Where can I find a medical bill advocate?

Where can I find a medical bill advocate?
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#1

I gave birth last November 2015. My baby’s vitals were dropping, so I had a c-section right away. I started getting bills from the anesthesia doctor’s billing office. After a few more bills were received, I called the billing office to find out what was going on. The billing office stated that my primary insurance paid for most of it, except for one line item, the c-section. It was not paid for because the insurance provider stated it should have been bundled into the entire procedure, but the billing manager said it was a separate procedure.

The billing office sent out two appeals and both were denied. My insurance provider said that they requested documentation from the billing office and did not receive it, so they denied the appeal. All this occurred because it was coded incorrectly.


#2

If in fact it was coded incorrectly your insurance company was correct in denying the services.
Did your insurance company provide you with an explanation of benefits (EOB) showing the reason for denial and with no patient liability?
If not then reach out to your insurance company to send you a corrected EOB showing no patient liability.
You can not provide the codes and this would be a dispute between your insurance company and the anesthesiologist.
You can have your insurance company reach out to the anesthesiologist’s office on your behalf.
If you need further assistance please reach out. We will audit the medical records for correct coding, compliance and pricing and negotiate any out of pocket expenses.
Best of luck to you!
Cheryl Welch, MBA
Hudson Valley Medical Bill Advocates


#3

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