Medical billing advocacy began with a focus on helping individuals, who were frustrated, confused, and overwhelmed with high medical bills and potentially facing bankruptcy. Today, medical billing advocates are also working with attorneys, businesses, and physicians.
A medical billing advocate has the expertise to understand medical billing, medical terminology, and insurance explanation of benefit statements. In a perfect world, this should not have to be that hard; especially at a time when health care consumers are faced with medical problems and recovering from illnesses.
In addition to helping individuals, attorneys are struggling to deal with medical bills. They do not have the time, the medical coding experience, nor the software and reference resources to decipher the bills. It becomes much easier for them to contact a medical billing advocate, who can perform a chart audit, a compliance audit, and provide a fair and reasonable amount for services provided. This factual information allows the attorney to negotiate based upon a true and accurate cost basis for services rendered.
A few articles published by Steve Lombardi expose the difficulties faced in deciphering medical bills. Medical Billing: Tricks of the Trade Part 1, and Medical Billing: Tricks of the Trade Part 2, offer great insight on the challenges faced by attorneys, and also provide recommended solutions.
Today, the vast majority of businesses are self insured up to a certain limit, which means that they pay the claims of their employees until that limit is reached. For those businesses, employing a medical billing advocate could impact their bottom line by significantly reducing the cost of the of the claims. Medical billing advocates can discover duplicate charges, unbundled charges, and routine supplies that should not be billed to the patient.
Physicians have to deal with payments issues from insurance companies. Sometimes, there are payment delays caused by a multitude of reasons or claim denials. Although doctors have staff that deal with these issues, sometimes they opt to enlist the services of a medical billing advocate who may find a way to expedite insurance payments, and clean up their backlog of receivables.
Medical billing advocates charge by the hour, or on a percentage basis for recovery, or a hybrid of hourly and percentage. It makes good sense for attorneys, businesses, and physicians to enlist the help of an expert when faced with difficult medical billing issues.
Medical Billing Advocacy of the Rockies is located in Loveland Colorado and specifically serves customers in the state of Colorado. Holly Knapp is the Owner/President and can be reached at 970.663.1735.