Medical Billing Explained

Understanding Medical BillingThe medical billing process has become more and more convoluted in America in the past twenty years, and it is leaving many patients “hung out to dry.”

The medical coding and billing process is a part of the medical industry that is now so complex, that colleges actually offer courses in this topic!

Medical billing in America is almost always a lengthy and stressful process now. First, your diagnosis and treatment records are submitted by the care provider to a medical biller. The medical biller then creates a billing record and submits it to an intermediary source, who edits your billing claim to meet insurance company criteria.

Next, the intermediary sends your medical bill to the insurance company to process the payment, and it is here where many problems occur.

And they happen at this particular stage of the billing process because the insurance company will conduct a series of “tests” on your bill to determine whether or not they will pay the claim. These tests include determining the patient’s eligibility for payment, the credentials of the provider, and the necessity for medical assistance in your case.

And believe it or not, sometimes the determination of whether your bill gets paid, and how much the provider is allowed to charge, depends greatly on the [Read more...]

How To Fight Medical Bills

These days, with medical billing errors being very common, and healthcare costs spiraling out of control, many Americans are wondering how to fight medical bills.

About 80% of medical bills contain errors, which can be anything from being charged for facial tissues and toothbrushes, to being double or triple charged for a medical procedure. If the cost of your medical bill seems wrong or unreasonable to you, then there is a very good chance that you are right.

Despite the rampant medical billing mistakes on many patients’ bills, all too often patients either don’t know that they are being overcharged, or don’t know that companies like us exist, who can help you fight unreasonable and wrong medical billing charges.

  • Is your medical bill much higher than the average cost of the procedure?
  • Have you spent hours upon hours trying to sort through the mysterious medical billing “codes” on your bill, only to find that you still can’t make sense of it all?
  • Are you tired of being relegated to insurance company call centers, when you just want to speak with one person who actually cares and who is willing to help you?
  • Do you want a solution and an end to your medical billing problems?

If you answered “yes” to any of the above questions, then we want you to know that our team of experienced medical billing advocates is here to help you, and was created to help everyday patients, exactly like you. Whether you are facing hundreds of dollars of charges, or tens of thousands, we want to help you achieve a permanent solution to your medical billing problems.

We will help YOU save time, win back YOUR money, and, most importantly [Read more...]

7 Common Medical Billing Errors

7 Common Medical Billing ErrorsMedical billing errors are becoming more and more common in the United States. As the government gets more involved in the health care field, and the disconnect between medical coding professionals and healthcare providers grows wider, the miscommunication that occurs is extremely common, and could be artificially inflating your medical bill.

Here are 7 common medical billing errors to watch out for:

1. Upcoding – Upcoding occurs when a medical billing code is improperly changed to one which represents a more severe diagnosis or treatment. This is illegal and can cause your bill to be inflated. Common examples of upcoding include things like coding for a name-brand medication when a generic one was used, or coding a regular office visit as inpatient care.

2. Unbundling – Unbundling occurs when charges that normally fall together under one billing code are listed separately. This can make your bill a lot higher because the [Read more...]