Facts

/Facts

When someone you love is in need of medical care, the last thing you want to be doing is managing the reams of paperwork from the hospital or debating what’s covered with the insurance company.  The provider wants you to pay a bill that’s wrong.  The insurers want you to give up without a fight when they tell you part or all of a procedure isn’t covered.  The in-network physical therapy office wants to see if you’ll pay in advance.  The lab runs blood work that the doctor didn’t request and the insurance company has denied.  Even when you win the battle, you’ve lost the time.

Understanding how private healthcare and government funded insurance operates is a full time job, and working the system when you need medical care is draining.  ExHale Health puts its corporate muscle into every individual case. We employ seasoned experts from the healthcare industry to give our clients an advantage.  Insurers and healthcare providers know that they can’t pull any tricks on us, because our ExPerts know how the system works.

Most people don’t question the costs of our healthcare because we trust our healthcare providers.  It’s difficult to consider that the doctors and nurses and hospital staff who help us would do anything that could harm us financially.  But even the most well intentioned professionals make mistakes.  Billing departments get codes wrong.  Insurance companies erroneously deny and forget to pay claims.  And some provider institutions (doctor groups, labs, therapeutic facilities, hospitals) want to make the most profit possible without considering fairness, ethics or the persons their actions harm.

Overcharging, billing errors, inflated procedure and prescription drug costs are unfair. You shouldn’t pay one cent more than what is fair for the healthcare you receive, and you deserve to receive the best care possible.

Often, doctors’ practices, hospital groups, labs/imaging centers enlist 3rd party billing collection companies to see if consumers will pay beyond what they’ve received from the patient and insurance company.  If the patient pays, it’s a bonus for the collector and the provider.  If not, maybe a series of phone calls or an official looking document will scare the consumer into paying the bill in full.  (The person who called me worked for a collection agency, not my doctor or the local hospital).

You owe it to yourself to have a trusted expert carefully review and question every medical bill you receive against your insurance policy’s EOB (Explanation of Benefits).

When a doctor or hospital sends an incorrect bill or attempts to get you to pay before the insurance company has had a chance to remit payment to the provider, it puts the your family’s fiscal health in danger.  Most individuals don’t realize that even if they indeed owe money, the amount can often be reduced through direct negotiations with the provider(s).  Instead, millions of insured Americans take the healthcare provider’s word for it and pay the debt.  We quickly accept that those we entrust with our lives wouldn’t mislead us, and dive into what seems to be the logical next step:  finding a way to pay.  It’s important to realize is that medical overcharging is not a personal affront, but a complex business strategy driven by a desire for financial gain.  Challenging a bill does not show weakness of character, but a commitment to fair and equitable treatment.

78% of those who filed say they had medical insurance.  How could insured Americans be bankrupted by medical costs?  Sadly, it’s a lot easier than you might think.  One moment you’re a Vice President with a PPO health insurance plan provided by your employer, the next you’re a patient with $80,000 in bills on your coffee table from a variety of doctors and the hospital that your insurer won’t cover and the providers (and their bill collectors) demand you pay.