Medical bill negotiators in the spotlight on ABC News

The other night Michelle Katz was on ABC News describing how a family that had been hit with a $50,000 bill for what seems to have been a normal c-section birth was able to use a medical bill negotiator to dramatically reduce their bill. Here’s the segment, about 2 minutes and 45 seconds long:

The family was able to reduce the bill at first by about $12,000 simply by pointing out to hospital that the national average for a c-section is only about one-fourth what they were charged ($12,397 according to Healthcare Blue Book).

After getting this discount through their own efforts, they then turned to CoPatient, a firm that specializes in reducing medical bills both by finding errors and by negotiating for additional discounts. In this particular case, apparently the hospital billed the family for extra care supposedly incurred because the child was born sick. Of course, he hadn’t been, but this was a $17,000 mistake by the hospital!

CoPatient was able to reduce the bill by $18,000, which on top of the $12,000 discount negotiated by the family brought their bill down to $20,000. Still high, assuming it was a normal birth, but a heck of a lot better than $50,000!

I’ve written about medical bill negotiators in the past, but I don’t know that I’ve specifically described CoPatient and how they work. The process as described on their web site is pretty straightforward and has one helpful service that I’ve not seen before from a medical bill negotiator. Here’s how they describe their services after people create an account and submit their bills:

  1. Organize all your paperwork. We match your provider bills to your EOBs. You get access to a consolidated view of all your bills.
  2. Review your bills and insurance coverage. We use technology. industry know-how and knowledge generated from other consumers like you to uncover the many errors that happen in medical billing.
  3. Provide you with a report. You can then go in and see a nice snapshot of what you owe and what we think you can save.
  4. Get the errors fixed and recoup or lower your expenses. We fight insurance denials and negotiate your doctor and hospital bills. We have the experience and relationships to do this and you don’t have to spend all day on the phone. We charge a small percentage of what you save as a fee.

One of the interesting things about CoPatient is that they provide you with a report before you pay anything, meaning if someone wants to they can use the information to try to negotiate a discount on the bill themselves. They address this in their ‘Frequently Asked Questions’ section:

Are you concerned the individuals will take the free audits and contact providers or payers directly? Our goal is to create an environment where consumers take a larger role in their healthcare management, and that starts by understanding medical billing. Our philosophy is that if a consumers shares their medical bills with CoPatient — which in turn helps our system grow smarter and faster — then we want to give them something of value in return. Some consumers may want to take action on that data, and we encourage them to fight for what is fair and accurate. However, others opt-in to our appeal service to let our Billing Advocates make the phone calls, send the letters and follow-up with their providers and health plans to fix errors and overcharges.

Needless to say, ‘free’ is a pretty good price for such a valuable report! But the thing that really caught my eye was the fact that CoPatient will also review patients insurance coverage and appeal adverse decisions by insurers to deny payment.

In the modern world of bureaucratic medicine, there are few more frustrating experiences than having medically necessary treatment denied by an insurer. Having someone like CoPatient to help navigate the insurance appeals process seems like a terrific option for self-pay patients who do have some form of insurance!

Generally speaking medical bill negotiators like CoPatient are for-profit entities, and they do get paid for their valuable services. Each company has its own model for compensation, and in CoPatient’s case they charge 30% of the savings that are eventually negotiated and received by the patient. So in the case of the family featured in the ABC News piece, CoPatient would have charged $5,400 – not bad, considering the alternative would have been paying an additional $18,000 to the hospital and doctors involved in the childbirth!

Some of the other medical bill negotiation companies include Medical Bill Mediation, My Medical Negotiator, Medical Bill Advocates of America, and Medical Cost Advocate. Some health care sharing ministries also have medical bill negotiators for members, including Samaritan Ministries and Christian Healthcare Ministries. Many of the ‘bundled’ services that are designed for self-pay patients such as The Health Co-Op,* Connect2Docs,* CADR Plus, and Common Sense Care include medical bill negotiation services as part of their bundles, along with services like telemedicine and drug discount cards.

Michelle Katz also did a follow-up to the ABC News segment on her blog, suggesting how people can go about finding the right medical bill negotiator. It includes some great advice, and I highly recommend people who are looking for help in negotiating their medical bills read it!

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