Advocacy groups argue with insurance companies on patients’ behalf

Jun 11, 2014 | Health Insurance Billing

The rising cost of health care and shrinking insurance reimbursements have both care facilities and patients frustrated. Disability insurance provider Aflac recently performed a study that highlights some of the most concerning aspects of the situation. 

The study found that more than half of Americans would need to borrow from their retirement funds or use a credit card to pay for sudden medical expenses, and nearly half have less than $1,000 on hand to deal with such expenses. Pointing to the rapidly rising cost of care and how hospital bills can quickly overwhelm American families, 69 percent of workers at least somewhat agree they regularly underestimate the total costs of an injury or illness, including medical, household and out-of-pocket expenses.

To help patients confront these realizations about the cost of medical care, the Affordable Care Act provided $58 million in grants to establish patient advocate groups. According to the Wall Street Journal, at least 24 states have taken the funding. 

The Patient Advocate Foundation is one such organization that exclusively works with patients that have life-threatening or debilitating illnesses. The Journal spoke to Nancy Davenport-Ennis, chairwoman of the organization, who said last year the group relieved patients of more than $48 million in medical debt. Because health insurance reimbursement and coverage policies can be so confusing, these experts are better able to argue on the patients behalf to insurance providers. 

However, if insurers do not agree to settle or reimburse the care facility for services provided, hospitals and care centers can quickly face a medical claims and billing backlog. Accounts receivable outsourcing can reduce this burden, and allow hospitals to refocus on providing quality patient care.