There are numerous help sources locatable in public libraries, in the front and yellow pages of telephone books, and on the internet by search engines.  If you don't have personal internet access, your local public library probably maintains access for local citizens.  If you feel intimidated or outclassed, ask a capable friend to help; and you be prepared to (1) promptly help that friend to help you in any way possible, and (2) find some way to do some pay-back to the friend in exchange for this time-consuming favor.  You and/or they must be bold but mannerly and respectful in asking for help. DO NOT threaten legal action...all doors will immediately close! Here is who you or they can enlist to help:

Low/no cash help:

• medical friends at church, at work, in clubs: ask for advice and how to cut costs.
• consumer activist friends: get their advice.
• at work: (1) your company MAY self insure initial expenses & be able to over-ride an insurance company's initial denial of a precertification of coverage; (2) ask benefits manager of your or your spouse's employer's usual health care benefits plan for advice on using the [a] insured health plan (which should have an external appeals board)...or [b] the self-insured health plan (the US Dept. of Labor regulates company self-insured health plans & there is no external appeals board).
• provider's (doctor, hospital, pharmacy):
  • their business office or insurance staff or account services representative may be able to guide you.
  • special circumstances: if you can honestly tell about your circumstances, they may be able to reduce your balance owed.
  • as to your balance owed: if this has strapped you financially...you may be able to give details and then request that the provider's chief decision maker grant you a special disposition so that your balance owed is recalculated based on the lowest "limit of allowance" contractual agreement this provider has in force for the CPT codes of services provided to you.
  • if they have one, their social services department may be able to help.
  • hospital or care facility departmental managers where service was provided (Radiology; ER; Lab) may be able to help.
• your insurance agent may have advice.
• non-profit organizations related to the disorder or disease you have (check library or internet) may have advice.
• your county's local Medical Society may have advice.
• your hospital's chief of the medical staff may have advice.
• ***your hospital's social services dept. may have advice.
• Appealing Medicare denials: tips from ElderCare Online.
• S. C. Insurance Dept.: check their "data bank" of community help sources website (launched 1 Sept. 2004).
• Patient Advocacy Coalition: check for PACs via internet search engines.
  • dispute resolution information for both after-the-fact insurance denials and denials of proposed treatments (precertification denials); & they can refer you to attorneys specializing in insurance problems.
  • "How to Play HMO Hardball" web site: (1) getting necessary tests and treatments; and (2) win appeals. arbitrations, and lawsuits [societal adverse impact of lawsuits].
  • The Patient Advocate Foundation...has list and links for state Insurance Commissioner offices (these offices ought to have help sources for resolving disputes).
• Medical Information Resources in Ogden, Utah (Pam Sarlo), 1-888-203-6062.
• South Carolina Medical Association's Medical Economics Dept. [SCMA]
• the Professional Review Organization (PRO) servicing the hospital providing services to you, such as MRNC
• political help: offices of your county, state, and federal elected officials
• Better Business Bureau
• your state hospital association [SCHA]
• State consumer affairs departments: South Carolina Consumer Affairs Dept. 800-922-1594
  • information from the Wisconsin Bureau of Consumer Protection
• South Carolina Department of Insurance  800-768-3467
• S. C. Consumer Help Desk (a growing list of links)
• National Association of Professional Geriatric Care Managers (GCM) web site offers resource web links (possibly giving clues to free help) and location services if you realize this is more than you can handle or if you are the family member in charge but live at too great a distance.

Who can you PAY to help:

• Above: some of the above "free" sources who decline to do "free"...offer to pay them faster if a very discounted bill.
• fee-for-service (you pay them) professional help: "insurance claims consultants", "medical claims assistance professionals", "patient advocates", or "patient advocacy counselors" (charges of up to $100/hour or 25% of the recovery)...search engine the internet for the above terms in your geographical area, such as:
  •  through an outfit like Medical Billing Advocates of America for a free search for any of their listed advocates in your area.
  • HealthConsumer.com has a free search for a professional advocate in your geographic area
    1. Arthur "Art" Cherry, "Optimal Recovery", Winnsboro, S. C., 29180-6259....specializing in hospital bill auditing for employer/company health self-insured programs
  • Mary Jane Stull (US News and World Report magazine, 12 Nov. 2001, p. 61)
  • Claims management, Inc. (CMI) of Salt Lake City, Utah serves providers, families, and individuals and has some self-help info on their site.
  • Medical Cost Advocate. One such as this may negotiate what is LEFT after insurance pays & attempt reductions in the balance you owe. May have special arrangements if you have an HSA.
• health care lawyers (check with local and state bar associations):
  • Clark & Mascaro, P. C. in Atlanta, Georgia
  • see Patient Advocacy Coalition, above.
  • Virtual Law Offices of David L. Trueman (especially as to HMO and Managed Care fights...site has lots of consumer info)
  • elder-lawyer sources via links from "resources" area of National Association of Professional Geriatric Care Managers (GCM). 
  • The National Academy of Elder Law Attorneys, Inc.: is a non-profit association that assists lawyers, bar organizations and others who work with older clients and their families. Established in 1987, the Academy provides a resource of information, education, networking and assistance to those who must deal with the many specialized issues involved with legal services to the elderly and disabled.
  • Jan. L. Warner (elder lawyer...deceased Oct. 2009), 1122 Lady St., Columbia, S. C. 803-799-0554 and Next Steps (book); his firm lives on HERE.
• web sites:
  • Planetfeedback.com (sends complaint letters for persons).
• You are The Caregiver: you suddenly find yourself the caregiver...where to turn for tips on local advice & help? HERE is a source concerning eldercare.
• Reducing the health costs, tips and sources:

[back to the main advisory index page]

(posted Aug. 2001; latest update 19 April 2010)