OUR SERVICES
Three stages to fighting your problem medical bill
Examine the Bill & Identify Concerns
The Problem Medical Bill Assessment guides the patient to review the medical bill and its circumstances. From these findings, Patient Fairness identifies questions and concerns that may lead to a reduction or elimination of the bill.
Dispute the Bill
Patient Fairness helps the patient select the questions and concerns identified from the Problem Medical Bill Assessment to present to the billing provider in a Letter of Dispute. The Letter of Dispute requires the billing provider to address the patient's concerns, and provide additional information about the services and charges.
Pursue Resolution
With the billing provider's response to the Letter of Dispute, Patient Fairness compares the medical bill's charges to Medicare prices and costs, and facilitates the patient's evaluation of the responses. Patient Fairness then enables the patient to pursue a settlement of the medical bill with tools and strategies, or to continue the dispute if the patient is not satisfied with the provider's responses.
empowering PATIENTS is OUR TOP priority
Patient Fairness Services
ASSESSING MEDICAL BILL
A customer completes the Assessment to share details about the medical bill and its circumstances. The Assessment gathers information about the patient, the person being billed (if different than the patient), insurance and health benefit coverage, the services and charges billed, and to what extent the provider disclosed in advance the details of the services and costs. From the Assessment, Patient Fairness identifies any initial reasons the medical bill may be in error so that it should be reduced or canceled.
Patient Fairness makes it easy to share key information about the medical bill to identify potential challenges to it.
NO SURPRISES ACT
The Assessment also identifies if the medical bill may violate the federal No Surprises Act. Customers can use Patient Fairness to dispute a medical bill based on the No Surprises Act, or decide to submit a No Surprises Act complaint on their own without opening a case with Patient Fairness.
There is no charge for the Assessment, and the customer decides whether he or she would like to pursue the medical bill case with Patient Fairness.
LETTER OF DISPUTE
With the information gained from the Assessment, Patient Fairness presents questions and concerns to the provider about the medical bill, and constructs a letter based on the customer’s guidance. The Letter of Dispute then formally requests the provider to respond. This letter also requests an insurance claim version of the medical bill to allow for evaluation of the provider’s charge levels and coding of services. Patient Fairness mails the Letter of Dispute upon customer’s approval, and tracks its receipt by the provider, as well as any response. The letter also serves as notice that the medical bill is in dispute, pending the provider’s satisfactory responses.
Patient Fairness sends the letter to the provider on the patient’s behalf.
COMPARE
Patient Fairness will analyze and compare the medical bill’s charges to the price Medicare would pay for the same services.
For hospital bills, Patient Fairness will estimate the cost for the hospital to provide the services, versus the prices the hospital billed.
You'll have key reference points to evaluate the medical bill's charges, and what you think a fair price might be.
RECORD
A patient and billing provider may agree to resolve a billing dispute. Patient Fairness' tools help the customer record in writing any agreement or conclusion with the provider to settle the medical bill.
It is possible the customer and provider do not agree on a resolution or settlement of the medical bill dispute during the Patient Fairness process. Patient Fairness maintains record of correspondence, documents and information so they are available for further discussion with the provider or other dispute proceedings.
A clear, written agreement is essential to settling any disputed medical bill.
A written record of your questions, concerns and disputes can be important if the provider continues to pursue a problem medical bill.