medical billing advocate meeting

What Is a Medical Billing Advocate? (Expert Guide)

Few things are more frustrating or confusing than getting hit with astronomical medical bills. Medical care costs have never been higher, and it’s one of the leading causes of stress and debt. In addition to being expensive, medical bills are also confusing and difficult to understand if you’re not familiar with the process.  If you … Read more

medical bill guide

Expert Guide to Medical Billing Assistance in Your State

Few things are more frustrating or overwhelming than large sum medical bills. They’re like an anchor weighing you down and keeping you from living your best life. To combat high medical bills, states’ federal government offers financial assistance programs, mostly through government health insurance programs such as Medicare and Medicaid.  However, not everyone qualifies for … Read more

Negotiating Medical Bills After Death: Complete Guide

Navigating medical bills can be a complex process. However, it can be even more complicated following the death of a loved one. You may question who pays hospital bills after death. The reality is that hospital bills after death pass to the deceased person’s estate and, in many cases, to their family.  Coping with the … Read more

utilization management nurse with doctor

What is a Utilization Management Nurse?

Utilization management is not an area of healthcare that most clinical nurses are particularly familiar with. Utilization management nurses do, however, play an important role in the behind-the-scenes clinical care of patients. Utilization management nurses ensure that the care that has been provided or is going to be provided is necessary and the best use of … Read more

hmo models

HMO Models

One of the many difficult decisions you make as an adult is determining which health insurance plan is best for you and your family. Purchasing health insurance can be an intimidating and often daunting process.  Over the past 20 years, managed healthcare plans called HMOs, have become commonplace. In fact, some 70 million Americans currently … Read more

concurrent review

Concurrent Review in Healthcare

Patients admitted to hospitals today often require multiple medical experts to meet their needs. Having a roster of medical experts vastly improves the care the patient receives. But the division of labor presents a number of problems. A concurrent review evaluates the current level of care that a patient is receiving and determines if any … Read more

retrospective review

Retrospective Review in Healthcare

In 2016, Medicare recipients spent over $5,000 in out-of-pocket expenses. If you did not have any supplemental coverage during this time, you could have paid up to $7,400 out of pocket. The insurance and healthcare industry is a tricky field to navigate. A retrospective review validates claims, payment, and coverage from services already received. Keep … Read more

doctors standing in a line

Levels of Care in a Hospital

Did you know that 145.6 million patients go to hospital emergency rooms all over the United States every single year? On top of that whopping statistic, there are general admissions, direct-to-care patients, and other admissions that don’t go through the ER. Each hospital carefully tracks and monitors each one of these patients, and one of … Read more

stethoscope laying on money

Contractual Adjustment in Healthcare

According to a 2020 study by InstaMed, medical bills are confusing to more than 70% of patients. On top of that, 80% of patients were surprised by a medical statement they received.  These numbers are staggering. Patients should know how much money they will owe for a doctor’s visit or medical procedure beforehand. One way patients can understand their financial … Read more

What Are Revenue Codes in Healthcare? A Complete Guide

Are you struggling to understand your medical bill? Bills from hospital visits and treatments can be very complex. Every test, procedure, and treatment need to be clearly marked on the bill in a way that can be easily understood. This is why the healthcare industry uses standardized codes. But to the uninitiated, these codes can … Read more