Advantage Medical Billing

I went in to private practice a year ago and tried to tackle the billing on my own. What a mistake. I finally gave up and contacted AMB. Soooo glad I did. They have been wonderful. They argue with insurance companies and fully explain the pay outs. My only regret is that I did not start out with them.

Advantage Medical Billing is an outside billing service that contracts with various medical professionals throughout the area. According to the website, the principal, Jennifer, has been working in this field for upwards of two decades. However, competence is extremely substandard and borders on fraud.

Received a notice from my insurance provider that a claim from one of Advantage's clients purportedly providing service to myself at the beginning of 2018 was approved. However, I haven't seen this provider for over a year. I reported this to my insurance provider who investigated the claim. Subsequently Advantage Medical sent a copy of a ledger printout which showed a reversal of the charges along with a handwritten note that said:

"I wanted to show you that the charges billed out for you in error for [date of service] have been reversed. I made a clerical error and the charge belongs to another patient with a very similar name. I am sorry for the error and for any concern my mistake caused you. Thank you, Jennifer (530) 345-7699".

While the copy did not specifically show a reversal (everything in the balance column showed a zero amount, nothing in fact was entered or removed), subsequent verification came through via the insurance provider consisting of several documents and a denial for the initial charge.

A week later, however, I received an email from my insurance provider stating that I had a claim approved. Lo, it was yet another claim from the same medical provider, this time for an additional $25 ($50 from the first billing, $75 on the second).

Lather, Rinse, Repeat.

Received a *phone* call this time from Jennifer. Along with a very grating apology came a plethora of explanations and excuses. I pointedly informed her that aside from the double billing on services that I never received, the increased amount was an indicator of fraud. That I had reported it as such to my insurance provider. However, at this point, I may look into filing a formal complaint with the District Attorney's office. The patterns are clearly indicative of fraudulent practices.