medical bill help

Tired of fighting medical providers? Hire a negotiator

J Roberts

 Check out Aaron Crowe’s recent article about Medical Cost Advocate which recently appeared on WalletPop.com. One thing is for sure, Aaron is right on when he states, “…one of the worst bills to receive is a medical bill.” Medical Cost Advocate is the resource that can assist you in reducing your medical bills.

Aaron Crowe

Of all the bills that arrive in the mail, one of the worst has to be a medical bill.

Whether from your insurance company or medical provider, the expensive bills are difficult to understand and patients don’t know if they’re getting ripped off.

Add in the fact that by a conservative definition, 62% of all bankruptcies in 2007 were because of medical bills, with 92% of those debtors incurring more than $5,000 in unpaid medical bills, and a hospital bill is enough to send you back to the hospital.

With an 80% success rate of getting patients’ bills lowered, Medical Cost Advocate, or MCA, negotiates with medical providers to get lower bills. It’s a service that makes everyone happy, said Derek Fitteron, CEO and founder of MCA. Patients pay less and doctors get paid.

“It’s not a lose situation for the doctor,” Fitteron told me in a telephone interview from his office in New Jersey.

With most of MCA’s negotiators being attorneys, they know how to negotiate a lower bill by providing data showing how much the same procedures cost across the country, and get the doctor paid soon instead of having to send out multiple bills to patients, Fitteron said.

I recently wrote a story for WalletPop about a Web site that lets customers bid for prices on health care before they visit a doctor. MCA turns that around and helps people lower their bills after their care. It’s rare for people to know how much something will cost before walking into a hospital, Fitteron said.

“When you go in for work, or a procedure, you don’t know how much it’s going to cost,” he said.

MCA doesn’t charge upfront fees for its service, but charges 35% of whatever savings it gets. Customers don’t pay if no savings are found. Once a settlement is reached, the customer’s credit card is charged to pay the medical provider and MCA’s 35%.

Here’s an example on the company’s Web site on how the process works:

If you submit a bill for $750 and MCA gets it reduced by $170, you’ll pay the difference, or $580 to your medical provider. MCA’s 35% cut of the $170 savings is $59.50, making your net savings $110.50.

Most bills submitted to MCA are for $1,000 or more, although they can be for as little as $200.

The most typical bills it gets are for elective surgeries, Fitteron said, such as gastric bypass and cosmetic surgeries that out-of-network providers must do because in-network doctors aren’t covered under most insurance. Large surgeries that are known about ahead of time are also popular bills submitted, he said.

Either through deductibles, co-insurance payments or uninsured or partially uninsured medical procedures, the typical family spends $1,500 per year on out-of-pocket medical expenses, Fitteron said. For 10% of Americans, those expenses add up to $14,000, he said. That’s a big enough reason to submit a bill for review.

Fitteron recommends getting a tax deferred health spending account through work to help pay medical bills, and for checking what coverage you have before you have to go to a hospital.

If they have the time before a major operation, for example, people should check how much insurance coverage they have for it, Fitteron recommended. Out-of-network prices are like the first offer a car salesman makes, so it’s worth negotiating.

He cited a recent MCA case that dropped a Florida woman’s hospital bill from $53,000 to $22,000 for knee replacement surgery. She had catastrophic, high deductible medical insurance, and her insurer only paid $3,000 — what it was legally obligated to pay under her insurance plan.

After MCA determined what the “market oriented rate” for a knee surgery was and received some support from the hospital, the bill dropped dramatically.

It’s one less bill to worry about when the mailman arrives.

Aaron Crowe is a freelance journalist in the San Francisco Bay Area. Reach him at www.AaronCrowe.net

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How to curb runaway medical costs

J Roberts

Here’s an article that details some of the factors behind the ever increasing costs of healthcare in the US.

Ken Alltucker

A good doctor can help guide us to a healthy lifestyle. A hip or knee replacement can ensure mobility and relief from pain. A well-run hospital can be the difference between life and death.

But physicians, medical devices and drugs cost a lot. Americans will spend $2.4 trillion on health care this year.

Hospital and doctor bills, especially for the uninsured or those without enough coverage, already can be devastating.

Without a health-care overhaul, the price tag is projected to grow, particularly as Baby Boomers swell Medicare enrollment.

Beware errors in your bill

One way for consumers to take charge of their own medical costs is by scrutinizing doctor and hospital bills, patient-advocacy groups say.

Medical Billing Advocates of America, a Virginia-based consultant, estimates that 80 percent of hospital and medical bills it reviews have some type of error. And those errors can be costly, inflating bills 17 to 49 percent more than they should be, according to Chief Operating Officer Christie Hudson.

Medical Billing Advocates has found a wide swing in pricing among hospitals and doctors nationwide.

For example, one hospital charged $15 per dose of Tylenol or $10 for use of a disposable cup. The hospital charged a patient twice for items such as gloves, swab alcohol, a warming blanket and a daily charge for an IV pump.

To monitor their costs, Hudson said customers should request a line-item bill from a doctor or hospital. She said coding errors are common. So is double billing – for example, charging for a hospital gown when it should already be covered in a hospital’s room fee.

Also, she said patients should make sure a doctor gets prior authorization from an insurance company before conducting a procedure. (more…)

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Insured, but Bankrupted by Health Crises

J Roberts 1 Comment

Health advocates warn of the dangers of the underinsured – the millions of Americans who have a basic form of health insurance, but not enough to cover a chronic or catastrophic illness. This group of people represents a “great hidden risk to our health care system” according to the below article published in the New York Times.  More and more people are facing financial hardship and burden due to the rise in healthcare costs and increased out-of-pocket expense.

New York Times

 

Health insurance is supposed to offer protection — both medically and financially. But as it turns out, an estimated three-quarters of people who are pushed into personal bankruptcy by medical problems actually had insurance when they got sick or were injured.


And so, even as Washington tries to cover the tens of millions of Americans without medical insurance, many health policy experts say simply giving everyone an insurance card will not be enough to fix what is wrong with the system.
Too many other people already have coverage so meager that a medical crisis means financial calamity.


One of them is Lawrence Yurdin, a 64-year-old computer security specialist. Although the brochure on his Aetna policy seemed to indicate it covered up to $150,000 a year in hospital care, the fine print excluded nearly all of the treatment he received at an Austin, Tex., hospital.


He and his wife, Claire, filed for bankruptcy last December, as his unpaid medical bills approached $200,000.


In the House and Senate, lawmakers are grappling with the details of legislation that would set minimum standards for insurance coverage and place caps on out-of-pocket expenses. And fear of the high price tag could prompt lawmakers to settle for less than comprehensive coverage for some Americans.


But patient advocates argue it is crucial for the final legislation to guarantee a base level of coverage, if people like Mr. Yurdin are to be protected from financial ruin. They also call for a new layer of federal rules to correct the current state-by-state regulatory patchwork that allows some insurance companies to sell relatively worthless policies.
“Underinsurance is the great hidden risk of the American health care system,” said Elizabeth Warren, a Harvard law professor who has analyzed medical bankruptcies. “People do not realize they are one diagnosis away from financial collapse.”
Last week, a former Cigna executive warned at a Senate hearing on health insurance that lawmakers should be careful about the role they gave private insurers in any new system, saying the companies were too prone to “confuse their customers and dump the sick.”


“The number of uninsured people has increased as more have fallen victim to deceptive marketing practices and bought what essentially is fake insurance,” Wendell Potter, the former Cigna executive, testified.


Mr. Yurdin learned the hard way.

(more…)

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