Have you received a medical bill that’s outrageously high? Did your insurance cover any of the fee? Feeling overwhelmed when you go to the doctor? These are questions that are constantly being asked by patients.
Healthcare is one of the most confusing industries that affects each and every one of us and this is why it’s so very important to have an advocate on your side. Whether it’s family, a friend, a neighbor or a professional advocate, having someone on your side helps give you peace of mind.
It is estimated that 80% of all medical bills consist of some sort of errors. As a Board Certified Patient Advocate that audits medical bills for errors, I have to agree. These errors are most likely mistakes but unfortunately, you have to be an investigator with concrete evidence to prove the provider made a mistake and that’s not easy to do.
What are the options if the statement has no errors but is astronomically high? Provider fee negotiation? Yes! Successful negotiations consist of two things: the provider wants to be paid and the patient wants to pay a fair and reasonable amount. Having a Board-Certified Patient Advocate that specializes in negotiations creates a positive outcome for both parties.
The best way to minimize insurance confusion is to know your policy. Not only do errors happen on the billing side but it also happens on the processing of claims and the coordination of benefits. Did the providers use the right codes? Did the providers file the claims properly and was the care medically necessary? These are all questions you and your Advocate can find the answers to and assist with the proper way to resolve the situation.
Lastly, having an Advocate attend doctor appointments with you to make sure that your voice is heard while you are understanding what the doctor said and that you are informed of any and all care options is extremely beneficial.
Don’t be afraid to ask question or authorize someone to ask questions for you!
Michelle Riddle is a Patient Advocate with Complete Dignity. Visit her website!
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