Explore Your Options

Medical debt is complicated. The rules around financial assistance, Medicaid, negotiating a settlement, appealing an insurance denial are hard to untangle, and the consequences of getting it wrong — or doing nothing — aren't always obvious until it's too late.

Most people facing medical debt don't know what options actually exist, or who can be trusted to help. Without that knowledge, it's easy to ignore a bill that could be eliminated, pay a debt that could be settled for less, or hire the wrong kind of help — or no help at all.

We provide an educational session that walks you through how the medical debt system works and what options generally exist for someone in your situation, so you have a roadmap of options to explore.

Our goal is simple: once you understand your options - you can do this. We want you to be able to take what you learn from our educational session and take action — apply for financial assistance, negotiate a settlement, or appeal an insurance denial. That enable you to save on professional fees.

If you're overwhelmed, out of time, or would rather have someone else represent you, we understand; for many it’s the best decision. So every educational session also includes referrals to qualified professionals we have already researched — so you can make an informed decision with the right person at your side, without spending time trying to figure out who to trust.

We provide a one-time session of up to one hour covering what options generally exist for people in your situation. It includes 30 days of email or text follow-up for clarifying questions about what was covered in the session.

Here are the topics we discuss:

Financial Assistance

Nonprofit hospitals are required to provide financial assistance to qualifying patients to reduce medical bills.‍ ‍You may be eligible for a discount or even be able to eliminate the entire bill.

The problem is hospitals do a poor job of making patients aware of financial aid that’s available and make it difficult to apply. For many, the process can be overwhelming. We work with a nonprofit that can help you determine if you qualify and apply for financial aid. And they don’t charge for this service.

Medicaid

You may qualify for Medicaid, a public health insurance program that provides free or low-cost health coverage to eligible low-income individuals and families.

Medicaid is designed to help certain groups of people, including low-income children, pregnant women, elderly adults, people and with disabilities. You must meet income and other eligibility requirements set by the state.

The program covers a wide range of health services. These typically include doctor visits, hospital stays, long-term care, preventive care like vaccines and screenings, mental health and substance use treatment, prescription drugs. as well as dental and vision care.

We can connect you with Medicaid planning specialists who can help you apply and, if you don’t qualify, help with planning strategies so you may be able to qualify.

Negotiation

Medical bills, especially hospital bills, may contain errors or charges for services that were not provided. Uninsured and out of network patients may be charged arbitrary, inflated amounts far in excess of the insurance reimbursement they would accept. However, hospitals are often willing to negotiate the amount you have to pay.

We can connect you with medical billing advocates to review your medical bills to be sure they accurately reflect what you should have to pay. They are experts in negotiating the amount of medical bills.

Insurance Denials

Insurance companies are notorious for unjustified denials of pre authorization requests and insurance claims even though the treatment or medication is recommended by your doctor.

This is extremely frustrating with the result that most people won’t challenge the denial and end up with medical debt or foregoing needed medical care. We can refer you to healthcare advocates who have the expertise to file an appeal. Appeals are often successful.

Harassment By Debt Collectors

We can recommend a consultation with a consumer law attorney to stop harassment by debt collectors.‍ ‍Usually there is no charge for the initial consultation. You may even have a claim for damages.

These cases are often handled on a contingent fee basis and the debt collector may required to pay your attorney fees if you are successful.

Debts in Collection or Litigation

If your debt is in collection it is usually best to be proactive. The debt will not just go away. If a lawsuit has been filed you need to respond. If you don’t file an answer in time (often 20 days) a default judgment may be entered against you. Then your wages may be garnished and other assets seized to pay the debt. You may end up in bankruptcy.

We can recommend attorneys that specializes in defending debt collection actions and we can refer you to a bankruptcy attorneys to review what you can do to protect your property.

Referrals to Professionals You Can Trust

Knowing your options is only half the battle. Finding qualified, trustworthy help is often harder — and more time-consuming — than people expect.

We have done that work for you. We maintain referrals to vetted professionals in each of these areas:

•      A nonprofit site to help file for financial; their services are free

•      Medical billing advocates to negotiate bills and file appeals of insurance denials or failure to approve a prior authorization

•      Medicaid planning specialists to help you apply for Medicaid and, if you don’t qualify, help with planning opportunities so you can qualify

•      Consumer and, if necessary, bankruptcy attorneys to stop harassment by creditors, represent you if a lawsuit has been filed and protect your assets.

These are professionals we know and have evaluated. We do not receive referral fees. Our only interest is connecting you with people who can actually help.

Continuing Support

You may have questions that come up well after the 10 day follow-up period ends — a new bill arrives, an application asks something you weren't expecting, or you come across something you don’t understand. So for clients who want continuing support, we offer month-to-month email or text responses clarifying questions about your options, not advice about your specific situation or what to do next. You can continue for as long as it's useful to you and stop anytime.

Medical debt is often negotiable — but only if you know what a fair price looks like. This report gives you the pricing intelligence needed to negotiate a settlement with confidence.

You tell us the procedure — knee replacement, hip replacement, MRI, CT scan, and so on — and the hospital or outpatient facility where it was performed. We research and deliver a report showing:

• The Medicare reimbursement

• The facility's cash price and average insurance reimbursement — for most hospitals and outpatient facilities, both figures are available and provide a realistic picture of what the provider actually accepts    

• The median provider charge and in-network allowed amount for providers in your geographic area — an independently derived estimate of a fair price for the procedure (not available for all procedures and not available in all areas)

This report does not tell you what to do with that information. That decision is yours to make. But it puts the relevant numbers in your hands — the same numbers a billing advocate would use — so you can negotiate from a position of knowledge rather than uncertainty.

What Our Services Do Not Include

•      Review of your individual medical bills

•      Advice on which option is right for you

•      Any recommendation about your specific debt

•     Debt counseling, management or financial advice

•      Contacting providers, insurers, or debt collectors on your behalf

•      Negotiating the amount of your medical debt

•      Legal representation