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The Medical Billing Advocate can analyze your medical bills and spot errors, overpricing, duplicate payments, frivolous payments, and even fraud. He or she can determine if your health insurance paid what it owes, and if not, why. 

A medical Billing advocate can also work on your behalf to establish inappropriate expenses or appeal denials of a health insurance claim. He can also negotiate with doctors and hospitals to reduce your debt.

Nowadays, many patients appoint these paid specialists who can help them in interpreting and cutting medical bills. But a medical billing advocate can cost you hundreds or, in some cases, even thousands of dollars.

There is no need for a medical billing advocate for everyone, but in some situations, people often require additional help, and these professionals can act as an anchor to them.

What is Medical Billing Advocate?

Advocates of medical billing often have previous work experience working for health care providers or insurance agencies, so they have an internal perspective. A medical billing advocate provides the following types of services:

  • Check your medical bills, insurance explanations of benefits (EOBs), and medical records for accuracy.
  • Find the mistakes and negotiate with your doctor or insurance company to cut costs. Mistakes can include discrepancies in the medical billing code, overcharging, denial of inappropriate insurance claims, and other errors that can unnecessarily increase your bill.
  • Work with your doctor to negotiate additional discounts.
  • Put together a medical bill payment plan for your health care provider (including hospitals) that fits your budget.

Qualifications

Education requirements for healthcare positions vary. A person hoping to start their nonprofit group or take a leadership position in an existing advocacy agency would do well if they graduated. Certification programs include nonprofit management and health advocacy. Simultaneously, advanced study options such as a Master of Science in Medical Communications can provide more in-depth knowledge of evaluating, designing, and implementing health advocacy programs.

Some college programs offer the opportunity to gain practical experience in social services or health care. Students can choose to seek health care support placements in terms of internships to complement their education. The American Medical Association facilitates advocacy for professionals and patients and can provide valuable networking opportunities.

There is no certification, regulatory requirement, or formal training to become a medical billing advocate. In the case of a medical billing advocate professional, the things that matter the most are the years and type of experience they have in this professional field. Areas of specialization in medical billing advocacy are also significant because this drives clients with the same cases as you and references from clients that have been your success stories. A medical billing lawyer should also have documented medical billing coding evidence to help you with complicated medical bills.

How much does a Billing Advocate cost?

Advocates of medical billing can charge hourly rates for a specific bill, a monthly fee to regularly review all of your medical bills or a percentage of the costs they help you recover. The charges of a medical billing advocate are based on your needs and the professional type of services. It would be best to ask in advance about the payment structure and payment policies to avoid any hassle in the future.

Advocates of medical billing tend to specialize in certain areas, such as hospital bills, working with seniors, or specific geographies. The specialities emphasize a lawyer’s experience, which he may have worked in in the past, and can genuinely make an advocate more valuable to your situation. So, it is better to find a more focused professional on cases like one of yours.

Finding a Medical Advocate

While medical billing advocacy is a growing business, it is still tough to find one who is best for your case.

You can search them in your contact list, via your friends of friends, or through websites that provide a searchable directory of medical billing advocates.

Once you have gathered the information for these medical billing advocates, you will need to contact each of them to get an idea if they can help you, what the process will entail, and how much their services will cost.

Since every case is unique, you should prepare a list of questions you can ask before interviewing them to assist with the right one for your particular case.

Some of these questions are;

  1. Do you have experience of handling similar cases before?
  2. What is your qualification?
  3. Your payment policy?
  4. How much time will you need to perform the necessary services?
  5. Do you have references?

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