We often hear of a friend or loved one who has experienced difficulty navigating our healthcare system. Perhaps you have experienced this yourself. During an illness or hospitalization patients come into contact with many different doctors, nurses, and other healthcare providers. And this is only the beginning. The patient or family will then have to deal with the incoming medical bills, insurance companies and billing departments.
Below are common concerns we are hearing
from our clients. Do any sound familiar?
Common Client Concerns
My hospital is in network, but now I am getting bills for other services while I was there. Who can help with this mess?
MEDICAL BILL REVIEW
Statistics reflect 30% to 70% of medical bills have errors. As a result, patients may unknowingly incur additional or incorrect charges.
Our company reviews medical bills for any errors, duplicate charges, and incorrect coding. We coordinate with the insurance company to monitor payments.
We negotiate the charges with the healthcare providers on behalf of the patient or their attorney.
MEDICAL COST PROJECTION
When a chronic or catastrophic condition exists, the attorneys need a plan for projecting the future medical needs and potential costs for that individual.
Our company provides this expertise. We complete a medical record review and interviews with pertinent healthcare providers, the patient and family.
The end product is a detailed and coordinated report reflecting the individual’s projected medical needs and associated costs.
Sarah Carbone RN, BSN, ARM
Sarah’s career began with clinical nursing in the fields of joint replacement, physical rehabilitation and chronic medical conditions.
She transitioned into the insurance industry as a Legal Nurse Consultant. Sarah has worked with numerous regional and national Insurance Carriers, Third Party Administrators, Managed Care Companies and PPOs.
These roles allowed her to gain expertise in Risk Management, Program Development, Medical Bill Review and Audit, Accounts Receivable, and Medical Case Management. These skills are vital when navigating healthcare in the 21st Century.