Experts suggest that as many as 80% of medical bills contain errors! Other experience indicates that about 25% to 30% of these bills show significant errors. An Equifax company audit found an average error of $1,300.00 occurred on hospital bills $10,000.00 or more.
The source of the errors is from care performed by a medical specialist, complex medical procedures, inpatient work, or care delivered by out-of-network providers.
Employees To any employer that self-insures, there is a direct major impact to costs and employee productivity. Employees who notice deductible creep also take on more of the financial burden because of the errors.
You can help your employees manage medical insurance errors by educating them to:
Become their own best advocate and diligent in reviewing their bills and insurance documentation
Look out for red flags like claim rejections, denials or bills that have no matching Explanation of Benefits (EOB) from their insurance company
Checking for differences between the carrier's benefits explanation and the provider's patient balance bill
Reviewing provider documentation to ensure it accurately reflects the services received
In addition to this being a time-consuming process, it can lead to less productivity at work especially for family members with chronic care conditions.
Employers Employers can provide employees with services, support, and tools. They can also educate employees with online tutorials, handouts, and seminars. This is to effectively equip employees to advocate for themselves better.
Another approach is to offer a medical billing advocacy or advisory service. These services could include:
Reviewing bills
Identifying medical bill errors
Answering employee questions about ICD codes on the services billed
Working with healthcare providers to get errors corrected for employee medical bills
Negotiating costs for services performed by out-of-network providers
When an employer decides to hire a speciality advocate, they need to find an organization with longevity, one that is reputable, and one that can provide data-based statistics on the amount of money the company saved for customers.
Some claim assistance professionals specialize with hospital (or facility), laboratory, mental health, ambulance, doctors' or other speciality providers. When advocating directly with a consumer, the healthcare claims advocate may charge an hourly fee or work on contingency. If, however, the medical billing advocate company partners with you, the employer direct, their services may be negotiated as an employee health benefit, assisting employees to better navigate and solve health insurance issues.
Once a firm is decided on, the employer needs to make sure the employees know about the services and how and when to contact the billing advocate firm.
MBCR understands the challenges in receiving a medical bill and successfully resolving a health insurance claim issue. Learn more at www.medicalbillandclaimresolution.com.