Medical bill advocacy
Encyclopedia
Medical-bill advocacy is the name generally attributed to the industry that has developed in response to a growing problem of erroneous charges on hospital
bill
s. According to the Medical Billing Advocates of America (MBAA), as many as 9 out of 10 bills from hospitals and medical providers include errors that may erroneously inflate the cost
of actual healthcare received.
Medical bill advocates help patients find errors in their bills, negotiate with their insurer to appeal coverage denials, and/or negotiate lower fees with their medical care providers.
Examples of common medical bill errors identified by advocates include the following:
Examples of companies that provide medical bill advocacy services include HealthCPA http://www.healthcpa.com, Billright http://www.mybillright.com, AdvoMed, TrueFACS
, and Medical Cost Advocate.
Hospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
bill
Bill (payment)
A bill or invoice is a document requesting payment for an order previously supplied. Presentation of a bill is common practice on the part of credit card companies, utilities, and other service providers...
s. According to the Medical Billing Advocates of America (MBAA), as many as 9 out of 10 bills from hospitals and medical providers include errors that may erroneously inflate the cost
Cost
In production, research, retail, and accounting, a cost is the value of money that has been used up to produce something, and hence is not available for use anymore. In business, the cost may be one of acquisition, in which case the amount of money expended to acquire it is counted as cost. In this...
of actual healthcare received.
Medical bill advocates help patients find errors in their bills, negotiate with their insurer to appeal coverage denials, and/or negotiate lower fees with their medical care providers.
Examples of common medical bill errors identified by advocates include the following:
- Duplicate billing: charging twice for the same service, drugDrugA drug, broadly speaking, is any substance that, when absorbed into the body of a living organism, alters normal bodily function. There is no single, precise definition, as there are different meanings in drug control law, government regulations, medicine, and colloquial usage.In pharmacology, a...
s, or supplies - Typos: entering incorrect billing codes or dollar amounts
- Canceled work: charging for a test your doctor ordered, then canceled
- Upcoding: inflating a charge, for example, adoctor prescribes a generic drug, but the bill lists a costlier, brand-name drug
- Inflated operating room fees: charging for more time than the anesthesiologistAnesthesiologistAn anesthesiologist or anaesthetist is a physician trained in anesthesia and peri-operative medicine....
's records show was used.
Examples of companies that provide medical bill advocacy services include HealthCPA http://www.healthcpa.com, Billright http://www.mybillright.com, AdvoMed, TrueFACS
TrueFACS
TrueFACS offers medical bill advocacy services to companies and individuals who are concerned about the accuracy of their medical bills.They are a part of the iCan Group, a family of companies in the insurance and marketing industries....
, and Medical Cost Advocate.