Billing error review as a benefit
Billing error review as a benefit means an employee or member can send a medical bill they think is wrong to a specialist service instead of paying it or giving up. mediloop reads the bill, the EOB and the itemized charges, finds charges that don't match, and asks the provider to correct them in writing.
It starts after the plan has processed the claim. mediloop doesn't adjudicate, reprice or edit claims. It works the bill the person was actually sent.
People don't pay bills they don't trust, and they don't challenge them either.
Debt is common
In KFF's health care debt survey, 41% of US adults said they were carrying debt from medical or dental bills.
Doubt is part of it
44% of those with debt said they had held off paying a bill because they weren't sure it was accurate.
Asking works more often than people think
In a 2023 national survey published in JAMA Health Forum, about a quarter of people who contacted the billing office about a bill had it corrected.
The checks a careful reader would run, on every charge.
To check the charges line by line mediloop asks the provider for an itemized bill. Under HIPAA people have the right to copies of their billing records, and a provider can't withhold them over an unpaid balance.
AI does the reading. A person does the talking.
The person sends their bill
An employee or member uploads the bill and EOB through mediloop's intake and authorizes their own case. HR doesn't collect or forward anything.
AI-powered investigation
mediloop's AI reads the documents, pulls out every charge and code, and runs them against the EOB, coding rules and published prices.
A human advocate gets it corrected
An advocate reviews what was found, asks the provider for corrections in writing and follows up until the bill is fixed or the person knows exactly what they owe.
A real answer for the employee. No bill in HR's inbox.
Where these facts come from
- KFF Health Care Debt Survey, KFF
- Duffy, Frasco and Trish, JAMA Health Forum, August 2024, JAMA Health Forum, American Medical Association
- CMS, How to read an explanation of benefits, Centers for Medicare & Medicaid Services
- CMS, Action plan: Bill with an in-network provider, Centers for Medicare & Medicaid Services
- HHS Office for Civil Rights, Your medical records, US Department of Health and Human Services, Office for Civil Rights
- HHS Office of Inspector General, Physician relationships with payers, US Department of Health and Human Services, Office of Inspector General
- CMS, National Correct Coding Initiative (NCCI) for Medicare, Centers for Medicare & Medicaid Services
Billing error review, answered.
Hospital financial assistance · Surprise bills · Insurance denials · Security and data · For employers
Last reviewed
Give people somewhere to send a bill that doesn't look right.
Tell us about your organization and what people do today when a medical bill looks wrong. We'll review the fit and come back to you about a pilot.
Prefer email? sales@mediloop.ai