A Medical Advocate Obtains Documents from Many Sources
A medical advocate starts off their work by obtaining an itemized version of their client’s medical bills from their client’s hospital and doctors. This is not a summary bill, which lists broad categories such as surgical supplied, radiology, pharmacy, but a detailed bill, as is required under the AMA (American Hospital Association) Patient’s Bill of Rights.
Medical advocates also know to ask for a copy of the UB-04, which is the billing form used for Medicare and is the detailed bill sent to insurers. Since doctor’s orders and nursing notes contain references to all drugs, treatments and procedures administered, those are also sought from the hospital medical records department.
Bills from outside providers, like the ambulance company, or the anesthesiologist flesh out the details and are very helpful for a complete review. A thorough review will also include examining any Explanations Of Benefits forms (EOBs) from the insurance company, if the client has health insurance.
Advocates ask clients to write down what they recall about their hospitalization and procedures: how many days they were there, what medicines they were taking, what tests they underwent, any treatments they were given, and any other details they can recall which could flesh out the picture of what happened for the person reviewing their records. Individual clients know which medications they are allergic to, what procedures or treatments they would never agree to have, and knowing this information can be very helpful to eliminate inaccurate charges that can show up in the bills.
Our office is expert at helping find insurance to pay these bills, or at negotiating a reduction in proper cases where there is inadequate insurance.
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