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Ways We Can Help

Medical Bill Organization, Analysis & Reconciliation

In order to ensure accuracy and avoid mistaken or unnecessary payments, we organize and review your medical bills. We deal with invoices from hospitals (including emergency room treatment, inpatient care, rehabilitative treatment, and other hospital services), diagnostic facilities, laboratories, physicians and other providers. We also review the “Explanation of Benefits” that you receive from your insurance company. After careful analysis and reconciliation of your statements, we may suggest, and, with your approval, initiate corrective action on your part. In such cases, we may interact with providers and insurers to ensure that you do not pay more than necessary. We might also initiate a review by your insurer, including preparation of an appeal for charges wrongfully denied.

Uninsured/Underinsured Cost Reduction Negotiations

If you are uninsured, or your coverage doesn’t extend to the types of expenses incurred, we can help by negotiating reductions in invoice amounts. Typically we obtain discounted rates for nearly all treatments, hospital services, testing, and prescriptions. Substantial cost reductions are available if a payment arrangement is made before treatment or hospitalization. This also applies at hospitals offering a “prompt pay discount” with which payment generally must be made within 24 hours of discharge. We also seek to negotiate reductions in charges after treatment.

Probate Medical Claim Reduction

Many Estates have claims made against them for medical debts of the decedent. While attorneys and Personal Representatives diligently manage the probate process, our services can result in significant savings to the Estate. Thus, there may be more assets available for distribution to the beneficiaries. We work with the Personal Representative and attorneys, review medical invoices for accuracy, compile medical records, consult with our experts, and ascertain whether health insurance benefits could be available. If so, we might interact with the provider to submit corrected claims, additional clinical support, or even commence a provider’s appeal. As appropriate, we submit claims, seek reconsiderations, and prepare appeals.

Assuming no insurance coverage is available, we utilize our proven expertise to negotiate reductions in the amount of the claims. Medical providers generally seek to collect higher rates from Estates than from an insured individual (private insurance, Medicare, or otherwise). We believe it to be unfair to deprive the family of a loved one to unnecessarily pay excessive amounts rather than distribute the savings for college educations, home improvements, retirement funds, and other much better uses. Consult with us and allow our team to assist the Estate in reducing claimed medical debt. The payments for medical debt by the Estate are likely to be reduced; often substantially.

APHA
Certified Patient Advocate
Greater National Advocates
NAHAC