SERVICES FOR PROVIDERS

You wouldn’t drive in a foreign country without having a map, directions, or a GPS. If you did, you’d surely get lost! The world of health insurance is complex, and layered with many hidden rules. It can be confusing and daunting. Insurance companies often take advantage of people’s lack of knowledge and unfairly deny out-of-network claims or pay them at only a fraction of what they should be. The medical provider then either adjusts these as “insurance write-offs”, or bills the patient for the balance, depending on the circumstances. “Insurance write-offs” mean decreased receivables. There may be many situations where a properly executed appeal could have resulted in recouping additional reimbursement from the insurance company. In cases where the medical provider bills the patient for denied or partially paid claims, the patient may be unwilling or simply financially unable to make payment. The result is an uncomfortable situation between provider and patient. The medical provider may ultimately choose to send the account to a collection agency to handle. This will not necessarily solve the problem, as the patient truly may not have the funds to pay the bill. A payment plan for a large bill means a lengthy time will elapse before the bill gets paid. Furthermore, the collection agency will likely negotiate a discount with the patient on the balance, and then take a percentage of that as their fee. Medical Bill Navigators can help you navigate your way out of messes like these. We are highly skilled at reviewing EOBs for appeal opportunities, and we involve appropriate state agencies as needed and provide backup documentation when necessary to make a strong case that additional payment is warranted. We are diligent in following a case through to its completion using our years of experience, knowledge, and skills to pursue all avenues of appeal thoroughly and aggressively to get the claim paid. The result: everyone’s happy. The provider-patient relationship is intact, and the medical provider gets paid a fair amount for his charges in one lump sum - no waiting for payment installments. Medical Bill Navigators is exactly the resource you need to fight the insurance company, and get them to pay what they truly owe for the valuable services you provide. Your billing staff does not specialize in pursuing maximum reimbursement for your out-of-network claims. We do! Don’t delay – call us right away and we’ll help you navigate your way to fewer write- offs and higher receivables.