Unfortunately, many people encounter problems with their bills from Medical Providers – whether those providers are a hospital or a “doc-in-a-box”. Most billing is performed by administrative staff who “code” or “imput” the correct number into their computer in order to bill your medical insurance, Medicaid or Medicare. If the “coding” is not done properly, those bills do not get paid and are rejected by the insurer or the government. In some cases the “services” you receive are “bundled” by the insurance company. This means that the insurance company puts all these services under one category in order to pay the amount previously negotiated in their contract. In some cases, providers will “unbundle” services because it allows them to charge more.
Many times you may not even know that your billing has been submitted incorrectly until you receive a bill for thousands of dollars.
At the Ford Firm, we work with individuals and families to help them correct those billings mistakes.
If you have a billing problem with your medical provider, you may contact our office and set up an appointment with our medical billing advocate. We will set up a convenient time for everyone to meet and discuss the billing issues and we will suggest possible courses of action for you to take.
1. Once your appointment is set up, you will need to bring the bill or bills (THE MORE DETAILED THE BETTER - ask your provider for a detailed billing statement), your insurance information and the Explanation of Benefits that your insurer sent to you when you purchased your insurance plan;
2. Our firm charges a fee of $150 per hour to assist with medical billing issues and there is a minimum charge of 1 hour;
3. The first hour of fees must be paid in advance. Hopefully we can resolve your issue within the first hour. Remaining fees must be paid at the appointment; and
4. We cannot guarantee results – this means that your insurance plan may NOT cover some of the charges that you have incurred (which is why we request your “Explanation of Benefits”), further legal action may be required to prove your claim in court, or there may be other reasons why the bill cannot be reduced. We will discuss this with you at the meeting.
Our billing advocate will work with you under the supervision of a licensed attorney to (1) determine the billing issue(s) and (2) devise a plan to resolve those issues. This may include preparing a letter from you to the hospital or insurance provider to explain the claim or problem and what action is requested. We have found that most hospitals will correct improper billing issues when those errors are presented to them.
If your billing error is relatively small, we encourage you to try to resolve it yourself. If you are unable to determine the problem or find a solution – we are here to help you!