When you ask us for help with your hospital bill, we first have to determine whether we can assist you. In order to do that, we need to review your itemized hospital bill. If you have only a summary bill, you will have to ask the hospital billing department to send you an itemized bill. The hospital should not charge you anything for the itemized bill. Please check to see whether your bill is a summary bill or an itemized bill.

When we review your itemized hospital bill, we determine whether the bill should be audited. Auditing a hospital bill means comparing the charges in the itemized bill line by line with the information contained in the corresponding medical records to uncover errors and overcharges. If we determine that your bill should be audited, you will have to acquire a copy of your complete medical records from the medical records department at the hospital. The hospital will very likely charge a fee for photocopying your medical records.

When we perform a hospital bill audit, we try to verify that each item in the bill:

      •   was actually provided to the patient;
      •   was ordered by a physician;
      •   was an item that can legitimately be billed to the patient;
      •   was consistent with the diagnosis and the overall treatment program; and
      •   was reasonably priced in relation to the cost involved in providing it.

We compile a list of unverified, improper or otherwise questionable charges -- which we call our audit findings -- and submit an audit findings report to the hospital. The hospital responds to our audit findings report and negotiations take place until all of the charges disputed in our audit findings report have been either verified or removed from the bill.

Not surprisingly, the entire auditing process -- and particularly our negotiations with the hospital on your behalf -- go a lot more quickly and smoothly if you have not yet paid the bill. If you have already paid the bill, we still may be able to save you some money. Call us, and we will be happy to explain your options.

We generally agree to audit only hospital bills of $10,000 or more, because it is not cost-effective for us to audit smaller bills. We reserve the right to refuse to audit any hospital bill.

We cannot audit your hospital bill if you had medical insurance during the entire period of time that you were in the hospital, regardless of how small a portion of the bill your insurance company is responsible for paying. A hospital will accept audit findings on a bill from only one party, and if you have insurance coverage, the insurance company is that party. If we submitted audit findings on your bill, the hospital would ignore them.

You can ask your insurance company to audit your bill, but it will probably refuse to do so. You can ask your insurance company to hire us to audit the bill, but it will probably refuse to do that as well. If your insurance company did hire us to audit your bill, the hospital would have to deal with us, because we would be representing the insurance company. We would not even have a contract with you. Most of whatever savings we obtained would go to the insurance company. How much you would save would depend on how your insurance coverage is structured.

If you had medical insurance during only part of the time that you were in the hospital -- if, for example, you were in the hospital for the last three days of June and the first two days of July, and your insurance didn't take effect until July 1 -- we could audit the charges incurred on the days when you did not have insurance, which, in our example, would be the last three days of June. You would receive all of the savings that we obtained on the portion of the bill that we audited. But we would agree to audit that portion of the bill only if it contained charges of at least $10,000.

We work strictly on a contingency fee basis, which means that our only fee is a percentage of the amount by which we get your bill reduced. The greater the amount of the reduction, the more money we earn, so you know that we will always do our best to save you as much money as possible. In the unlikely event that we are unable to save you any money, you owe us nothing -- not even a penny -- no matter how much time and effort we have spent working on your bill.

Our standard fee is one-third of the amount that we save you. Say you were faced with paying a hospital bill of $50,000. If we got the hospital to reduce your bill by $15,000, our fee would be $5,000. Instead of paying the hospital the entire $50,000, you would pay the hospital $35,000, pay us $5,000 and keep the remaining $10,000 in your bank account.

Our fee is not due and payable until we receive written confirmation from the hospital that your bill has been reduced as a result of our efforts. We prefer that you pay our fee in full at that time, but if you can't, we will make arrangements for you to pay us in monthly installments.

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