We need someone to be a primary source of information regarding all medical bills. We’d need all the medical bills digitally organized by person, doctor, and condition, easily distributable to other doctors, reviewed, paid, and tracked. Here is a breakdown of tasks for the perfect VA.
1. Support: Organize and track all medical expenses.
a. Monitor activity on bills and benefits payments, make payments and recommend timing of payments.
b. Submit required paperwork to primary and supplemental insurance companies and reimbursement accounts.
c. Provide annual health care utilization and savings reporting for tax and benefits planning.
2. Optimization: Answer billing and insurance questions - Review medical bills and explanation of benefits (EOBs) to ensure charges are reasonable and accurate.
a. Identify coding errors, duplicate charges, data entry errors, etc.
b. Resolve issues/errors with insurance companies and providers.
c. File appeals when benefits have been denied.
d. Negotiate out-of-pocket procedure cost before or after treatment.
3. Advisory: Evaluate insurance benefits based on utilization history and recommend opportunities to optimize plan effectiveness ongoing.
a. Eliminate duplication of coverage.
b. Research financial implications of medical conditions, treatments and drugs.
c. Assist with elder care, COBRA and Medicare issues.