: 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. Medical Billing Advocates. Many states offer help to consumers with health insurance problems through Consumer Assistance Programs* (CAPs). If you’re dealing with a legal issue – go with an attorney. If you do not consent, please do not peruse this site. Broadly speaking a lawyer is an expert on the legal system – they understand the laws of the US, state,and locality they practice in (and sometimes other locations). Listen to MedWise Interview on Generation Bold Radio. Most hospitals also have financial aid policies to help people on lower incomes (and sometimes with larger bills). (845) 238-2532 or e-mail us today. CAPs that are still in operation are funded exclusively through mechanisms other than federal grant funds. In general, we recommend consumer protections attorneys as a natural first step to understanding what can be done about outstanding medical bills. In fact, medical billing advocates often cannot provide legal advice in a situation as doing so may be the unauthorized practice of law. Through a federal grant, many States have established CAPs in order to better assist consumers experiencing problems with their health insurance or seeking to learn about health coverage options. Braden founded Resolve after experiencing first hand how unfair the system is for patients. 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. Prior to Resolve, he built and ran Operations for a renewable energy company and then built and ran Product, Growth, and Operations for a VC-funded edtech company. 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. Healthcare Enrollment Dates, Fees and a Delicate Dance for Coverage, Surprise Medical Bills and Balance Billing or Just Billed. MedWise Interview On StressFreeNow.info, Listen! Provides advocacy and consulting services to legal professionals and individuals throughout the U.S., including the quad-state area comprising the New York metropolitan area (New York, New Jersey, Connecticut) and Pennsylvania. 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). 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. : If your insurance company is denying care coverage and you think litigation is the right route to go – consider reaching out to insurance lawyers. Services include analyzing and resolving medical bills, medical lien claims, medical insurance pre-authorizations, denied insurance claims, medical letters of appeal, understanding explanation of benefits and more. Medical Rebates and Financial Aid: Many medical device manufacturers and pharmaceutical companies will offer rebates directly to patients for devices used. If that doesn’t work, there’s also the potential to. – hospital chargemaster pricing (the rack rate charged to uninsured patients) are absurd and completely disassociated with reality. Is a health insurance consumer advocate and consultant for insured individuals, helping them obtain the money they deserve. Understanding what certifications a Medical Billing Advocate has can be a useful way to evaluate their experience. Some medical billing advocates will specialize in one area while others have experience in all four areas and will adapt to your given situation. 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. : 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). Most hospitals also have financial aid policies to help people on lower incomes (and sometimes with larger bills). 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). MedWise Insurance Advocacy is a division of MedWise Billing, Inc. In general, we recommend consumer protections attorneys as a natural first step to understanding what can be done about outstanding medical bills. resolve is Open. 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. At resolve we talk to people everyday who are looking for a lawyer to help them with their medical bills. They can and will use the court system to maximize your benefit. Consumer Protections Attorney: 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. : 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). Consumer advocates are calling for improved access to Medicare. They also have experience navigating the complex bureaucracy of hospital and insurance billing systems and speaking the right language (saying the right things to the right people). Note that there is a significant amount of overlap between personal injury and medical malpractice lawyers. 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. That being said, the laws of our land are incredibly complex, so lawyers (like medical professionals) specialize in specific areas of the law. Anyone can represent themselves as such (that doesn’t mean that there aren’t very good advocates out there). Understanding what certifications a Medical Billing Advocate has can be a useful way to evaluate their experience. If that doesn’t work, there’s also the potential to file in small claims court to force the hospital to lower their price. We use cookies to ensure that we give you the best experience on our website. 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.