The Alliance of Claims Assistance Professionals (ACAP) is a nationally recognized association of independent Claims Assistance Professionals (CAP). Our members provide medical claims assistance and patient advocacy to individuals and businesses across the country. We are each independently owned for-profit businesses whose services are fee-based. All members undergo a rigorous application and vetting process and provide multiple professional references in order to be invited to join the organization. Our membership provides a broad array of assistance that ranges from local and regional focus to national and even global representation.
What Have You Got to Lose??
A client recently reached out to me. He had just received a $39, 935.23 bill from the office that had provided their son with ABA (Applied Behavior Analysis) Therapy & PT (Physical Therapy) 3 and 4 years prior.
The family’s health insurance had paid his claims until this time. In fact, some months they paid and then randomly decided not to pay claims the other months; sending letters stating the provider was out of network (NOT SO!); or the patient did not have this benefit. (NOT SO!).
Three (3) months later, I succeeded in reducing the family’s financial responsibility to $5, 038.12 (less than 13% of the debt). Based on their in network benefits, this was the patient’s deductible & co-insurance over 2 years.
It took much determination & a dose of persistence, but I accomplished what we set out to do with cooperation from the health insurance company, the provider’s office & the family.
This certainly was worth pursuing!
-Karen Weiss from ABC's 3R Solution
Charity Care…Don’t be Embarrassed to Ask
Most hospitals offer assistance with medical bills through charity care, or financial need applications. While the existence of these funds is often not actively publicized by the facilities, they are available and accessible to patients at varying income levels.
In a recent case, a client with more than $10,000 in hospital and related-provider bills reached out to us, to help reduce their financial liability. After successfully navigating the patient through the financial need application process, we were able to erase $8,000 in charges and are now finalizing the same process with the affiliated providers who are recognizing the hospital’s determination of financial need for the patient.
We recommend that the first step that patients with excessive hospital bills should take is to investigate what funds might be available for those in financial need. Keep in mind, don’t be afraid to hear “no” as the answer.
You are no worse off than if you didn’t ask, but you will frequently hear “yes,” and this, after all, is your goal.
-Robert Berman from SysteMedic, Inc.