Web Extra: Healthcare Problem Solver

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If you've ever dealt with a healthcare issue, I can relate. I myself have received a surprise bill and getting it resolved was a bit of a nightmare.

What I didn't realize at the time is I have a free service through my employee benefits that I could have used to help me through the process. You might have this same free service available to you. And even if you have to pay for it, it might be worth it.

"HealthAdvocate was started 16 years ago on the idea that healthcare is confusing," Dr. Abbie Leibowitz, Co-President HealthAdvocate.

The company's mission is to help confused consumers.

HealthAdvocate bills itself as a one-stop place for all things healthcare related. That includes help finding a doctor, understanding what was discussed during your appointment, or dealing with a change in your prescription medication.

"We cover the entire gamut of health issues for people," explained Dr. Leibowitz.

Companies like HealthAdvocate are known as claims consultants, medical billing advocates or patient advocates.

HealthAdvocate is based in Plymouth Meeting and serves as your liason between insurance companies, hospitals and physician's offices. Its team is comprised of doctors, nurses, benefits experts and administrative professionals who take calls 24 hours a day, 7 days a week.

"We build an independent, trusting relationship," he said.

A big issue HealthAdvocate helps with is medical bills. It can help negotiate large balances down and research whether you even owe the particular amount for which you've been billed. One buzz word that could greatly affect your bills is coding.

"Every service, every kind of medication you take has a unique code assigned to it," said Dr. Leibowitz.

Health professionals use those codes to tell insurance companies what service they provided to you.

"If I've coded it wrong, it's possible that the insurance company will misinterpret what I did and the code may not fit the service that is covered," he said.
Which could land you with a hefty bill.

"When you have a problem you just want to get well you shouldn't have to worry about whether someone codes something right or they send your specimen to the right lab," he said.

And HealthAdvocate staff members don't just help you with your medical bills. They can also find you child care, elder care and alternative therapies. They can also keep you on top of preventative measures, help come up with a treatment plan for a specific illness, and can even help you choose benefits during open enrollment times.

HealthAdvocate is partnered with 11-thousand companies nationwide and if it's part of your benefits, it's free to use.

Click this link to find out if you're already subscribed.

The service may also be available to you for free directly through your insurance company. For instance, Independence Blue Cross individual consumer members have access to HealthAdvocate. IBX also states: "Whether a person has their own insurance, receives coverage through an employer, or through Medicare, our customer service representatives are available to help our members find the best resolution possible when issues arise. If our member receives an unexpected bill from a doctor, we want the member to contact us immediately. We will take it from there, and work directly with the doctor to resolve the issue."

If you don't have free access you can also sign up with the company's consumer counterpart, HealthProponent. There's a $29.95 sign-up fee and a $99 fee for each case.

And the resource isn't just for you your entire family can use it!

"Our service covers the individual employee or member as well as their spouse, their dependents, their parents and their parents-in-law," he said.

There are a number of other patient advocate companies so remember to do your research. Read the documents carefully and see exactly what is covered and what isn't. For instance, HealthAdvocate helps with bills that are over $400. Also understand how the advocate will get paid. Some work on commission, and get paid a percentage only if they successfully solve your problem. Also make sure to get references and check the company's reputation online and with the Better Business Bureau.

Additional Resources:

Patient Advocate Foundation: Free help for patients with chronic, debilitating, or terminal illnesses.

More info on surprise bills:

How to haggle with your doctor

That CT Scan costs how much? How to avoid surprise medical bills

Consumers Union Insurance Complaint Tool

Websites where you can look up billing codes and prices:

You should try to contact your insurance company, hospital, or doctor's office for help with a bill first. Many state insurance departments can also help. Here are links:

To find other advocates in your area, you can try these links:
AdvoConnection directory
Medical Billing Advocates of America

When it might be time to hire a medical billing advocate

Information on a PA bill designed to fight balance billing
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