Friday, January 22, 2010

Medical Bill Helper: The Rest of the Story

As promised when introducing the newest member of the "Resources" section of our sidebar, here's what Rick Lifsitz, CEO of Medical Bill Helper, shared with me in an extended phone interview:

InsureBlog: First, thanks so much for taking the time to help our readers understand what your service is all about. Can you tell us about your background? Are you a physician, for example?

Rick Lifsitz: I'm always happy to explain what we do. No, I'm not a physician, I'm a businessman, MBA, with many years of experience starting and running companies. Mostly with technology and how to apply technology to solve business problems.

IB: What was the original motivation for Medical Bill Helper (MBH)?

RL: As a business owner, I'd heard lots of stories, and seen firsthand, how folks with no insurance, or who had to go out of network, were routinely charged much more than the insurance companies paid. They needed the health care, and were stuck with the bills. I didn't think that was right.

For example, I looked at what radiologists were charging in a specific area for a certain test. The exact same test ran anywhere from $300 to $3,000, all from providers all within a few blocks or miles of each other. It just didn't seem to make sense. And it didn't seem fair that people without insurance were having to pay such high amounts. I knew that a lot of these prices could be negotiated, but most people don't know that, or know how to go about it.
[ed: This may be particularly helpful when dealing with Hidden Providers]

IB: How is MBH different from, for example, those discount card programs we see advertised so heavily?

RL: Well, for one thing, we don't have any kind of on-going fee arrangement. You sign up and we charge you a percentage of what we save on a claim. There's no monthly "membership fee" or the like. And we don't charge anything if we aren't able to save our client at least 10%. I think that any consumer can go to their doctor and ask for a simple 10% discount, so we don't charge unless we generate a bigger savings than that. And that's also why we don't work with charges under $500; the point is to deal with the runaway costs, not the small ones.

IB: Okay, but that begs the question, just how do you know what the "right" number or charge should be?

RL: We have databases with UCR [ed: Usual, Customary and Reasonable] for different procedures and areas, and we have people on staff with many years of experience negotiating these costs for the insurance companies. Even though we actually opened up MBH in 2009, our people have decades of experience in these kinds of negotiations.

IB: One of the challenges with the discount cards is that they typically require payment in full at time of service, or within a very narrow timeframe afterwards; there's generally no "payment plan" arrangement available. Does MBH work pretty much the same way?

RL: Well, by definition there's no requirement for payment at time of service; we only come into the picture afterwards. Our experience is that providers, while the preference is for payment in full, we've also had occasions where there's been a payment arrangement set up. The big issue is that there are really two kinds of people in this situation: those that have no intention of paying, and those that want to but have finance or budget issues. That first group (non-payers) isn't coming to us, anyway; why bother negotiating on something you're not going to pay in the first place? It's that second group that we're trying to help.

IB: Thanks so much for your time, and we'll remind our readers that they can find the MBH link in the "Resources" section of our sidebar. And we'll also point out that that's a direct link to MBH; we don't receive any compensation for folks who find you because of us [ed: darn!].
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