Ways we help
One review. A path for the plan you actually have.
These are the situations a hospital bill falls into. Pick the one that matches the card in your wallet and the paper in your hand. The figure review does not change: we only use numbers printed on the file.
By plan type
Reference-based plans
The plan pays from a reference price, often a multiple of Medicare, instead of a contracted hospital rate.
Fixed-benefit plans
The plan pays a set amount for a service. The hospital charge can be higher than that fixed payment.
Regional PPO plans
A regional PPO has contracted rates inside its area. In-network and out-of-network are different bills.
National PPO plans
A national PPO is the same idea with a wider network. Travel does not make every hospital in-network.
By situation
Nonprofit financial assistance
Charitable hospitals that are tax-exempt under 501(c)(3) must keep a written financial assistance policy. Ask for it by name.
Balance-bill check
A balance bill is the gap between the hospital charge and what the plan allowed. Some of those gaps are limited by federal surprise-billing rules.
Figure review
We add the charge lines that can be read and compare them with the total printed on the same page. We do not invent a contract rate.
Advocacy letter
When the figures disagree, the letter quotes those figures. You send it. We do not call the hospital for you.
For your file
Records to collect
The statement in the mail is not enough. Collect the itemized bill, the explanation of benefits, and the visit record before you argue a number.
Hospital bill negotiation
Negotiation starts with a number you can point to: a duplicate line, or a total that does not match the lines.