How Health-Care Advocates Help Struggling Patients

The family sued and reached an out-of-court settlement, stipulating that the insurance company should cover their costs. But while they had already amassed more than $70,000 in medical bills, they only received $50,000 in reimbursements.

Fortunately, Ochs's husband's cancer is in now remission. However, if they hadn't contacted Jessie Maurer, a patient advocate in West Des Moines, Iowa, last summer, they'd still be chipping away at the $18,000 they still owed. Maurer, who reviews patients' medical bills for errors, told the family that they had overpaid by more than $20,000.

Like many consumers, the Ochses had no idea that insurance companies negotiate lower fees with hospitals and doctors. As a result, when their insurance coverage kicked in retroactively, they were due the difference: information the hospital didn't volunteer. "My husband and I both have PhDs, so we're used to the research process, but this one floored me," Ochs says. "Who would have known!"

With soaring health-care costs and a system that has become as difficult to navigate as the tax code, people like Ochs are increasingly seeking out professional patient advocates. For an hourly fee or a percentage of the cost savings, these advocates review medical bills for errors and help consumers get reimbursed. (Their services can also include helping you select an insurance plan or a medical specialist to fit your needs.)

While such services are nothing new — Medical Billing Advocates of America, one of the largest patient-advocacy networks, has been around for 10 years — they are gaining popularity, especially among employers. Today, more than 3,200 companies, including large corporations like Home Depot, Citigroup and General Electric, have added health-advocate services to their benefits.

"The service fills a void," says Tom Lerche, senior vice president and health care practice leader for Aon Consulting, an employee benefits consultancy. "Employees don't feel like there's anybody advocating for them when they have issues with payment claims or how to research a rare disease."