What exactly do I get with my membership?
All memberships include:
- Historical Claims Review – We review all of your past medical expenses to make sure you have been properly billed and reimbursed.
- Ongoing Claims Administration – We continue to review your medical expenses moving forward, filing claims and negotiating bills where appropriate.
- Advocacy – We appeal to your insurance company or employer, where appropriate, to ensure you are being treated fairly and pursuant to your health plan.
Other services such as Alternative Payment Solutions, as well as HSA/FSA/Cobra/Medicare Advisory, are covered under certain, but not all, membership plans.
How do I know which Membership is right for me?
A few guiding principles below may be helpful:
Membership plans are structured based on out-of-pocket sensitivity levels. The Trial Plan is for those who do not want to pay out of pocket up front but are willing to pay more once we perform. Premier Plan is for those who know they have had large expenses and expect us to return money back to them. In this case, the higher up-front membership fee results in a lower shared percentage to MCL later on. Lastly, the Pay-As-You-Go Plan is designed for those who have had large medical expenses, expect MCL to be successful, and want to minimize the fees paid to MCL in the event that MCL is able to get back a lot of money in those cases. In this Plan, MCL bills hourly, like a law firm, showing you the time spent by our customer service reps, as we go.
If the answer to this question is not obvious when you look at the Membership Benefits pricing page, the best way for you to learn which Membership is right for you is to call us and let our customer service reps help guide you to the right plan.
What is the difference between Membership and Trial Membership?
A Trial Membership allows you to see how we perform without any cost to you, unless we get you money back from your insurance company or reduce outstanding medical bills. With a Trial Membership, you provide MCL with all of your historical medical bills, explanations of benefits and any other paperwork that you want us to look at. We review everything we can get our hands on and see whether we can get you money back.
How much does a Trial Membership cost?
With a Trial Membership, you pay nothing unless we get money back for you, either in the form of a reimbursement or a reduction in an existing bill. Trial members share 33% of any reimbursement or bill reduction with MCL. You keep 67% of every cost reduction.
How long does it take to sign up?
Signing up is easy and only takes a few minutes. It depends on how many family members will be covered under our service, as well as on the complexity of any medical expenses you have incurred.
What happens if I have not saved any of my bills? Can you still help me?
Of course! Copies of your past bills are not necessary for us to do our thing. They simply allow us to get started more quickly. With every Member, we take the names of all of the providers you and your family have visited. We then contact each provider to request copies of all medical bills processed during the past year (and longer, if appropriate).
How far back can MCL go to adjust my bills and reimbursements?
It depends. Every insurance policy has different rules on this. It is in our interest to test the limits – in the case of one prominent carrier, we have gone back three years!
Who does MCL work with?
We aim to maximize benefits at the patient level – however, providers, plan administrators and other parties are all beneficiaries of our service – and are all clients. To learn more about how we work with different parties.
Does MCL underwrite or sell insurance?
No. MCL is neither an insurance carrier nor an insurance broker.
Does MCL provide advice on which doctors I should see?
No. MCL does not give medical advice. MCL offers administrative and advocacy services on issues relating to medical billing and reimbursement.
Does MCL provide support for Medicare and Medicaid?
MCL has expertise on Medicare-related issues. Medicaid is not a focus of our business but we welcome you to call us with any questions. If we can be of assistance, we will be happy to do so.
What about my additional insurance policies?
MCL understands that many people have supplemental coverage and, in some cases, tertiary coverage. We are accustomed to working with numerous types of coverage. We enjoy navigating the complexities of multiple policies!
Can MCL help me with my HSA/HRA/FSA?
Yes. Depending upon which membership type you select, MCL will help you navigate these benefits.
Once I sign up, what do I need to do?
Relatively little. Each month, by email, you will be prompted to select the providers that you and your family members have visited during the prior month. We then follow up with these providers on your behalf, receiving copies of your medical invoices which we review for proper coding, before filing with your carriers. For new providers, you will need to notify us – by phone, email or via website – of this addition to your profile. We do the rest.
Will MCL review my medical bills and tell me what I owe?
Yes. MedClaims Liaison will review your medical bills for you. Where appropriate, we negotiate reductions in balances due and propose coding adjustments to providers. It is important to note, however, that MedClaims is not a bill-paying company. Ultimately, the responsibility for actually paying the bill rests with you, our clients.
When am I billed?
After you have paid your initial membership, you are billed after confirmation of receipt of a bill reduction or reimbursement. Your My MedClaims page will track your current balance due so that you always know what you owe as of that point in time.
Am I able to request my own MCL representative?
Yes. However, we do not recommend this. MCL employs numerous highly qualified professionals. We believe that we can provide better, faster service by allowing our entire team to be accessible to you. Certainly, in complex reimbursement cases, there will be a senior manager who is responsible for your matter and with whom you can have contact.
Will MCL help me choose which health plan is best for my family?
No. MCL is not an insurance broker or reseller.
Does MCL need my social security number?
No. Your social security number should not be necessary for us to manage or negotiate your medical bills and claims.
How do I pay for MCL service?
MCL will collect your payments using the credit card you provided during registration.
Can I cancel my membership?
You can cancel your membership at any time. However, even after cancellation, MCL will be entitled to be paid for any reimbursements or savings on work we started on your behalf.
Will my health records be kept private and confidential?
Absolutely! MCL complies with all HIPAA requirements. Confidentiality and Security are at the core of our mission.
Will MCL share my health records with anyone?
MCL is focused on medical expenses – NOT medical records. If we need to access your health records as part of an appeal on your behalf, those records would only be discussed with the doctor who performed the service and your insurance companies from whom we are trying to procure payment. In the event that you are covered by an employer-sponsored plan, we may benefit by interacting with your employer. But, in no way, will we ever speak to your employer about your medical records without your express, written, authorization.
What is MCL’s security policy?
MCL has comprehensive security and privacy policies and is HIPAA compliant.
Can MCL help me even though I recently changed my health insurance?
Of course. MCL routinely works with members who have changed insurance carriers or have multiple insurance carriers.
How long does it take for MCL to get money back for me?
Typically, we are able to show results within 30-45 days. However, every situation is completely different.
When will my membership become effective (active)?
In the case of the Trial Membership, we begin working once we have a signed HIPAA authorization form and MCL contract. Other membership levels go active once we receive valid payment.
When can I change my membership?
You can change your membership at any time by contacting MCL. All work in progress will stay under the original membership fee schedule, but all new work can be done under the new membership level. Contact Us
When can I add a family member?
You can add a family member at any time. The most common addition to memberships comes from the addition of a newborn.
Can I remove a family member? (ie. Divorce)
You can remove a family member from your MCL membership at any time by contacting MCL. However, even after removal, MCL will be entitled to be paid for any reimbursements or savings on work we started on their behalf. Contact Us