EPISODE 18 ~ SAVE MORE: Medical Billing Advocate: Hire a Specialist to Catch The Errors in Your Medical Bills
Now let’s plow into our SAVE more segment for the week: how hiring a medical billing advocate can save you thousands of dollars on hospital and other medical bills. My guest is Jeanne Woodward of Medliminal, a firm that specializes in finding and fighting erroneous medical charges. Welcome, Jeanne!
First of all, how common are erroneous medical charges?
Medliminal estimates, based on our years of analyzing medical bills, that 90 percent of them contain errors. And guess what? Most of those errors are in the hospital’s or other medical provider’s favor, not yours!
That’s a huge number. How does this happen?
•Sometimes patients are charged twice for the same service under different codes or descriptions.
•Maybe your surgeon charged full price for multiple procedures, even though they were on the same day.
•Often hospitals charge for related services that should not be billed separately.
You’ve got some specific examples of products or services that hospitals charged big bucks for. I’m going to name them and you explain and tell us the pricetag, OK?
•Thermal Therapy. That’s a euphemist for a bag of ice and one hospital charged $15 for it.
•Handling fee. They carried a vial of blood to the lab and charged $18 for that.
•Cough support device. This was literally a teddy bear! And it cost $62!
•Venipuncture. That’s the technical term for inserting a needle to draw blood. One hospital charged $680 for it.
So medical billing advocates help people find and fight these charges. How do you do that?
•First we request the patient’s complete medical records and an itemized bill. Patients rarely see those and they are a goldmine of details. We compare the medical record against the medical bill and look for discrepancies.
•At Medlimimal, we have developed software that scans hospital bills for errors and overcharges. Plus our people are nurses and coding experts, so they KNOW healthcare. They also comb through the patient’s bill personally looking for things that don’t make sense.
Are the errors they find just accidents? Or do they seem intentional?
•Mistakes can be simple human errors like misplaced decimal points or the wrong patient ID number.
•Or problems can be more intentional, such as: Upcoding, where a hospital bumps a procedure up to a more complicated code in order to charge more. Or charging for things that are supposed to be included, like surgical supplies that are included with the surgery.
Without naming names, can you give me an example of an individual you helped, what the major errors on their bill were, and how much you saved them?
Cynthia K. of Florida thought being diagnosed with breast cancer was the worst thing that could happen to her. But then the hospital where she had her 40-minute lumpectomy overcharged her. Before the operation, the hospital told her it would cost $5,000. Instead she got a bill for $12,700. Her medical billing advocate found all sorts of classic errors. The hospital had billed Cynthia for two first hours in the operating room. There were drugs listed on the medical bill even though they weren’t in Cynthia’s medical record. And the hospital had charged Cynthia $192 for a postoperative support bra that her advocate was able to find for just $19 on the internet! All in all, the advocate was able to save Cynthia $6,858!
How much does it cost to hire a medical billing advocate?
Some charge an hourly fee, ranging from $25 to $150, for their work. Others work on contingency. That means you pay nothing unless they negotiate a lower payment for you. They then charge a percentage of the amount they saved you. 15 to 35-percent is typical.
If people listening have insurance, they may wonder why they would ever need a medical billing advocate?
•If you have a high deductible health plan, that means you have to pay the first few thousand dollars worth of care, so it’s worth it to reduce the cost as much as possible.
•Plus, many of us have co-insurance plans these days where we have to pay a percentage of our medical bills. If you’re hospitalized for something like a heart attack, your portion could easily be $20,000. You would want to reduce that bill as much as possible to shrink your own portion.
We’ve been talking about hospital bills, but what other kinds of medical bills can billing advocates help with?
—Lab and other diagnostic bills, like for MRIs or CT scans.
—And we can also help people get paid when their insurance company refuses to cover a claim.
At what point in the process should you hire a medical billing advocate?
It’s crucial to hire a medical billing advocate BEFORE you pay your hospital or other bills. It’s a lot easier to pay less money in the first place than it is to get money back after a hospital or other medical company already has it.
Jeanne Woodward of Medliminal, thank you so much for being here on Easy Money! And, lucky us, Medliminal has provided a guest blog post telling you steps you can take on your own to try to reduce your medical bills. If it’s complicated you’ll want to hire a pro… and they are also sometimes called claims assistance professionals, medical claims professionals or healthcare claims advocates. I will link you to several sites where you can find one, whatever they’re called!
Medical Billing Advocates of America: BillAdvocates.com
Alliance of Claims Assistance Professionals: Claims.org
Patient Advocate Foundation: PatientAdvocate.org
Healthcare Advocates, Inc.: HealthcareAdvocates.com
Health Proponent: HealthProponent.com
Care Counsel: CareCounsel.com (This service is only available through employers, so check with your HR department to see if your company participates.)