If you disagree with a medical bill or processing of a medical claim and find the process to resolve the situation to be too complicated, too time-consuming, or otherwise overwhelming, we can assume management of the case as your Medical Claims Advocate.

With your written permission, we will contact all involved parties (e.g., health insurance carriers including Medicare and Medicaid, hospitals, laboratories, diagnostic testing facilities, physicians, billing companies) to attempt to resolve the disputed matter and to finalize claims processing according to the appropriate plan provisions.

Sample situations include:

determining if bills and insurance claims accurately reflect services provided and to discuss any discrepancies.

determining the status of an insurance claim and if needed, facilitating its re-submission, appeal, and re-processing.

identifying information and documentation needed for claims processing and coordinating delivery of that information to the appropriate parties.

Don’t Get Fooled:

Prior to surgery, you confirm that your surgeon and facility participate with your plan. What about services and providers over whom you have no control?

If you don’t do your homework, you could end up with expensive bills from ancillary service providers including labs and anesthesiologists.

identifying, discussing, and negotiating your payment obligations and potential payment options if it is determined that you are financially responsible for the disputed matter or some portion of it

confirming with the involved parties that you are not financially responsible for the disputed matter

Fees are determined and provided to you upon review of the complexity of the case.