Medical-bill advocacy

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 bills. 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.^[1]

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.^[2]

Examples of common medical bill errors identified by advocates include the following:

• Duplicate billing: charging twice for the same service, drugs, 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 anesthesiologist's records show was used.^[3]

Examples of companies that provide medical bill advocacy services include HealthCPA [1], Billright [2], AdvoMed, TrueFACS, and Medical Cost Advocate.

References