Be Intelligent
No one expects you to take a crash medical school course after being diagnosed with an illness. It’s not necessary that you understand anatomy and physiology or cell biology. It is important that you know how your own body works. What are the unique features of your body? What illnesses and injuries have you had? What medications are you allergic to? How do you respond to medication? It’s also important that you have at least a basic understanding of your diagnosis. You should know the actual diagnosis and all its particulars. If your specific disease has stages, phases or degrees, know where you are on the continuum. Do enough research so that you aren’t buried in information on your first doctor’s visit.

Be Curious
Curiosity may have killed the cat, but it could save your life. Today’s healthcare culture is about increasing the numbers of patients seen by doctors while reducing the reimbursement schedules and insurers increasing malpractice insurance premiums. Curiosity allows you to feel prepared for your consults. It shows the doctor that you are part of the team and not simply a bystander or a victim. Curiosity may even get the doctor to think twice about a test, a diagnosis or a treatment. It tells the doctor that you’re not simply a tourist in this process, but you are truly the CEO of your own health. Curiosity also keeps the medical team connected to you even when you’re not present. They will think about questions or research answers about protocols and outcome studies so the next time you come in for a visit they are just as prepared as you.

Be Assertive
Western culture has created a power imbalance between the doctor and patient. It’s not uncommon for doctors to be put on pedestals, unfortunately that means many fall off. When meeting with your healthcare team make clear your expectations. If you feel a particular test needs to be done, don’t take a simple “no” based on the insurance company declining the request. It’s fine to ask the doctor or hospital to appeal the decision and requesting the doctor to provide additional information if necessary to make sure the test is authorized. If you have specific side effects that you don’t feel are being addressed make a firm request of your provider. Suffering should be eliminated at every possible juncture of your treatment process. This is no time to be a wallflower. Your presence is important, so make sure your voice, your concerns and your problems are addressed.

Becoming your own healthcare advocate provides you with a sense of ownership. It gives you the presence of mind to partner with your healthcare team. You’re empowered to ask questions at every step of the process. Your inner strength translates to improved immune function. We all need an advocate so either step up and take that role or team up with someone who has the experience in that position, but don’t be led down a path without having a voice.

All kinds of errors are found on medical bills. We see examples of billing more than once for the same service, billing for services or supplies you didn’t receive, using the wrong diagnosis and procedure codes, unwarranted denials by the insurance company, and plain old human error. All of these causes can add up to you, the patient, paying more than you should be for your health care services.

Medical billing advocates help individuals review medical bills for errors. We make sure that what you are being asked to pay is something that you actually owe, that you are not being over-billed, and that your insurance company (if you have one) is paying the amount it is obligated to pay.   You can think of us as medical bill analysts too. We analyze your bills and your coverage and make sure you get the benefits you are paying for.

National reports show that 90% of medical bills have errors, and they are not to your favor! Most people do not ask for and do not receive an itemized statement showing what they are being charged for. If you went to the grocery store and they handed you a receipt that said, “produce $40, meat $100, and canned goods $50, total $190″ you probably wouldn’t accept it. Why do we accept these types of bills from medical providers?

If you are interested in hiring a medical billing advocate, where do you find one? As with most professional services, the best way is through word of mouth. You can also check out billadvocates.com, the website for the Medical Billing Advocates of America. This site offers a feature that allows you to search for an advocate. Since most of what medical billing advocates do is done by telephone and email, it isn’t necessary to hire someone who lives near you. It’s best to hire someone who has a background in health care, insurance, or related fields.

Many  medical bill consultants conduct an initial NO-COST telephone review to help you determine if hiring a medical billing advocate makes sense for you.  In general, if your advocate doesn’t find savings, you only pay the costs associated with obtaining copies of your medical records.

When you submit your initial application there is usually a 3 to 6 month waiting period in which approximately 35% of all applicants are approved nationally. If you need help with this process there are many good advocates to work with such as Freedom Disability located in Shelton Connecticut.

This company can guide you with completing the initial paperwork such as the Social Security disability application and a detailed information Activities of Daily Living Questionnaire as well as any other required paperwork. Once you have all your paperwork in order, a doctor will verify information on your application to determine that the disabling condition will last at least twelve months.

At this point the (DDS) better known as the Disability Determination Services located in your particular state will need to make the initial disability determination regarding your condition. They will collect medical evidence about your current state of health and coordinate further consultative exams if additional evidence is needed to make their decision.

In the event that your social security disability insurance claim has been denied, there is an appeal process.

First Appeal or Reconsideration – The average wait period for first appeal is between 3 and 5 months in which 13% of First Appeals from all sources approved nationally. Your request for an appeal or reconsideration must be filed within 60 days of the denial of your initial application.

Second Appeal or Hearing – An average 12 to 16 months wait period with 37% of Second Appeals from all sources approved nationally. Your second appeal or hearing must come within 60 days of being denied. This appeal moves your outcome from the SSA claims processors to an Administrative Law Judge (ALJ).

Third Appeal/Appeals Council – 8 months average wait period and 3% of Third Appeals from all sources approved nationally. Appeals Council review must come within 60 days of being denied.