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There are millions of people with enormous medical bills, and the cost of medical care is still on the rise. In fact, over 90% of medical bills contain errors. The complex billing system that has developed in the healthcare industry makes it virtually impossible for most individuals to decipher these bills, and even the attorneys representing them sometimes need a little help.
MBAA advocates specialize in analyzing medical bills for errors--and we can translate our findings into testimony that can help you in court.
What distinguishes our organization from other medical/hospital bill auditors is our copyrighted compendium of federal billing guidelines established to identify fraudulent and abusive billing. Additionally, we target inflated charges that cannot be justified, such as a $1,028 billing for a contrast solution that retails for $2.80.
Advocates review every line of every bill from every provider, looking for possible duplication, unbundling, probable data entry errors that produce inappropriate charges, and other frequently encountered errors.
MBAA’s analytic advocates include legal nurses with first-hand experience covering most clinical settings, case managers, certified coders and other billing personnel, insurance fraud investigators, managed care professionals, former members of hospital administrative staffs, and physicians.
Our reviews for legal cases address three distinct areas:
- Are the charges that appear on the itemized hospital statement, allegedly associated with the patient’s medical care and treatment, corroborated by the medical record documentation?
- Are the charges billed in conformance with federal billing regulations that govern inpatient and outpatient billing compliance?
- Do the charges billed meet the definition of fair and reasonable / usual and customary?
MBAA has a sincere interest in serving law firms in medical billing reviews. If you feel your firm could benefit from an expert review of billings, please contact an advocate from the list.
Contact an advocate today, or call the MBAA corporate headquarters for a referral: 540.387.5870.
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