Third Party Assistance (TPA)

With today’s trend towards increasing medical cost and limited medical benefits more patients now than ever before need help meeting the financial obligation for medical services they have had or will be receiving.

At MedBill Services Inc. (MSI) for our clients, the health care provider, we work to resolve this problem by assigning one of MedBill's eligibility specialist /patient advocates to work with our client’s self-pay patient to identify Third Party Assistance (TPA) programs available to meet financial needs.

Health Care reform and legislative changes are key factors in identifying and determining which Third Party Assistance  (TPA) program is best suited for each referred patient.

At MedBill Services we stay abreast of these legislative changes and constantly seek the best programs for our client and their uninsured patients.

At MedBill Services as part of our overall effort to service our clients and their uninsured patient we go through the following process and provide the following services to ensure we acquire the best results possible.

	Screen all uninsured patients referred by client to MedBill.
	Assist the patient and or client in completing any and all necessary forms that are required to receive third party assistance.
	Provide transportation for patient when necessary to acquire needed documentation or attend scheduled appointment with the respectful government agency.
	Provide staffing to work the referred accounts for the duration of the client agency agreement.
	Conduct home and off-site visits - When other means of contacting the referred patient have been exhausted. - When it’s needed to complete an application or acquire a patient’s signature. - When it’s needed to acquire supporting documentation. - When it’s needed to represent a patient when they can’t represent themselves. - When a patient is unable to make a required appointment or when a patient has other transportation problem     as it relates to their pursuit of Third Party Assistance (TPA).
	Provide translators for non-English speaking patients
	Provide reports, daily, monthly and quarterly on the statue of all referred patients.

To find out more about our Products and Services select one of the following areas:

MEDICAID

SOCIAL SECURITY

CRIME VICTIMS

CHARITY PROGRAMS

CUSTOMERS &  BENEFITS:   CLIENT BENEFITS  |  PATIENT BENEFITS  |  GOVERNMENT AGENCY BENEFITS

MEDICAID

One of the primary Third Party Assistance (TPA) programs available to our Clients self-pay patients is Medicaid. At MedBill Services our Patient Advocates, Caseworkers and Case Managers are Medicaid eligibility specialists. With Medicaid and other TPA programs MedBill Representatives receive continuous training in order to address both Health Care reform and legislative changes.

Medicaid can often times be very complicated as the criteria for approval varies by state. In many instances specialized knowledge is needed to improve the processing of a case and the possibility of approval.

At MedBill Services our staff has been well trained to address the reality of state criteria differences and continues to take the necessary training to stay on top of new government rulings.

In addition to MedBill representatives being trained to deal with state criteria difference they are also trained to assist the increasing number of immigrants being serviced by our health care providers, particularly our Hispanics. For both legal and illegal immigrants regardless of their origin the staff at Medbill Services are sensitive to their needs and have been well trained as we maintain our own staff of translators.

When our clients have self-pay patients who are non-English speaking we provide translators to assist their patients in communicating with social service or the government agency which is responsible for administering the financial assistance program. Language barriers have been and continue to be a major problem for many of our clients uninsured patients who don’t speak English and are often times non-U. S. Citizens.

At MedBill Services we are comprehensive but flexible and we work with our clients to improve their rate of recovery in numerous ways. Not only due we maintain a staff of translators, we personally fill out all forms, transport our patients, represent our patients and conduct home and off-site visits when needed.

MedBill Services representatives take pride in working with our clients disadvantaged patients and enjoy assisting them in completing the required paperwork and securing the documentation necessary to apply for government assistance.

It’s our position at MedBill services to make sure all the forms, which need to be completed and submitted to the appropriate government agency, be completed by the MedBill advocate and personally submitted. At no point due we put the responsibility on the patient to complete and deliver the forms when it’s in our clients best interest for a MedBill representative to do it.

When our clients internal recovery program needs assistance with patient home visits, transporting patient scheduled appointments to social service or any appropriate government agencies assisting with their financial need we are there.

When our client has patient’s which have been discharged and have been displaced, sometimes having to move and have no access to a phone, a MedBill Services representatives will go the extra mile. A MedBill Service representatives often will utilize our home visit referral program and request a MedBill field representative go into the community and locate that discharged patient when no other options are available.

It’s also MedBill position that ideally applicants for Medicaid be taken at the hospital/clinic or the facility of the health care provider. To often after a patient is discharged they become displaced and are difficult to contact. In instances where a patient has been discharged its MedBills policy to put forth all effort to contact that person including conducing home visits when appropriate.   

In order to maintain this level of commitment to our clients and render the best service possible for the referred patient MedBill’s case managers’ review accounts on a regular basis to ensure that the highest level of service is being given by MedBill representatives and patient advocates to both our client and the patient.

At  MedBill Services Inc. we realize it takes knowledge, experience and commitment to address the challenges of most TPA programs particularly Medicaid amidst of the current health care reforms
and legislative rulings. At MedBill Services we welcome the challenge as we continue to monitor the changes both locally and nationally for our clients, their uninsured patients and the community
they’re in.

For more information on Medicaid changes and updates go www.MedicaidCongress.com

 
SOCIAL SECURITY

Social Security Disability is another TPA program available to a select number of our clients uninsured patients. At MedBill Services our advocates/case managers work with our legal department to secure Social Security Disability and/or Supplemental Security Income (SSI) for our clients uninsured patients when appropriate. Social Security Disability and, SSI are not a TPA program that’s suited for just anyone; they are designed to financially assist our client’s patients who suffer from prolonged or terminal disability.

The advocate/case managers at MedBill Services are experienced in completing all the necessary forms and acquiring the supporting documentation needed to meet the Government requirements. MedBill Services advocates/case managers are also trained to recognize the opportunity when it avails to pursue these programs as a viable TPA program for our clients referred patients.

Developing a patient’s case/claim for either Social Security program can be a long and complex process, often times requiring appeals, at MedBill Services we don’t just initiate the claim we work with our clients referred patient for the duration of the process.

At MedBill Services it’s our belief that if a referred patient has an on going disability and is not and will not be able to meet his/her financial needs as a result of their disability it’s in our clients best interest and in the patients best interest that we pursue a Social Security program as a alternative source of financial assistance

FOR MORE INFORMATION ABOUT SOCIAL SECURITY CLAIMS GO TO www.socialsecurity.gov


CRIME VICTIMS

Victims of violent crime can get help. At MedBill Services on the behalf of our clients we work with patients of violent crime. Depending on the state where our client is located MedBill representatives usually work with the Attorney Generals office to secure financial assistance. The crime victims program is another one of the TPA programs a referred patient is screened for at MedBill Services Inc.

A MedBill caseworker/advocate in addition to screening for Medicaid, SSI, Charity, and so forth also screens a patient for crime victims. The programs receives some of it’s funding through the federal Victims of Crime Board and and funds are awarded via the approval of the crime victims Reparations Board.

The program varies from state to state and if a patient is awarded financial assistance it’s because that patient was injury or died as a result criminally injurious conduct. The act must have been punishable by law and can in some cases can even include acts of terrorism committed outside the United States.

With this TPA program the patient, the Health Care Provider, and some times the family can all be compensated. Again, this TPA program varies from state to state and it takes knowledge of the program both locally and nationally to best serve our client and the patient. At MedBill Services we have that knowledge and the experience and we work to ensure the patient and our clients that if a referred patient qualifies for this program a MedBill Services representative will fill out all the necessary forms and acquire the necessary documentation to navigate through the system and receive desired results.

IF YOU WOULD LIKE TO INFORMATION ON CRIME VICTIMS GO TO www.crimevictims.gov


CHARITY

Often times a health care provider is required to provide charity discounts for patient who falls below the federal and state poverty guidelines. At MedBill services, as part of our screening process, questions to determined eligibility for charity discounts are addressed. If a patient does not have financial means but has medical needs and they fall below the poverty level the health care provider can often times benefit from the application taken and supporting documentation secured during MedBills initial screening process and be subsidized for the services rendered.

Upon determining whether a patient is eligible for one of the TPA programs or not it’s the MedBill case manager’s responsibility to secondarily see if they qualify for charity. If it appears a referred patient may qualify a MedBill Service representative will take the application, secures the supporting documentation and on the patient’s behalf submits it to the client for consideration.

In instances where a patient does not qualify for a TPA program the MedBill Case Manager’s responsibility is to take a charity application and submit it to our clients business office for charity consideration.

In some instances a patient may qualify for a TPA program and the reimbursement to the client is limited. In cases like that it’s the MedBill Services Case Managers responsibility to take a charity application if the patient is under the poverty guidelines as a secondary coverage or as an alternative means of securing some compensation in case a patient can’t pay for their portion of the medical bill.

This is a service that MedBill Services extends to it’s clients as part of our overall service offering and is available to our clients upon request. As there are some providers who handle charity themselves. In cases where MedBill Services is assisting the client, it saves our client manpower hours, it helps the client in securing the information and it ultimately helps the client in meeting their financial goals.                 

At MedBill Services we provide our client with a detailed monthly report of all applications taken and submitted for eligibility. Depending on the type of charity program our client has this is often a free service to our client as it is part of the overall MedBill Services TPA program.

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FOR MORE INFORMATION ON MEDBILL SERVICES INC. AND THE SERVICES OFFERED OR TO TALK TO A CUSTOMER SERVICE REPRESENTATIVE, PLEASE CALL US TOLL FREE AT 1-866-534-4880 OR COMPLETE AND SEND YOUR CONTACT INFORMATION BY VISITING OUR CONTACT PAGE.