What does Understood Care do?

Understood Care provides one-to-one patient advocacy for Medicare members and caregivers, including help with benefits, appointments, care coordination, medical bills, insurance questions, denials, and paperwork.

How can a patient advocate help with Is a denied claim your financial responsibility? — Understood Care?

Understood Care advocates help with is a denied claim your financial responsibility? — understood care by explaining options, organizing paperwork, coordinating care, and helping families understand Medicare coverage and next steps.

Does Understood Care work with Medicare patients?

Yes. Understood Care focuses on Medicare patients and their families, with advocates who understand Medicare, Medicare Advantage, care coordination, coverage rules, billing issues, and appeal pathways.

Understood Care is a virtual patient-advocacy service for Medicare members. Unlike case management or brokers, our advocates cover claims, appeals, and care. Compared to helplines, it is one-to-one.

Is a denied claim your financial responsibility?

Video · 1:22 · hosted by Deborah Hall

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Auto-generated from the video, lightly edited for readability.

I wanted to come on and talk about denied claims or getting a bill from a provider that you don't think that you should have gotten. Two things.

When you get an explanation of benefits or a notice from your insurance company that they process the claim whether they paid it or deny it, this is not a bill. Okay? You do not have to pay anything based on an explanation of benefits.

If you get a bill from your provider, a lab, a hospital, an imaging center, that's where I come in or that's where somebody like me comes in. What we do is look at your benefits. We review the bill along with explanation of benefits from your insurance company and then we determine is this something you actually have to pay based on your benefits.

If it's not, we work directly with the provider and explain your benefits to them and why this bill is not your responsibility. Sometimes what's called balance billing happens because most of what's done today is by computer.

So if the computer doesn't know the rules or the rules aren't input into the system for that provider, the computer doesn't know not to send you a bill. We help you out by looking at those, comparing it with your benefits to make sure that you're not paying something you're not responsible for.

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Is a denied claim your financial responsibility?

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