), How To Deal With COVID-19 Related Medical Bills, COVID-19: An Update for Current Patients and Website Visitors. Consumer advocates are calling for improved access to Medicare. The program provides health care coverage to beneficiaries who are more likely to suffer from the coronavirus. Avoid the frustration and upset of trying to understand those medical codes and bills on your own. *These programs received funding through Section 1002 of the Affordable Care Act. : If you have court judgements or liens related to an outstanding debt or feel like you’re being harassed by a debt collector – reach out to a Consumer Protections Attorney. He received his MBA from Dartmouth’s Tuck School of Business and BA in Philosophy from the College of William and Mary. No CAPs are in operation with a Federal Grant, A federal government website managed and paid for by the U.S. Centers for Medicare & If you do not consent, please do not peruse this site. : If your insurance company has denied your claim, an Advocate can walk through the multi-step appeals process – gathering and presenting the right evidence in the right way to increase the chances of success (and helping you to avoid a paperwork filled headache in the process). Medical billing advocates are experts on medical bills and the medical billing system on both the insurance and medical provider side. State CAPs offer direct assistance by phone, direct mail, email, or walk-in locations to help consumers learn how to obtain or use their insurance effectively. MedWise Insurance Advocacy provides medical billing and consulting services to Legal and Medical professionals, as well as individuals throughout the NY, NJ , CT, Tri-State area. : If you are fighting a bill based on a major error on the part of the medical provider (that is – you think the doctor or hospital committed malpractice in their treatment). They may also be able to identify when a hospital adjusting the codes used could get a claim overturned without having to file an appeal. The leading non-profit focused on Medicare advocacy and education in California. : Many medical device manufacturers and pharmaceutical companies will offer rebates directly to patients for devices used. In general, we recommend consumer protections attorneys as a natural first step to understanding what can be done about outstanding medical bills. That being said, the laws of our land are incredibly complex, so lawyers (like medical professionals) specialize in specific areas of the law. If your State doesn’t have a CAP, the map will direct you to other possible resources – such as the State Department of Insurance and the US Department of Labor – including phone numbers, email addresses, direct mailing addresses, and websites. Listen! 7500 Security Boulevard, Baltimore, MD 21244, Information Related to COVID–19 Individual and Small Group Market Insurance Coverage, FAQs on Essential Health Benefits Coverage and the Coronavirus (COVID-19), FAQs on Catastrophic Plan Coverage and the Coronavirus Disease 2019 (COVID-19), FAQs on Availability and Usage of Telehealth Services through Private Health Insurance Coverage in Response to Coronavirus Disease 2019 (COVID-19), Payment and Grace Period Flexibilities Associated with the COVID-19 National Emergency, FAQs on Prescription Drugs and the Coronavirus Disease 2019 (COVID-19) for Issuers Offering Health Insurance Coverage in the Individual and Small Group Markets, FAQs about Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act Implementation, Postponement of 2019 Benefit Year HHS-operated Risk Adjustment Data Validation (HHS-RADV). Note that there is a significant amount of overlap between personal injury and medical malpractice lawyers. Medical billing advocates will look at the following 4 areas to help lower your medical bills: Billing Errors: reviewing medical bills for correctness. Types of Medical Billing Advocates . Below are a few of the specialties you might consider: Personal Injury: if you were injured in an accident and are considering suing someone (usually not the hospital) it may be worthwhile to talk to a personal injury lawyer. Note that there is no required education to becoming a medical billing advocate. When you retain our services, you can count on our expertise and professionalism to meet your needs regarding medical insurance and medical claims—from recouping previously denied coverage and reimbursements to tracking benefits statements and medical bills to forensic work on medical claims. There are some organizations that have created standards and certifications to help consumers – such as the. In fact, medical billing advocates often cannot provide legal advice in a situation as doing so may be the unauthorized practice of law. Many Advocates can use data surrounding hospital costs, medicare rates, insurance negotiated prices, and usual and customary rates to convince the hospital to accept a lower price. If you’re dealing with a legal issue – go with an attorney. Many states offer help to consumers with health insurance problems through Consumer Assistance Programs* (CAPs). While sometimes their specific situation calls for a lawyer, oftentimes they may be better served by working with a medical billing advocate to lower their bills. Use this advice from Consumer Reports to get help with your medical bills. MedWise Interview On StressFreeNow.info, Listen! We can help. Contact MedWise Insurance Advocacy for more information about how our experts can help individuals and legal professionals make sense—and cents—from denied medical claims. Patients and consumers can hire an advocate to audit their medical bills, seek out errors and negotiate lower costs. Follows through on every case on your behalf, saving you time and money acquiring reimbursement for medical claims. She provides counseling on coverage options and advocates for their access to needed medical services, durable medical equipment, and home care as a part of Medicare Rights Center’s membership in the Independent Consumer Advocacy Network (ICAN), a NY state ombudsman program for people with Medicaid who need long term care. Is a health insurance consumer advocate and consultant for insured individuals, helping them obtain the money they deserve. MedWise Insurance Advocacy is a premier medical insurance advocacy firm, owned and managed by Adria Gross, a New York State-licensed insurance broker and consultant with over 25 years experience in the medical claims health insurance industry. They should be willing to spend 15-20 minutes talking through your case and give advice on the best path forward. (845) 238-2532 or e-mail us today. Medical Billing Advocates. Client Advocate Services was established to: - inform patients of their rights when dealing with New Brunswick Medicare - provide help and guidance on matters of dispute or disagreement - ensure the Medical Services Payment Act is appropriately applied - ensure the process of the different sections of the Act is respected. While often expensive, lawyers are experts at navigating the legal system. Some medical billing advocates will specialize in one area while others have experience in all four areas and will adapt to your given situation. In this post we’ll dive into the difference between a medical billing advocate and a lawyer, and walk through the key things to consider when deciding whether to hire one or the other (or neither). The map below will help you find the contact information for your State’s CAP. They may also be able to identify when a hospital adjusting the codes used could get a claim overturned without having to file an appeal. Learn More. Unfortunately medical bill negotiation lawyers generally don’t exist – the type of lawyer that may work for you depends on your given situation. Medical billing advocates are experts on medical bills and the medical billing system on both the insurance and medical provider side. Generally if you have liens or judgments filed against you, are being sued, or are thinking about suing – this is a legal issue. Note that there is no required education to becoming a medical billing advocate. Investigates medical bills and liens, supporting patients, individuals, elder law and personal injury attorneys to ascertain and evaluate Medicare, Medicaid, and private insurance medical claims and bills. Braden founded Resolve after experiencing first hand how unfair the system is for patients. to force the hospital to lower their price.