MEDICAL BILLING ADVOCATES

Could medical billing advocates keep me from bankruptcy?

medical-billingMatt and I met with an outfit called CoPatient, a company which helps individuals make sense of their medical bills and advocates on the patient’s behalf to recoup unfair costs, billing errors, etc. I decided to see how they could help me resolve my bills once and for all! Here’s the story:

The Back Story

Cancer diagnosis was in late February, and by May the bills were piling up. I had no money, no assets and was unemployed, so I had no income either. This medical disaster could ruin me.

I spent hours online researching medical assistance programs and submitting applications, also applied for assistance through each medical billing office. All this took an enormous amount of work, as each program I contacted gave me more resources to look up. Most were irrelevant to my situation or had run out of funds. Only one company out of dozens helped, and they thankfully covered my $7,500 chemotherapy medication.

The largest bill was with St. John’s hospital, who has their own financial assistance program, and because all other medical offices who served my case were associated with St. Johns, all would charge me based on the discount St. John’s Financial Assistance would offer, if any. The offices agreed to defer payments until the St. John’s financial aid determination.

For six months I went back & forth getting St. John’s the paperwork they required. When I sent what they asked, they would tell me to wait two weeks to call back. When I called back, I would wait on hold for twenty minutes, then find out that they did not receive my paperwork, or were missing another document. I could not keep holding off the other billing offices forever. I needed an answer.

Finally, I got a supervisor on the phone, and he told me that because my out of state residential address, I was ineligible under their assistance program. No exceptions. But he would be happy to take a $200 per month payment plan. I was unemployed! What does “no income” mean to them?

I was distraught and frustrated by the news. The waiting, the anxiety, the time and the disappointments. Now the other billing offices would expect full payment, and possibly send my accounts to collections. If I pay $200 per month to St. John’s, what kind of payment plan could I make with the other offices?

What a roller coaster. What now?

New Plan

I wrote letters of hardship to each organization. This campaign would do two things for me, it would show that I want a good relationship with the billing offices, and it would delay their expectation of payment, hopefully long enough for me to decide what to do.

Matt helped significantly to leverage my power as a consumer by suggesting the persuasive language of the letters. The appeal letters all said the same thing, stating my financial situation and describing my character and my intention to be negotiable. Then I offered each office an amount that I could afford to pay, and was proportionate to the overall total I owed. If every single office did not agree my negotiated offer, I would be forced into bankruptcy and they would all get nothing.

Most of the offices played ball, and my bills went down by 50-70%! The exceptions were St. John’s (CA), Tower Imaging Medical Group (CA), and St. Vincent’s Hospital (OR). Later I learned that Tower Imaging, with it’s own financial assistance program, paid it’s entire balance ($5,000, yippee!)

Yes! Great, huh? But when you consider a $5000 deductible and $12,500 Out of Pocket insurance costs, plus $750 per day hospital copays, an unemployed person has not room for additional costs. Clearly more work was ahead.

The Turning Point

Until now, I was doing well on my own. Then new bills started to arrive. Bills which had already been settled months before, but were now popping up as my insurance company claimed they made coding errors which meant I now owed thousands of dollars more. For example, a hospital facility, which was initially billed as an In-Network facility was rebilled as Out-of-Network. On top of that, it was eight months after the original bill was settled. Fishy, right? This was happening again and again, costing me thousands of dollars in error.

My anxiety skyrocketed as I wondered, what was happening. The frustration was making me ill. This could be my life for years to come. I felt hopeless. I wanted it all to end so I could begin fresh and rebuild my life. Bankruptcy, again, was on the table.

New Hope

Already, I had spoken with a long-time family friend and attorney, David Bennett of Landye Bennett Blumstein, a real estate law firm. From a legal perspective, I was able to get the gist of whether bankruptcy was a good idea. Because of the moving-target nature of my billings, bankruptcy is an option, yet may not be helpful. Say I file Chapter 7 and wipe out my bills, and then more bills come in, I am not protected against those. He suggested other places I should seek alternatives such as from a consumer credit agency. 

A Time Magazine article, “Bitter Pill”, which my mom found, was an expose on the healthcare industry. She pointed out a section highlighting a cottage industry of medical billing advocates who are trained and certified from a national chapter, and work with billing offices and insurance companies to reduce bills on a patient’s behalf. It is common knowledge that medical facilities will overcharge for medical items, such as Aspirin, reused blankets, bandages, etc. The advocates will find errors and overcharges in bills, then will negotiate with the company to lower the cost of the bill. The advocate’s fee is based on a percentage of the of money they recoup. Cool, huh?

Between my parents’ urging, the meeting with David and the article, I researched medical billing advocates and began making calls.

This led me to CoPatient

Through my experience this past year with managing my own billing, having successes, frustrations and failures, I was ready to bring in outside help. Only one of the four companies I contacted returned my call, and that was CoPatient. They are an exclusively online business, meaning wherever a client is in the world, the online technology allows for all necessary communication and transactions. CoPatient just happens to be based in downtown Portland, so I could schedule a face-to-face meeting with the people who I would be sharing my medical bills with.

Matt and I went together to interview the CoPatient company co-founder and my oncology billing specialist who would be my case manager. The two women were down-to-earth and personable, professional, passionate and compassionate. They explained their business model, and assured us that the initial set up would be free. Any money they could win back for me they would take 30% of for their fee.

Matt wanted me to be free of my mental distress. I wanted to see what they could do for me. I will keep you posted!

happy-days-ahead

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