financial issue catches you.
Clear You About Ins and Outs:
After dealing with these medical billing advocates, you can understand all the ins and outs of medical billing and claims. It helps you in the future whenever you have a visit to the hospital, so you don’t have to hire advocates.
Help with Out-of-Network Issues:
Last but not least, getting treatment from an out-of-network provider can be confusing when it comes to pay. Hence, advocates help you understand all the financial things. In addition, if the bill is out of your budget, they will negotiate with the insurance company or doctors to lower the amount.
Hence, all these benefits can help you decide to hire the medical bill advocates of America when you need them. Dealing with everything by yourself when you are already stressed about your health can be challenging. So, it’s better to get help from them.
How to Find the Best Medical Billing Advocate
As you have seen, hiring an advocate is highly beneficial. But how to find one? We have listed the best possible ways to find the best advocates below:
Referrals:
Firstly, ask your relatives or friends for good suggestions. Your doctors or insurers may also help you in finding one. Because they are familiar with many advocates. In addition, ask those who have already hired advocates for the same purposes.
Professional Organization:
If not, then go to the special groups having a certified billing advocate list. These groups are as follows:
- The Alliance of Claim Assistance Professionals (ACAP)
- American Medical Billing Association (AMBA)
- California Medical Billing Advocates (CALMBA)
- The Alliance of Professional Health Advocates (APHA)
- Dollar For
- Patient Advocate Foundation (PAF)
- National Association of Healthcare Advocacy (NAHAC)
- Medical Bill Advocates of America (MBAA)
Online Search:
Lastly, you can also search online for the best advocates. Hundreds of reviews are present on several websites that help you pick an advocate. We suggest you select that advocate who has fair pricing, as you already have to pay a lot of money.
Here’s a quick tip: if you have a complex medical bill of $30k, try using a professional negotiation service. The professionals handle the simple bills and justify their fees. And if your ER bill is $4k and nothing serious happens, try to deal with it all by yourself, but still, if you don’t understand anything, go to the advocate present in that hospital to get some help.
Top Healthcare Bill Negotiation Services
In America, many companies provide advocacy services. They have well-trained teams to contact and tell your whole story. They then help you in every way to solve the problem that you face.
We have created a list of top healthcare advocacy services below:
Solace: The great benefit of hiring Solace is that you have to pay nothing out of your pocket for your medical bills. They spot errors and overcharges, negotiate if possible, navigate insurance claims, and connect you to the best financial assistance programs.
Furthermore, you get a “care team” at Solace in which you have direct contact with a supporting physician and a patient advocate. The advocate is in contact with your doctor, researches possible solutions to your problem, and gives updates to you. While a supporting physician offers ways and resources to you and your advocate.
CMS.gov (Centres for Medicare and Medicaid Services): You can find the best advocate here, too. Patient advocates first navigate the hospital, where they get medical services. They ask you some questions, take down the important information, and support you. If you are not getting the proper care, they can also help you get the services you deserve.
Resolve: You can hire them if you have doubts about bankruptcy. They have a huge team of senior advocates, patient advisors, junior advocates, a lead engineer, and a senior front-end engineer in case any technical issue comes up with your medical bills.
Many Americans find themselves in medical debt every year due to unfair medical charges. Resolve has the main goal of helping people understand unfair and fair pricing.
Aequum: Aequum is a strong legal support for patients who face unfair collections, expensive out-of-network bills, stressful billing disputes, and other credit problems. Medical billing disputes are increasing day by day and can cause collection calls, credit score threats, legal pressure, and confusion for both patients and payers.
Aequum provides medical billing defense services to protect you from stress, risk, and problems.
Medical Bill Advocates of America: This institute gives membership to registered nurse advocates that enables nurses to provide care for patients with all their crucial needs.
TallyMD: They can audit your medical bills within 60 seconds and create a dispute letter. They will only charge $39. You will get a refund in 14 days if you are not satisfied with their services.
The list doesn’t end here! There are many other options when it comes to hiring the best medical billing advocates of America, such as:
- MedClear
- Peterson Center on Healthcare
- Athelas
- Ceris
Each organization works differently and focuses on different things. The thing is to observe what your actual problem is regarding your medical bills and hire someone accordingly.
We also suggest that you do not ever pay anyone who promises that they can remove medical bills from your credit report or protect you from surprise out-of-network charges. Furthermore, be careful of scammers who demand a fee in advance to fix your debt or credit problems.
Look for trusted credit counselors because they are honest about what they can really do and how much it costs. They don’t work in a hurry and pressure you to sign up.
FAQs
What do the medical bill advocates of America charge for their services?
Some advocates charge per hour, such as $75 to $350 per hour. Others may charge based on savings, like taking their share of about 25% to 35% of the money they help you save. Hence, most people can easily afford them, and others can’t.
What type of medical bills need an advocate?
You can call your insurance company or talk to your healthcare provider if your medical billing problems are very simple. But you may need an advocate when the problem is complex, the cost is high, or you don’t have the time or information to handle these errors on your own.
What to provide to advocates while hiring them?
Medical billing advocates need the following things:
- A payment history or receipts related to the bill
- Your basic details
- Medical bill copies
- Your insurance info
- A signed authorization form, i.e., permission to work on your case
- Medical records or doc’s prescription if needed
What do you mean by a hospital bill audit?
It is a detailed review of your hospital bill. It means checking in detail everything like hospital bills, itemized bills, medical records, nurse notes, and surgery reports. It is done to make sure everything is correct and fair.
What is the provider dispute problem, and how can it be handled?
Provider disputes can disturb HR teams and admins. These types of problems take a lot of time, attention, and internal resources. It pulls away their focus from their core work. Advocates handle the entire situation from start to end, so healthcare systems don’t need to waste their time.
Conclusion
In conclusion, Medical Bill Advocates of America are exceptional in providing financial, mindful, and billing relief. They handle medical billing disputes, so you don’t have to pay extra.
Always choose the right medical billing advocacy services according to your needs. Check their fees and their specialty before hiring one. We have made everything clear about advocacy, but still, if you have any questions, do reach out to us!
