Providers have far less incentive to cooperate with, and satisfy, another party representing the patient. Insurance companies and government agencies are just a couple of the types of entities with which hospitals must regularly deal. With some of these dealings, such as negotiations with insurance companies, the provider may take an adversarial position to protect its interests. Providers can adopt a mindset of being more aggressive and unwavering when dealing with outside parties compared to how they deal with their patient customers.
A provider will not necessarily bend over backwards to satisfy a patient, but it is less likely to take an adversarial stance dealing directly with a patient compared to a representative of the patient.
2.
Patients look out for their own interests best
Patient Fairness puts patients in control of their medical bill disputes because patients understand best the circumstances of their problem medical bill and what they consider to be fair manner to settle the dispute.
A patient directly managing his or her medical bill dispute avoids conflicts of interest under which a representative for the patient may have incentive to settle a dispute for a patient under terms to which the patient might otherwise not agree. For example, a representative being paid on a percent-of-savings model will only get paid when the medical bill dispute is settled. This may influence the representative to recommend and pursue settlement of a dispute that may not be the best outcome for the patient, but will allow for a quicker settlement of the dispute and faster payment of a fee to the representative by the patient.
Patient Fairness’s model puts the patient in charge of the dispute at all times. There is never a situation in which the patient is not making his or her own decisions about the dispute, using his or her own judgement and objectives.
3.
Patients have the most at stake
A patient has the most to gain or lose in his or her medical dispute. That is why it makes sense that the patient be the one raising his or her concerns about the medical bill, and standing up get fair treatment for him or herself. This makes the patient his or her own best advocate in the dispute when he or she uses the support of the processes, information, and tools from Patient Fairness.
4.
Lower Costs
Patient Fairness can charge far less for its services compared to fees charged by billing advocates and other services that use hands-on staff and manual processes. Patient Fairness’s automated, web-based processes and tools allow patients to represent themselves in disputing their bills, and avoid the costs of large staffs and high overhead.
You Really Can Do It Yourself
Representing yourself in disputing a medical bill doesn’t require any special skills or training. Patients are consumers, and consumers are used to handling their own problems - speaking to a restaurant manager about an over-cooked entree, calling a bank to have an erroneous credit card charge removed, and informing a grocery cashier that the sale price did not ring up correctly during checkout. The money involved may be higher for a medical bill dispute than in these other examples, but the premise of the consumer expecting fair dealings, and sticking up for him or herself, is just as applicable to health care as other types of commerce.
True, the details of medical billing and payments can be complicated. Patient Fairness’s programs and tools help simplify those details for a patient to understand. Armed with that understanding, a patient can manage his or her medical bill dispute with assuredness and competency.
If you still are uneasy about dealing directly with a hospital or physician about a medical dispute, here are some ways to gain confidence and improve your chances for a successful outcome for the dispute.
1. Focus on Your Objectives
Keep top-of-mind your ultimate objectives in why you have disputed the medical bill. Let those objectives guide your actions and decisions in the Billing Provider discussions. Try not to let insignificant issues or emotions distract you from pursuit of those main objectives.
2.
It’s Business
Remember that your medical bill dispute regards the business of health care, and that the patient is involved in what is an economic transaction. If it was not an economic transaction then the provider would not have issued the medical bill to you requesting payment. You as a patient, just like any consumer, have an expectation to be treated fairly when purchasing health care. And just like other consumer, you as a patient sometimes need to assert those rights and challenge instances in which you are not afforded fair treatment.
3.
You Have Leverage
In most cases, the patient has more leverage in challenging a medical bill then they realize. By issuing a medical bill, the provider is asking you for funds. Assuming you haven’t paid the bill yet, then you have something the provider wants. That is leverage for you.
Even though the provider is bigger than you as a single patient, the provider has incentive to close patient accounts by bringing in what payments it can, and writing off erroneously billed or legitimately disputed amounts. This means that a provider should want to reach a settlement of your dispute, even if it does not always appear that way.
When Not to Represent Yourself
There are situations in which you likely should seek professional representation.
Patient Fairness does not give, nor do its programs and information constitute, legal advice. Consider using the advice of an attorney for any of the following:
- A provider or collections firm is suing or taking other legal action against you.
- You want to consider legal actions you can take regarding the medical bill.
- You are unsure about a legal matter related to your dispute.
- Your concerns include a quality of care, malpractice, or other serious matter beyond the dispute of a medical bill.
