We offer a number of valuable services to help you resolve insurance issues, improve operations and enhance your bottom line.
HOW PATIENT ADVOCACY GETS RESULTS
EMPATHY WORKS WONDERS. The best way to resolve client (both healthcare provider and patient) versus insurance carrier disputes is to put ourselves in our client’s shoes. This is where experience counts and where we earn the “advocacy” part of our name.
ANALYZE THE PROBLEM. We review each claim to determine the exact impediment to the processing. If it is stalled or needs an appeal, our legal and/or medical team will handle. If the request is for patient information, we ascertain that the request is valid or if there is potential for additional requests after the initial documentation has been gathered — a common stall tactic.
PROPOSE THE BEST ACTION. Patient Advocacy can often determine within 48 hours if a denial is valid and should indeed be dropped to self-pay. Over the course of 20+ years, we’ve learned that insurance carriers make errors on claims processing 57% of the time! These errors cost you.
DEAL WITH THE PAPERWORK. We help your patients cope with the “we need more information” blitz (requests for claim forms, coordination of benefits, accident details, subrogation releases, medical histories, medical record release, proof of student status, proof of dependency, etc.).
ON-SITE VISITS — AS NEEDED. While we contact patients and carriers in the most efficient ways, we are always willing to visit patients in their homes (or a place of their choosing), and carriers in their offices. With patients, this also allows us to judge their level of understanding of the claims process. Meeting carriers face-to-face allows us to gauge their level of sincerity in rectifying the improper processing of claims.
ADDITIONAL PROVIDER SERVICES
PARALEGAL ON CALL — With a signed contract — and at no additional cost — we welcome you to speak with a Patient Advocacy paralegal on the best ways to handle particular claims. These consultations usually solve the problem, but some claims involve complex legal or medical issues that are best addressed by our staff paralegal directly with the carrier or patient.
RN EXPERT OPINION — Patient Advocacy has on staff registered nurses who can review patients’ medical records/histories and treatments and provide expert opinions based on their experience and professional knowledge on issues of medical necessity.
OFFICE OPERATIONS ANALYSES — To help you improve account management and cash flow, we can examine your procedures from Registration to Medical Records to the Business Office. We’ll report our findings in writing and recommend changes that can enhance your revenues and bottom line.
COLLECTIONS ON THIRD-PARTY PAYORS — This service includes all types of medical insurance, worker’s comp claims, and third-party liability issues.
TRAINING — With a signed contract, Patient Advocacy can provide on-site training for your staff.