AdvoMed helps avoid overcharges with a line-by-line scrutiny to assure the service you’re billed for is the service you got!  We’re here to serve:

• Individual patients who don’t understand their bills;
• Corporations who need to control health care costs;
• Attorneys who need help with billing analysis and court testimony; and
• Physicians who need help collecting form insurance companies.

Did your last hospital bill shock you?  It may contain charges for services you never got.  Or it may show a charge that is far above the norm for the service you received, such as $12 for a “mucus recovery system” that is really a box of tissues … or a “fog elimination device” at $57 that’s really a two-inch-square piece of gauze used to wipe down surgical equipment.  How about a toothbrush at $1,004? 

Those are all actual charges, and similar ones may be on the bills you’re getting.  You’re not alone.  It’s been proved over and over again that there are duplicate charges and/or overcharges in almost every inpatient bill. 

In fact, statistics show us that the incidence of errors in bills—both inpatient and outpatient—is increasing by as much as 1,000-fold. That’s a lot of money.  It’s money you, your insurance company, and (if applicable) Medicare are expected to pay. 

And that’s when you come up against your second problem:  your insurance company.  Which is not really “your” insurance company at all anymore; it belongs to shareholders who demand profits even at the cost of your health.  More and more, these managed-care companies are rejecting claims for services that were legitimately received.  They’re banking on your meek acceptance of their decisions.

These kinds of abuses inspired the growth of a whole new advocacy group: medical billing advocates.  AdvoMed is proud to be among these warriors for honest billing and payment of legitimate claims.

AdvoMed is led by Jim Genaro, whose background qualifies him to seek, find, and dispute wrongful billing and unfounded claim rejections.

AdvoMed serves individuals, corporations and attorneys who need skilled interpretation of billing and claims rejections.  We are associated with Medical Billing Associates of America, based in Salem, Virginia—the first and best-known patient advocacy group in America. 

Call 330-856-6288 today to learn how we can help YOU! 

Did you know that most people never see an itemized statement from a hospital or medical provider—not even from the insurance companies! So most people don’t know what they’re being charged for or what’s being paid on their behalf.
Here’s how AdvoMed puts you, the patient, on top of all this paperwork:

• We conduct a copyrighted compliance hospital bill review by scrutinizing every line of every hospital bill, looking for possible duplication, non-billable services, unbundling, data entry errors that produce inappropriate charges, and coding errors in addition to strict application of, and adherence to, federal compliance billing guidelines. We also target inflated charges that cannot be justified, such as a $1,028 billing for a contrast solution that retails for $2.80. 
• We scrutinize physician, anesthesiology, radiology, pathology, ambulance, durable medical equipment, pharmacy, dental, emergency department and other outpatient billings for accuracy and compliance. 
• We make sure the insurance companies pay in accordance with the terms of policy provisions.

For Corporations:
Did you know that service agreements (contracts) between Third-Party Administrators and self-insured companies are written by the TPA, to protect TPA’s interests?  This can translate into unforeseen expenses for your self-insured company.  Audit clauses are designed to deter the self-insured company from performing independent audits of claims adjudication.

Re-insurance contracts that are signed by the TPA and re-insurance, and not by the self-insured and re-insurance, limit the self-insured company’s access to information.  And TPAs rarely perform detailed hospital bill audits.  Time would not permit them to, and hospitals are very much aware of this fact.

AdvoMed takes the time and the knowledge to look for and catch these tricky practices.

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For Attorneys:
Millions of people have had to turn to the court system for justice in dealing with enormous medical bills, many of which are not legitimate.  In fact, we have proved that more than 90% of medical bills contain errors.

AdvoMed specializes in analyzing medical bills for error, and we can translate our findings into testimony that can help you in court. 
We work in accord with federal billing guidelines that have been established to identify fraudulent and abusive billing.  We target inflated charges that cannot be justified.  Advocates review every line of every bill from every provider, looking for possible duplication, unbundling, probable data entry errors that produce inappropriate charges, and other frequently encountered errors. 

Our reviews for legal cases address three distinct areas: 

• Whether the charges that appear on the itemized hospital statement, allegedly associated with the patient’s medical care and treatment, are corroborated by the medical record documentation.  
• Whether the charges are billed in conformance with federal billing regulations that govern inpatient and outpatient billing compliance.
• Whether the charges billed meet the definition of fair and reasonable / usual and customary.

If you feel your firm could benefit from an expert review of billings, please contact AdvoMed today.

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For Physicians:
AdvoMed can help you collect from insurance companies for your patients’ health care and protect your relationship with your patients at the same time.

When an insurance company doesn’t pay your patients’ claims, the usual option is to bill the patient for payment, or write the debt off and take the loss. If patients don’t have the money to pay, their account is sent to collection and your relationship with that patient often ends. We know you’re a medical professional, but you’re also a business person—and in that capacity, you know that when this happens, you lose a valuable customer.

AdvoMed will review the billings, looking long and hard at the patient’s insurance policy, and assure that the insurance company pays everything they’re obligated to pay.  We’ll help you:

• Reduce your income loss. 
• Free your staff for more important work. 
• Be confident that if you have to ask your patient to pay, you’ll ask only for what they truly owe.

Call Jim Genaro at AdvoMed today to learn more about how we can help your practice!  We can be paid for our services on an hourly rate, or on a contingency basis:  let’s talk about it! 330-856-6288.
Visit us online now at http://www.advomed.net

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