SERVICES FOR PATIENTS
We also offer services for Medical Providers. Learn More >
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 medical bills and insurance EOBs is like a foreign country to most people. It can be confusing and daunting. Insurance companies often take advantage of the average person’s lack of knowledge of the benefits due to him. Medical claims are often unfairly denied, or paid at a fraction of what they should be. The patient is then stuck with bills from the medical providers. Don’t just pay those medical bills without being sure if you truly owe that money. Medical Bill Navigators is exactly the resource you need to fight the insurance company, and get them to pay what they truly owe for your medical claims. Our highly experienced staff possesses the knowledge and skills to review your medical bills, and appeal and file complaints as appropriate. Don’t delay – ignoring your medical bills will not make them go away and could affect your credit. Avoid being harassed by collection agencies. Don’t get lost in the maze of medical bills. Call us for help, and we’ll safely navigate your way out.
- Appealing denied medical claims
We will put our extensive skills to use in fighting your improperly denied medical claims. We’ll research all the relevant background information on the claim, and use the correct terminologies and procedures to get the denials overturned.
- Obtaining additional reimbursement for
poorly reimbursed claims
Insurance companies often pay out-of-network claims at a fraction of what you’re entitled to under your plan’s benefits. We’ll review the claim looking for underpayments and follow effective steps to get the insurance company to pay the additional reimbursement that’s due.
- Ensuring that you receive all the health benefits you're entitled to
We are highly proficient at reviewing your insurance benefits package, and in turn understanding how your medical claims should be paid to the fullest extent to which you're entitled.
- Obtaining pre-authorizations for medical
services
Many diagnostic and surgical procedures require pre-authorization from the insurance company. Sometimes the insurance companies deny these requests as “not medically necessary.” Doctors and their staff often do not have the time nor the patience to go to the lengths necessary to get a procedure approved. We can act as a liaison between you and your doctor’s office and the insurance company to assess if the insurance company was justified in denying authorization for the procedure. In cases where the denial was unjustified, we will compile the documents necessary to appeal the denial.
- In-network exceptions (in-network
benefits for out-of-network claims)
In certain cases of serious illness or injury, the patient may feel the need to go to out-of-network providers who can offer the highest level of expertise in treating the condition. In such situations, the claims for these services will be reimbursed at the out-of-network benefit level which means that the patient will be liable for deductibles, co-insurance, and balance billing. In certain cases, we may be able to prove to the insurance company that going out-of-network for treatment was the patient’s only viable option. The insurance company will then be required to pay for these claims at the in-network benefit level. This will assure you of minimal financial responsibility for the services.
- Contacting collection agencies to halt further action
We will contact the collection agency to clarify what the balance is for. We will notify them that we are working on obtaining further payment from the insurance company, and ask them to halt their collection actions in the interim. We will provide them with our contact information, and ask that they direct any further communications or inquiries to us.
- Contacting providers and insurance companies to resolve claim problems
Some claims get processed incorrectly due to coding errors, typos, human errors, or misunderstandings. We will analyze the claim, identify the problem, and work with the provider and the insurance company to get it corrected.
- Reviewing and organizing medical bills
and insurance correspondence
Send us your paperwork, and we’ll sort through it. We’ll discard anything unimportant, identify duplicate correspondences, advise you of documents which require a response. We will ascertain which medical bills are justified, and which demand follow-up action to reduce or eliminate the bill completely.