Medical Bill Rescue is a new patient advocacy division of Medical Consulting From A to Z, Inc. which advises consumers on handling unpaid health insurance claims. The company obtains potential solutions by working with your insurance carrier and your medical facility provider. They educate consumers on different types of insurance coverage consisting of Medicare (Parts A, B, C, and D), Medicaid, and Commercial Insurance Options as in Preferred Provider Organization or a Health Maintenance Organization that is best for their specific situation. This company answers your insurance questions when you do not know where to turn to on coverage questions and issues that “just do not look correct” on your medical bills and insurance claims. They work with your physicians’ offices, laboratories, surgery centers, hospitals, and insurance providers to get a solution to your concerns.
One of Medical Bill Rescue’s first clients was being billing approximately $8,000. The insurance company requested the medical records and unfortunately an error occurred and the records were not sent. Therefore, since the records were not sent to the insurance company, the insurance company would not pay the claims. The medical office placed the balance on the patient to pay.
Accidents like these are unfortunate, yet can be very common. It can depend on the number of billing/coding staff available in a facility (are they understaffed) and their training.
A to Z Medical Audits works with all types of medical facilities with their coding, billing, auditing, compliance, and individualized one–on-one training for specific billing or coding issues.
There are millions of dollars of incorrect claims filed to insurance companies on an hourly, daily, weekly, and monthly basis. Medical billing and coding is not a simple process. Common types of errors include: misspelling, use of nicknames instead of legal names, sending claims to wrong addresses, medical coding errors where the procedure does not match the diagnosis or the diagnosis is totally incorrect for multiple different reasons. The problem of unpaid bills is not always the fault of the medical provider.
To add to the medical provider confusion the U.S. Department of Health and Human Services (HHS) proposed in the Federal Register, new code sets on August 21, 2008 to be used for reporting diagnoses and procedures on health care transactions. Under the proposal, the ICD-9-CM code sets, which are current diagnosis codes, would be replaced with the new version ICD-10 code sets, effective October 1, 2011.
Education is the key to understanding not only what goes on a claim, but also how the medical provider codes the procedures and diagnosis will determine how a claim will be processed by the insurance company. The medical provider obtains their information from the patient and/or another medical provider and this relates to how the claim will be processed. Every commercial insurance carrier, like Anthem, Aetna, Sagamore, and Medicare and Medicaid has coverage requirements that must be met. Some of these rules take thousands of pages of documents to fully explain.
The owner of Medical Consulting From A to Z has over twenty years experience in the medical arena in medical coding, billing, auditing, compliance, and training of physicians, medical staff, and training students to get their national coding and billing certifications. She has been certified by the American Academy of Professional Coders for ten years as a Certified Professional Coder. She is currently writing a national medical coding textbook at the request of Lippincott, Williams, and Wilkins; Wolters Kluwer Health.
Medical Consulting From A to Z will be conducting a public training session on September 27, 2008 at Hope International Ministries; located at 1205 East New York Street, Indianapolis, IN 46202 at 1 pm. This session will include information on different types of insurance carriers that are available with different types of coverage, what to expect from your insurance company and your medical providers, what are the state and federal laws in relation to medical bills, and what choices a provider or consumer have when the insurance company will not pay an appropriate claim that should be covered. There will be a question and answer session at the end.
Reservations are required. The fee is $20 per person/$25 per couple. A portion of the fees will be donated to Hope International Ministries to further their mission in helping in disaster relief, the homeless, and other people in financial need.
With the myriad of issues that both the consumer and the medical provider face to get claims paid in today’s challenging insurance world, contact Medical Consulting From A to Z and its divisions Medical Bill Rescue and A to Z Medical Audits, or log onto AtoZMedicalAudits today.