Member FAQs

Why does Billdog require HIPAA authorization forms for some issues?

HIPAA authorization forms allow the Billdog member services team to speak to insurance companies and providers and fix issues from start-to-finish. Providers, facilities, and carriers each have their own HIPAA forms, policies and procedures which Billdog must follow.To bypass the lengthy HIPAA process and get straightforward issues solved quickly, Billdog expedites issues by setting members up with the important details so they may work directly with insurance and providers to solve an issue.


Why can HIPAA authorizations take so long?

Billdog sends signed HIPAA forms to each entity. Each has its own compliance department, forms and practices, often requiring faxed or mailed forms. Some providers have multiple layers of HIPAA procedures within the same organization.  Even after the signed HIPAA authorization is received by the insurance company or provider, 5-10 business days may be required to link the signed HIPAA authorization form to the member’s account.

How does Billdog work with members to expedite issues?

Billdog sends pre-filled HIPAA forms to members for quick e-signature. Billdog performs repeated follow-ups with providers and insurance carriers to process the forms. Where possible, Billdog works with members to expedite issues by avoiding the lengthy HIPAA process. Billdog also initiates resolutions and informs the member. If problems persist the member may reengage. If the resolution plays out and no further action is required, they may simply ignore the outreach and the issue will be auto-closed.

What happens when a billing error is identified?

Billdog member services team identifies the error and notifies member so they may work with member services to expedite the issue with the provider to correct the billing mistake and have the claim resubmitted to the insurance company. This process typically requires multiple follow ups across different organizations within the provider, facility and insurance company to ensure the issue has been resolved.

Can co-pays, deductibles, and coinsurance be negotiated?

Providers are typically contractually barred by your insurance plan from allowing a negotiation of copays, coinsurance, and deductibles.  Insurance encourage members to utilize medical services discriminately and copays, coinsurance, and deductibles are a way to do this. However, Billdog has successfully negotiated these fees and in cases where negotiations are prohibited, will take steps to facilitate alternative payment arrangements.

How are negotiations and provider refunds handled?

The Billdog negotiation team recommends instances where negotiations have a high likelihood of success. In some cases, members are prompted to make-an-offer and Billdog facilitates the negotiation. In other cases, alternative arrangements, payment plans or financial assistance are recommended. Billdog uses normal and customary charges to ensure that members and providers each have a fair experience.


How are refunds from providers handled?

It's common for members to have a credit balance at a provider. This often occurs when the patient pre-pays for a procedure and then insurance pays the claim, resulting in overpayment.  Providers may auto refund the  balance or hold the balance and apply it to future medical expenses. Billdog indicates instances where an overpayment is likely due and advises members on follow up with providers. Billdog does NOT store member payment information so the responsibility of arranging the refund lies with the member.

Why is Billdog so inexpensive to members?

Billdog has been designed to solve the complex problem of medical billing and claims issues management. Next generation technology and an experienced medical admin and clinical team allow Billdog to be offered at a highly competitive price. Often your Billdog subscription is paid for by your employer or employer's health insurance broker so employees can get the most out of their health benefits plan.

Can Billdog make medical decisions on members' behalf?

No. Billdog is to be used only after a service is performed and a patient has a confusing medical bill.  Any medical records that Billdog requests will only be used to complete the medical bill review and any necessary negotiations or appeals.


Can Billdog make any changes to members' insurance?

No. Bill Dog is only to be used after a service is performed.  Billdog inquiries and requests for claims reconsideration are only performed in response to member initiated medical bill reviews.


When Billdog negotiates a bill reduction, do they keep any of the savings?

No. When Billdog corrects or negotiates a bill reduction, our member keeps 100% of the savings we find.

Will Billdog negotiate any bill?

No.   There are many bills that are straightforward, accurate and where the member is obligated to pay the bill in its entirety.   Balance bills for out-of-network or non-covered procedures may be eligible for negotiation.  Members are notified on bills that fail the reference price check.


How does Billdog protect customer privacy?

Billdog is HIPAA compliant and takes personal privacy very seriously. Medical details are not shared and info can be seen here: https://www.billdog.com/privacy. Questions may be directed to support@billdog.com.


Does Billdog Provide Clinical Advice?

No.   Billdog does not offer clinical advice or pre-procedure provider decision making support. Any questions about the medical suitability of a procedure or medication should be directed to a provider.


Can Billdog predict how much a planned procedure will cost?

No.  Billdog does not get involved with pre-procedure price shopping or negotiation. Bill Dog responds to a member-initiated request for a medical bill review.

Can Billdog make providers change the medical coding on a claim?

No.  Members often ask us about "preventative" and "diagnostic" or "sick visits and whether we can get their providers to change coding so that insurance will cover a procedure as preventative. Since Billdog specialists are not in the room with providers and patients during the visit, we will NOT place direct requests to providers to make explicit coding changes and resubmit claims. Billdog will research and inform members so they may contact providers directly to discuss the matter and request the update.