AdvimedPRO Blog
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AdvimedPRO founder Martine Brousse is a healthcare industry expert with over two decades of medical billing management experience and vast knowledge of the intricacies of navigating all types of payment claim issues.
AdvimedPRO Blog
3d ago
By Martine G. Brousse (nope, not AI)
"The Medical Bill Whisperer"
Patient Advocate, Certified Mediator
AdvimedPro
March 25, 2024
While we all understand that using an Out Of Network is not beneficial to our wallet, and in some cases not even covered by our insurance plan, there are 6 good reasons why it may be necessary to do so.
Should this happen, there are remedies to force the insurance to cover such services at the Higher In Network and therefore save you $.
A. Quick reminder: In vs Out
In Network is the highest level of pay from your insurance - and therefore preferred. It ..read more
AdvimedPRO Blog
2w ago
By Martine G. Brousse (not AI!)
"The Medical Bill Whisperer"
Patient Advocate, Certified Mediator
AdvimedPro
March 16, 2024
You get EOBs from your insurance company every time a claim sent by a medical provider is processed. It is one of the most important document you can received from your insurance. It is imperative that every patient be familiar with what an EOB is, and what it means, as their financial circumstances will be affected by this document.
A. What is An "EOB"?
"EOB" means "Explanation Of Benefits".
It is the description showing what medical service wa ..read more
AdvimedPRO Blog
3w ago
By Martine G. Brousse (not AI!)
"The Medical Bill Whisperer"
Patient Advocate, Certified Mediator
AdvimedPro
March 4, 2024
Do you know the status of every account you have with every medical provider and facility that you consulted or that treated you? Are you sure they can be trusted to refund you what you might have overpaid?
As a previous billing manager, I can attest to an ugly but all too common practice (not mine though!) : credits owed to patients are not always issued. Sometimes, they are not even identified unless you ask.
A refund is owed to you if:
· &n ..read more
AdvimedPRO Blog
1M ago
By Martine G. Brousse (not AI!)
"The Medical Bill Whisperer"
Patient Advocate, Certified Mediator
AdvimedPro
February 5, 2024
Watch the video: https://youtu.be/O7UOF-1pZbE
What is a “patient Advocate”, what do they do and how can they help you?
Let me explain!
A. HOUSEKEEPING FIRST
1. The dictionary defines an advocate as a defender, supporter, promoter, champion of a cause or person. It is not wrong. Advocates are “helpers”
2. An advocate meets your needs (financial, legal, clinical), watches o ..read more
AdvimedPRO Blog
2M ago
By Martine G. Brousse
"The Medical Bill Whisperer"
Patient Advocate, Certified Mediator
AdvimedPro
January 22, 2024
Watch the video:
“Medical Necessity” affects your medical care at every level as well as your wallet.
Are you aware of what it means exactly?
It is based on a number of points of view. To keep it simple:
A. MEDICAL POINT OF VIEW
“Medical Necessity” is what your Dr or medical practitioner deem to be the necessary, appropriate, indicated, responsible steps needed now to establish a diagnosis and prescribe the safest, most ..read more
AdvimedPRO Blog
3M ago
By Martine G. Brousse
"The Medical Bill Whisperer"
Patient Advocate, Certified Mediator
AdvimedPro
January 5, 2024
Watch the video:
There are a number of reasons why your insurance plan would reject payment of a lab test.
The two most common were explored here: https://www.advimedpro.com/post/denied-lab-tests-fix-it-part-1
But LDT tests (Lab-developed tests) are sometimes harder to get paid. Let’s see why.
A. WHAT IS A LDT TEST?
· It means “Laboratory developed test”
· These are tes ..read more
AdvimedPRO Blog
3M ago
By Martine G. Brousse
"The Medical Bill Whisperer"
Patient Advocate, Certified Mediator
AdvimedPro
January 3, 2024
Watch the video: https://youtu.be/SW3odhgNLno
There are a number of reasons why your insurance plan would reject payment of a lab test.
Today we will see how to fix the most common reason: THINGS DON’T MATCH THAT SHOULD!
A. Coding errors
1. Coding and Billing protocols are simple: any medical procedure/service/lab/test/supply/item/intervention/care/Rx/consultation/device MUST have a specific, documented ..read more
AdvimedPRO Blog
3M ago
By Martine G. Brousse
"The Medical Bill Whisperer"
Patient Advocate, Certified Mediator
AdvimedPro
January 3, 2024
Watch the video: https://youtu.be/SW3odhgNLno
There are 2 kinds of lab tests.
How do their differences affect your insurance coverage and your bottom line?
Let’s explore some more:
A. Terminology clarification
The term “lab” in healthcare can mean 2 things:
1. The actual laboratory, structure, place, facility that handles and processes your samples and issue a report on its findings
2. &n ..read more
AdvimedPRO Blog
3M ago
Continuation Of Care: Take Advantage
By Martine G. Brousse
"The Medical Bill Whisperer"
Patient Advocate, Certified Mediator
AdvimedPro
January 2, 2024
What is Continuation Of Care? Why should you be aware of its benefits and how to obtain it?
Let’s explore the topic.
A. What is Continuation Of Care?
1. Continuation Of Care (“COC”) is a policy holder’s right to continue ongoing treatment/service, with the same medical provider, under the same terms of coverage and payment, when that provider’s status changes from In Networ ..read more
AdvimedPRO Blog
3M ago
By Martine G. Brousse
"The Medical Bill Whisperer"
Patient Advocate, Certified Mediator
AdvimedPro
Jan 10, 2024
Watch the video: https://youtu.be/D_MoT7lhx-M
,In healthcare, and especially in insurances’ approval and claims paying-process, codes rule.
Descriptions are not enough, and missing one code or miscoding one will result in rejections with heavy financial consequences for you, the patient.
Let’s look at the most important ones
A. what are “Codes”?
1. They are used by medical providers and insurers to be able to identify, recog ..read more