Robert Berman

All of my professional experience has required and focused on hands-on work with medical claims submission and processing. I have extensive experience with Medicare, Medicaid, commercial insurance carriers, workers compensation carriers, and auto medical claims carriers. In particular, my work has required understanding the peculiarities and idiosyncrasies inherent in medical coding and billing. I not only understand how medical services are billed which translates into knowing how to detect errors and unethical billing practices, but also how to successfully reduce associated medical costs.

The services I provide are:
- Medical claims/bill/EOB review and analysis
- Medical claims/bill disputes and denials
- Medical claims/bill negotiation and resolution
- Prescription cost comparison research and management
- Medical bill auditing services
- Medical appeals
- Medical claim submission to insurance companies
-Assistance with FSA/HSA/HRA accounts 

MBA, Health Care Administration, Baruch College/Mt Sinai Medical School 1980

I have spent my entire career in the healthcare field. Beginning that work in hospital administration, I transitioned to medical practice management for physician practices in the New York metropolitan area. As part of that work, I placed a strong focus on the area of billing and collection. That focus segued into an expertise in medical billing and insurance claims processing. Soon I took that experience and launched a medical billing company. Over 30 years of processing claims for a variety of medical specialties, I have learned how to navigate the health insurance maze in order to efficiently and effectively secure appropriate payment for my clients.

As talk of the ACA began, I realized that these changes in our healthcare laws would significantly impact not only the quality of medical care, but also the burden of financing that care. I believed that shifting the burden of payment to the patient through higher copays, deductibles, and coinsurances, along with vast changes in network coverage would put most people in financial peril. After all, many people didn’t understand their copays. How would they understand monumental changes to that system? I wondered who would assist people so that they maximized the coverage they had and minimized the unintended expenses that might result from utilizing those benefits?

The answer was me.

With the advent of the ACA, I added a consumer-focused medical claims advocacy division to my medical billing company. The result has been millions of dollars in savings for our clients, and the satisfaction that we have been able to help the individual triumph over massive and powerful insurance companies and medical facilities. 

As we work to help our clients, we don't take "no" for an answer. When we encounter resistance from the first point of contact, whether it's a provider's office, hospital, or insurance company, we always escalate the conversation to a supervisor or manager. If we still aren't satisfied, we continue to work our way up the chain of command. If all these attempts fail, with the approval of our client, we enlist our close media contacts in our endeavor to see if they can shine a searchlight on the inequities we have uncovered. Together as a team, we have always prevailed for our clients. Refusing to accept "no" has proven to be quite beneficial to our clients.