Medical Billing Advocate?

[Christy]

Has anyone ever looked into becoming one? According to Time magazine, they can make $100 per hour...

[PMRNC]

Who pays them the 100$ an hour? They used to be called CAP's Years ago and while today there is a need for advocates with the new ACA coming in.. again, who's going to pay that $100 an hour? Will it be the millions of newly insured's already being forced into buying from the exchanges with higher premium rates not to mention their higher out of pocket deductibles?

[RichardP]

Google on "Medical Billing Advocate" .  A number of the links there talk about advocates charging from 25% to 33% of the money saved by examining medical bills.  One advocate spent 95 hours on saving her client about $25,000.  At 25% of the savings, that's about $66 per hour.  At 33% of the savings, that's about $87 per hour.

[PMRNC]

Google on "Medical Billing Advocate" .  A number of the links there talk about advocates charging from 25% to 33% of the money saved by examining medical bills.  One advocate spent 95 hours on saving her client about $25,000.  At 25% of the savings, that's about $66 per hour.  At 33% of the savings, that's about $87 per hour.

 

Oh I have researched this and more recently with the ACA, and I've actually tried this market before. Most of the links you see especially like to advertise fighting hospital bills, if you have insurance your insurance carrier already is auditing those bills and/or negotiating down as low as they can, and if you don't have insurance well it's actually even easier to get the bill knocked down more than 50% with a phone call and or a trip to the Medicaid office, plus hospital's have their own advocates that will work with patients and balances with or without insurance. I used to do hospital bill audit's at the insurance company, guaranteed we got down every bill 35-60% most times.  Same with surgical procedures the carrier may cut for U&C, doc sends in op report, carrier pays more or the rest on first and/or second appeal anyway. So patient gets bill paid and then pays the advocate?   People are not even liking having to purchase insurance policies I don't see them paying us.  Sure maybe it can be something we do on the side as an added service but our contracts would have to all be between the patient and us, there have to be HIPAA agreements completed and sent to the carrier on behalf of each patient, each claim.

With the ACA there might be a need for advising people on what plan's are most beneficial but again, I just don't see people who are being forced into buying insurance going to put out MORE money when the govt will be putting all the information out there. For the heck of it I put up a flyer and biz card at my local pharmacy advertising helping those choose plans, many nibbles but no one wants to pay. JMHO

[RichardP]

For the record, I was not advocating for folks to become Medical Billing Advocate.  I agree with your thoughts on this issue.  I was just pointing out how some Advocates calculate their payment.  When charging a third of the reduced fee, as in the example I gave, that still does not get up to $100 per hour.

[DMK]

I wish there was a way to teach people how to choose the right insurance and to educate people REALISTICALLY what they can expect from insurance (and get paid for it).  I can't tell you how many times I've heard "but I have good insurance" when the company doesn't pay.

[PMRNC]

I wish there was a way to teach people how to choose the right insurance and to educate people REALISTICALLY what they can expect from insurance (and get paid for it).  I can't tell you how many times I've heard "but I have good insurance" when the company doesn't pay.

Teaching them isn't a problem. Actually when you purchase insurance it's VERY straight forward, insurance sales people are very highly watched. With the plan of the ACA and the state exchanges it's going to be even MORE straight forward. Plan's are laid out very easy, the problem is CONSUMERS like any consumer LOOKS at their bottom line. For example BCBS may sell a family plan to a family of 4 for $11,000 a year, they will be told they could also pick a plan for $14,000 a year. Which do you think they are going to buy w/out looking at the whole picture?  It's just like car insurance, we look at ways to decrease our premium but when we decrease the premium we increase the deductible. Why do we do this.. human nature ... "I won't get into an accident, I will be very careful"  "I won't need any major surgery or hospitalizations, I'm generally pretty healthy".    The ones who WILL look at the whole picture even will still go for the lower premium because they will meet their out of pocket if they are already sick and generally at the doctors more.

Educating consumers is MUCH different than educating physicians.  Insurance companies are already gearing up to market and one of the things they will market and campaign against is people like advocates going in and charging them money to help them when they don't need it. The state exchanges and choosing the policies is going to be the easiest part of the whole process.

[SLITTLES]

Actually, I have been an Medical Billing Advocate since 2011 and it is very rewarding to me in that I get to help people.  I find that more than often we are simply educating patients more than anything, a lot of consumers just think they are being overcharged simply because they have to pay out of pocket; the consumers that are more educated simply don't want to use their time going back and forth with providers and hospitals.

Yes, the patient is responsible for paying you and there are tons of forms they have to complete in order for you to act on their behalf.

I can say that I have saved consumers money by finding instances where providers posted EOB's incorrectly, billed them for services that they should not have, un bundled charges or simply negotiating. 

I was kind of thrown into this when my dad had a hospital stay and I was reviewing his bills; after researching my area, the need was far greater than I thought.  I actually do seminars in some of the area facilities educating patients.

Again, the reward of helping people is why I continue to be an Advocate!