The Goodbill process typically takes around 60 days. This can be broken down into 5 main stages, as described below. The work on Goodbill's side is relatively quick - most of this time consists of waiting for billing records, or a negotiation outcome, from the hospital.
Stage 1: Gather Info
During this stage, Goodbill collects the information needed in order to review the bill. The collection of these documents is managed through a series of tasks in the bill summary page.
Goodbill requires authorization to speak to the hospital about your bill. Once this form is completed, it creates a HIPAA-compliant form which we send to the hospital - this then authorizes Goodbill to speak to the hospital and to request the detailed billing records that are needed.
If you have a bill from the hospital, then this task asks for your billing documentation. Goodbill will review this documentation, and request more information from the hospital if it is required.
Explanation of Benefits
If the bill was covered by insurance, then Goodbill requests your Explanation of Benefits. This is from your insurance, and will tell Goodbill which parts of your bill are covered by your insurance, and which you are responsible for. It breaks down in-network and out-of-network costs, how much your insurer covered for each, as well as what portion of your out-of-pocket expenses count towards your annual deductible.
A medical record is a full medical description of your hospital visit, and usually includes items such as Visit Summary, History of Present Illness, Physical Exam, and Review of Systems.
Patients can obtain medical records by calling the hospital, logging into the patient's online patient portal, or sending in a release of information form. The patient portal is generally the easiest way to get medical records. Depending on the hospital, the medical record might be called something like “My Record,” “Health Record,” or “My Health Summary.”
If the hospital portal is connected to Goodbill, then this is the easiest way to send the medical records through.
Stage 2: Reviewing
Once Goodbill has authorization and has received all the necessary documents, then all the charges in the bill are reviewed. This typically takes 24-48 hours.
Stage 3: Preparing
Once the bill has been reviewed, Goodbill creates a negotiation letter for the patient's consideration. The outcome of this is a full formal letter, which details all the dispute reasons that were found during the review. This could be a combination of coding errors, medically unnecessary charges or treatment, or pricing disputes. All of this information is then collated into one letter, which also includes another HIPAA-compliant authorization form which allows Goodbill to negotiate the patient's bill. The letter is sent to the patient for consideration.
Stage 4: Negotiation
Once the letter is approved by the patient or guardian, it is sent immediately to the hospital for negotiation. During this stage, Goodbill's team of experienced negotiators call the hospital regularly - firstly to ensure that the letter has been received and processed, and secondly to negotiate the balance, based on the dispute reasons in the letter.
This stage typically takes around 30-40 days; the length of time is wholly dependent on the time it takes the hospital to respond to our requests.
Stage 5: Results
The final stage is the results stage. If a negotiation is successful, then a new, discounted offer for the hospital balance will be sent to the patient. If the patient accepts the offer, they are given the choice to have Goodbill settle the bill with the payment method on file, or directions to settle with the hospital directly. Once this stage finishes, the Goodbill process is complete.