The Bill Fighter: How Private Patient Advocates Battle Big Hospital Bills

The NBC Bay Area Responds team takes medical billing complaints ranging from a few dollars to six-figures. But we're not the only advocates helping consumers in disputes with hospitals and insurance providers.

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Lisa Berry Blackstock is a bill fighter.

"Once people are stuck, I help them negotiate medical billing," she says.

We first met the Stanford University alumna in 2019, when we worked with her to help a family resolve a $140,000 air ambulance billing dispute. More recently, the NBC Bay Area Responds team joined forces with Berry Blackstock again, this time to help a San Francisco student facing a $162,000 hospital bill.

"Out of utter frustration and despair, she reached out to me as a patient advocate," Berry Blackstock said. "With your help, we were able to -- without any real negotiation -- suddenly get someone with the CFO's office."

While we work with consumers on a variety of problems, Berry Blackstock's full-time job is focused squarely on medical issues. She's known as a "private patient advocate."

"Most people still don't know -- including the medical profession -- do not know what a private patient advocate is," she said.

Berry Blackstock's path to private patient advocate started after 18 years working as an estate administrator. She found her new calling after a medical crisis of her own.

"It was a very rare and painful nerve disorder," she said.

Berry Blackstock was entirely on her own, fighting first with doctors to acknowledge and diagnose the problem. Then, she faced another battle with her health insurance provider, as it initially refused to pay for a specialist neurosurgeon.

"I won," she said. "My neurosurgeon asked if I would help his other patients, and that was the beginning."

What Private Patient Advocates Do

Some hospitals and insurance companies have patient advocates on staff to take questions. But you can hire your own -- like Berry Blackstock -- to do more.

"Whoever pays you -- that is ultimately who a person is beholden to," Berry Blackstock said.

Berry Blackstock says she can help clients decode hospital lingo and punch through their paperwork. That includes scrutinizing every line on a bill, and even negotiating the price being charged. Berry Blackstock says she's saved her clients hundreds of thousands of dollars over the last decade. They pay a flat fee -- typically less than $2,000.

"If I don't save them more money than they pay to retain my services, I will give them a refund," Berry Blackstock says.

Private patient advocates are a rare breed. The National Association of Healthcare Advocacy lists just 149 for the entire United States. Only 32 are found in California.

Berry Blackstock says you can act as your own patient advocate, but it might be a bit overwhelming.

"I have various sources, and so does the average layperson," Berry Blackstock said. "You can go online. You don't have to pay anything. [But] it's very tedious."

Berry Blackstock says patients facing a problematic hospital bill should demand a detailed, itemized list of charges -- and never accept a summarized invoice. They should also challenge any charges they don't believe are necessary and fair.

When it comes to disputing a bill, Berry Blackstock doesn't deal with the hospital phone bank. She demands the hospital's chief financial officer review the account, and she makes her case by certified mail. Berry Blackstock says spending $3.35 at the post office to mail a certified letter -- with a signature needed for delivery -- usually gets the hospital's attention. That's $3.35 that could save you hundreds or thousands of dollars.

"I put together the scenario of what really happened, and what a fair and reasonable price is, and that's my offer," she said.

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