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How To Be Your OwnHealthcare Consumer      Advocate      Courtesy of:Montana Medical Bill Review
Overview: Medical Billing                ProcessConsumer (patient) goes to doctor, hospital, or other provider for preven...
Anatomy of a Medical BillDoctor’s Office VisitHospitalPhysician Service – Inpatient
Top 10 Things You Can Do to Help            Find Billing Errors Check Name Check DOB Check Account Number Check SSN C...
Working with Provider or Insurance Company to Correct Errors Collect all your information (bills, account statements, EOB...
How to be your own healthcare consumer advocate
How to be your own healthcare consumer advocate
How to be your own healthcare consumer advocate
How to be your own healthcare consumer advocate
How to be your own healthcare consumer advocate
How to be your own healthcare consumer advocate
How to be your own healthcare consumer advocate
How to be your own healthcare consumer advocate
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How to be your own healthcare consumer advocate

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Basic steps you can take to determine if your medical bills contain over-charges; how to detect errors and what to do about them.

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Transcript of "How to be your own healthcare consumer advocate"

  1. 1. How To Be Your OwnHealthcare Consumer Advocate Courtesy of:Montana Medical Bill Review
  2. 2. Overview: Medical Billing ProcessConsumer (patient) goes to doctor, hospital, or other provider for prevention or treatmentData collectionServices rendered and documentedBilling document generated using collected data and codes from patient’s medical recordElectronic claim form submitted by provider to insurance company (If no insurance, payment collected from patient.)Provider receives payment from insurer in 30 days
  3. 3. Anatomy of a Medical BillDoctor’s Office VisitHospitalPhysician Service – Inpatient
  4. 4. Top 10 Things You Can Do to Help Find Billing Errors Check Name Check DOB Check Account Number Check SSN Check New Patient vs. Established Patient Request a detail bill Check type and number of procedures (X-rays, lab tests, EKG,etc.) Hospital bill – check inpatient vs. outpatient status/number of days Check room rate – Private vs. SemiPrivate/ICU, etc. Check type and amount of medications
  5. 5. Working with Provider or Insurance Company to Correct Errors Collect all your information (bills, account statements, EOB, cancelled checks, credit card statement, insurance policy number,etc.) and have it available to refer to, before you contact provider or insurance company customer service Remain calm Smile when you talk on the phone  Provide necessary information to verify your identity and account number Briefly state your issue/concern/questions Ask for clarification of any charges or insurance payment denials Specifically identify billing errors Request a corrected bill If necessary, use the appeals process outlined in your insurance policy to appeal a claim denial you believe is in error Follow up: review account statement from provider to confirm corrections; review subsequent EOB from insurance company to confirm claim status/payment
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