I worked for a company that provided extensive revenue cycle services & technology to healthcare providers. Lisa Berry’s comments are right on target. A legitimate medical bill warrants payment. In my experience, It’s best to work something out with the provider before it goes to a collection agency. The majority of providers are willing to com…[Read more]

I never pursue the small claims court option unless there is clear cause to do so. The process is fairly straightforward and there are small claims advisers in each county courthouse that can assist with the process. It’s important to know that attorneys are not allowed to represent a client in small claims court. I’m not an attorney and have had…[Read more]

This may be a good time to jump in to remind everyone that Marshall Allen will be APHA’s Expert Call-in guest in January:

Meet Marshall Allen, Author of Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win

I worked for many years as a staff nurse and team leader on a transplant unit (liver, kidney, pancreas, and bone marrow). I am more familiar with the actual surgery and post-op process/complications/meds/etc. more so than the pre-tx process. Sounds like you got some good Cali referrals above, but feel free to reach out if needed.

Bridget

The book mentions the advocate Lisa Berry Blackstock on this topic. I suggest you reach out to her

Here’s some information to help you assess this situation, and to provide a bit of perspective.

The Advocacy Liability Insurance Conundrum

We’ve got your backs 🙂

Linda – thanks for being lawyerish! It does help.

We actually provide more information, and terminology, on exactly what you have explained – right here: https://myapha.org/centers/insurance-for-your-practice/advisor-insurance/questions-terms/

As most of you know, I often say that being an advocate means being able to help your clients…[Read more]

Great discussion – at the risk of sounding lawyer-ish, here are some thoughts in connection with AnnMarie’s post, because insurance terms are opaque and rarely explained:
* In case you missed this point, anyone can sue anyone else for anything at just about any time – and that means you need to file a response with the court or risk being held…[Read more]

If the payer hadn’t increased the allowable, the insurance payment and the patient balance should have been less. This is my thinking.

I will be calling insurance next week so we will see what happens.

Thanks for everyone’s comments

Bonnie and Sylvia – you are right that the lack of definition gets in our way. That said, some of our lack of definition is part of our definition!

If you look at the list of services provided by advocates: https://advoconnection.com/advocacy-services/ You’ll see such variation. I explain it by saying advocates touch every part of healthcare…[Read more]

Melanie – yes, of course, Markel is a legitimate company and of course Kyle is a licensed broker. You’ve been in excellent hands, and your policy will be 100% effective for as long as it lasts.

(I’m not sure why you would even ask that question?)

Kyle has no control over what Markel decides to do with its business (any more than a real estate…[Read more]

HoustonHealth,
EXCELLENT point!
I am working with a UGA/Small Business Development Center business startup consultant.
He and I had a conversation last week about the fact that he cannot locate any industry information on the patient advocate industry.
He asked me how long our industry had existed and what the average advocate income is.
He…[Read more]

Many of these 3rd party “revenue cycle” groups that are hired by health care providers now have attorneys on staff. I would investigate the billing group to see if they do—because that would probably mean that they could win in small claims court? I agree with Melanie that this could be a bad deal if your client loses as the bills would be…[Read more]

There was another discussion with other pt advocate colleagues that suggested we be classified under the designation “consultant”? I think since the insurance world does not have a specific designation for “patient advocate” that can result in a range of costs for E&O insurance?

I guess we need some insurance expert to tell us that our services…[Read more]

Hi
I replied to this in the General Conversation forum yesterday.

If you add the billed amount to the
Plan discount amount, it totals the allowed amount.

Once you subtract the paid amount, the amount due by patient is $4289.00

I suggest you audit both the original claim against the EOB.
Did your client pay any co insurance/deductible…[Read more]

Who is he going to file an action against, and why?
I used to represent a medical practice in small claims for non payment of charges. It’s time consuming and laborious.
Does he have a legitimate case, or is he upset that he’s not been successful in his attempt at negotiating a lower fee?
If he proceeds, and the defendant “shows” he may be on t…[Read more]

This is very concerning. I’ve paid for a E&O policy from Markel via Kyle Pass for the last three years as I found his contact info through APHA.
I’m now wondering if Markel is a legitimate insurer and is Mr Pass a licensed broker, and most importantly does my policy even exist or have I been defrauded?
My policy is going to expire in April and…[Read more]