Transforming Medical Billing Challenges 

CONNECTING YOUR BUSINESS TO THE TECHNOLOGY RESOURCES YOU NEED 

At Patient Advocacy Solutions LLC, we are dedicated to resolving even the most complex medical billing issues. Here are some real-life success stories that highlight how we can help clients overcome medical billing challenges and achieve significant financial relief. 

Case Study #1

Resolving Complex Billing for Crohn's Disease 

Client A faced numerous hospitalizations due to Crohn's Disease complications, resulting in a complicated coordination of benefits between multiple insurance policies. With Medicare eligibility, changes in employment, and COBRA policies, claims processing became a nightmare. Patient Advocacy Solutions LLC stepped in to: 

• Inventory and organize all medical bills. 

• Coordinate communication between Medicare and private insurers. 

• Ensure correct reprocessing of claims by 26 different healthcare entities. 

• Track all communications and billing meticulously, easing the burden for the family. 

Financial Outcome: Beginning balance of $195,712.59 reduced to $12,584.76. 

Total savings: $183,127.83. 

Case Study #2

Appeal for Denied Surgery 

Client B underwent laparoscopic surgery for a hernia, only to have her insurance company deny the claim as "not medically necessary." 

Our team: 

• Gathered and reviewed all relevant medical records. 

• Submitted two levels of appeals, including strong arguments for medical necessity. 

• Kept consistent communication with the billing department to prevent collections. 

Financial Outcome: Beginning balance of $8,451.41 reduced to $0. 

Total savings: $8,451.41. 

Case Study #3

Overpayment Refund for Breast Cancer Treatment 

Client C paid upfront for extensive breast can-cer treatment while a pre-existing condition in-vestigation was underway. After the insurance company processed the claims, we: 

• Worked closely with the insurer to verify the process. 

• Liaised with the hospital for timely refund requests. 

• Escalated the issue through certified letters when delays persisted. 

Financial Outcome: Successfully secured a re-fund of $7,728.15 for Client C.