The hospital billing system seems to be very complicated for naive patients. They don’t know how billing works and what charges they owe. Well, this might be a cause of concern too because many unreliable healthcare facilities take advantage of this lack of knowledge and bill a patient wrong. This leads to paying bills for those services that you didn’t even take. So what can patients do here for a smooth healthcare experience? The answer is that they can seek external assistance like a medical billing advocate.
You, as a patient, always have a chance to hire a third party that communicates with the healthcare provider on your behalf. They are experts in their areas. Thus, a medical billing advocate’s experience will benefit you, be it at the time of negotiation or rechecking the bill to ensure there are no errors.
Let’s learn more about these professionals, situations where you can use them and do they charge very high fees. Read till the end to know all about them.
Scenarios Where Medical Billing Advocate Can Help You
To provide a quick overview, medical billing advocates are professionals who possess skills in helping patients by making direct contact with healthcare providers. You can use them mostly when there are doubts that the bill contains errors, you want to reduce the bill amount or you are stuck in any complicated situation. Just contact them and they will be on their way to get you out of the situation.
Here are listed some common cases where patients are already using advocate’s expertise to get benefits:
Insurance Denials
A lot of the time, healthcare providers deny your insurance coverage and expect you to pay the bill as a whole. An advocate here can take up your case. They first understand the reason for denial, gather the required documents, and conduct the appeal process with informed steps. This way after a little negotiation you will get treated under the coverage of your insurance provider.
Unexpected Medical Bills
Billing inaccuracies are a big issue in healthcare. You must hire a billing professional during any treatment as there might be a chance that you are billed for the services you didn’t receive. Duplicate billing is another common mistake that makes patients pay more than expected. So get them to review all of your bills to find out any potential erroneousness.
Complex Billing Errors
Besides omissions in bill amount, medical bills also have a high potential of wrong medical codes, services mentioned that are suggested but not conducted, or duplicate charges for a single treatment or supplies. Medical billing advocates have expertise in identifying these errors. They know appropriate ways to approach a provider and conduct a negotiation process.
Negotiation
If you are unable to pay the bill upfront, these advocates have got you covered. Other than basic billing negotiation, they know how to describe your financial conditions in such a way that providers trust you and offer some patient payment plans. You will be avoided to pay a high bill amount. Instead, your bill will be divided into installments or other terms.
Get to Know More About These Professionals
Complicated Medical Procedures
For treatments involving different healthcare providers and facilities, the process might be a mess for an innocent patient. Billing advocates can assist you in understanding the whole process and explain it to you in an easy-to-understand way. Also, they will bear the burden of communicating, negotiating, and working with providers to ensure accurate billing at every stage.
How Much Do They Charge?
Now come to the main point and that is what are the charges these advocates demand. Where you might think hiring them is more expensive than handling bills yourself, let us tell you that if your bill’s extra charges are not reduced then you will pay the healthcare provider with the same amount or maybe more than you pay the advocate.
So why pay expensive bills when you can hire a medical billing advocate who will charge relatively less than your entire medical expenses? However, they mostly work for an hourly rate that ranges anywhere between $75 to $350. But this price may vary depending on the complexity of your case.Â
Billing advocates may also charge a specific percentage of the total bill amount reduced. So it’s up to you and them to decide on a suitable payment option.
Documents Billing Advocates Require To Begin
We have talked a lot about patient benefits regarding getting help from a medical billing advocate. But one thing worth discussing here is that you must have some documents ready in advance so that they don’t face any hurdles while negotiating. You have to ease their burden by gathering all the details and records at hand. Here is a checklist of some documents to be prepared with before hiring billing advocates:
- Medical bills (itemized if available)
- Health insurance policy documents
- Explanation of Benefits (EOB) forms
- Authorization to communicate with healthcare providers and insurers
- Access to medical records
- Proof of payments made
- Summary of prior steps taken to resolve the issue
Considerations Before Hiring A Billing Advocate
If you are beginning your research to hire an advocate for your medical bill, let us help you with one last thing that will make your work easier. Following are the things to keep in mind when communicating with them for your billing tasks:
Expertise: Look for an advocate who has a successful track record in handling billing cases similar to yours.
References: Ask for their references and get to know about their skills with their past clients. Get proper feedback on how well they handle medical billing.
Fee structure: Before signing the contract, clear payment matters. Know what their fee schedule for services you receive and do they charge any extra fees for additional support.
Accessibility: Ensure that the advocate is accessible to communicate and is under easy reach to discuss the billing issues. Make it clear how the communication will be conducted between you two, defining the preferred contact modes as well as update frequency.
Advocacy approach: Get to know their strategy for dealing with your case and what plan they have at hand regarding negotiation and disputes.
Confidentiality: Make sure they protect your sensitive data. Ask about their security measures to ensure crucial data safeguards.
Potential conflicts: Another must-know thing is that any potential conflict may arise during the negotiation process and how they plan to resolve them.
Expectations: Clearly communicate your goals to the advocate. This way you will ensure you both are on the same page and that they work strategically towards meeting your desired outcome.
Win The Billing Battle
After reading our guide you may think that medical billing advocates are angels. You are right to some extent as you are out of the tension game; now there is a helper to handle your entire billing. All you have to do is make the process easy for them by providing appropriate documents to begin with.
After all, the more ease you provide to them, the quicker you are likely to win your case. So protect yourself from paying unjustified bills. Have a professional working for you and let them handle everything.