What is Billing Advocacy and why should you care?

This week I've been working on a billing advocacy case for one of my favorite clients. The client had an emergency room visit and hospital stay in February, and called me right away to find out what his total out of pocket maximum would be. When bills started rolling in, we found that the amounts on the bills didn't match up with his plan. I immediately contacted the plan's broker line, and the broker service representative escalated the case to the claims department. Turns out that the bill hadn't been paid properly, and that the client's bill would be going down from $9000 to $3400. 

My help was included as part of this client using me as his broker from the start of his enrollment. WIHIA offers it as a service to non-clients at a fee that varies by claim. Resolving billing issues can be as easy as alerting the insurance company to a missed issue, or as complicated as negotiating prices with a hospital system or appealing a coverage denial with CMS. 

Billing advocacy is one of my favorite parts of my job. I know what it's like to get a surprise medical bill, and how it feels to waste time on a customer service line just to talk to multiple people who can't seem to solve the problem. What I love about being an independent broker is that in most cases I have a direct line to a representative at the insurance company who specifically works to help brokers solve problems for clients.