A bill arrives. We take it from there.

This is the whole of it, start to finish, on one real case.

01

They send us the bill. That is all we need from them.

A photo or a PDF, from their phone, in under a minute. No records to chase, no hospital to call, no forms to work out. From that point the case is ours.

2 of 2

Upload a photo or PDF of the medical bill you’d like us to work on

bill.pdf

I don’t have it

Continue
02

We pull every record the case needs.

Octi goes and gets them, from the provider and the insurer, while the person holding the bill does nothing at all. Dozens of cases are collecting at the same moment, which is the only way this works at the speed it does.

Octi is HIPAA compliant. They decide what they share with us, and they can delete it whenever they want.

CASE 4102Records
Itemized statement
UB-04 claim form
Explanation of Benefits
Operative report
Medication administration record
Discharge summary
03

Then we work the bill from three directions.

Not one after the other. All three run on the same case at the same time, and what one of them turns up changes what the others go after.

Every line on the bill

Each charge is read on its own and asked the same question: should this be here, at this amount, at all? Coding that overstates what happened, services that were never delivered, charges the rules do not allow.

Emergency visit, level 5$1,240

Level 5 billed, level 3 delivered.

Basic metabolic panel$186
MRI with contrast$890

The scan was done without contrast.

Pharmacy$94
Respiratory therapy$148

The records show it never took place.

The help nobody told them about

Assistance is not one question with one answer. The same person can be eligible three separate ways, through the hospital, through where they live, and through what they were treated for. We check all of them and apply on their behalf.

CASE 4102
Treated at Fairview General Hospital Qualifies under the hospital’s own policy
Lives in Lakeview County, OH Two county programmes apply
Treated for Cardiac care A condition fund covers part of it

The price itself

A hospital’s list price is the top of a range, and every payer in the country settles somewhere below it. The patient is the only one handed the top and expected to pay it. So we negotiate, properly, until the number moves.

What was still on the bill $2,388
After we negotiated $1,200

Hospital self-pay discounts range 10 to 75% · Health Affairs, 2023

04

Everything we found becomes one plan.

Which angles this bill is actually open to, and the order that takes the most off it. Decided once, from the whole picture, rather than tried one at a time.

CASE 4102Strategy
This patient qualifies for financial assistance from the hospital.

Also found on the bill

2 upcoded charges
1 service never delivered
1 charge billed against active coverage
1 fee not permitted on this service
Strategy set. Let’s get to work.
05

We run the reduction with every party involved. Our member hears from us at every step.

The hospital's billing office, its compliance office, the insurer, the assistance programmes. Most of it is letters, portals and notices that go unanswered until somebody chases them. Nobody should have to do that for themselves, and nobody should have to wonder whether it is happening.

CASE 4102Progress
18 Mar Registered mail

Formal notice to the billing compliance office.

14 Mar Call

No reply. Called to confirm it was logged.

8 Mar Email

Charges flagged that break federal billing rules. Reply due in 10 business days.

3 Mar Provider portal

Itemised statement requested.

06

And we come back to them with a reduced bill.

One number, lower than the one that arrived. Nothing for them to file, argue or follow up on, and nothing they had to learn to do. By the time they see it, the work is finished.

The bill that arrived $5,040

This case is illustrative and the figures on it are not a customer’s. Cases vary, and some are cleared outright.