Clear communication is necessary in every aspect of life and often in the medical community, to save life. But try to interpret an insurance company statement or medical bill and it often feels as though it’s in a different language. Monongahela Valley Hospital recognizes the difficult task that people often encounter when reviewing such statements and they’ve implemented a program where experienced volunteers will help to decipher what can often seem to be written in a foreign language.

Through the Monongahela Valley Hospital Medical Bill Advisor Program, community members receive help in understanding and organizing their physician, hospital and other medical bills. The program was the idea of Concierge Manager, Erin Sinko.

When Janice Johnston and Sally Spina were retiring from the hospital’s insurance department, Sinko hoped that they would continue to serve the hospital in volunteer roles. She knew that the professional caliber and knowledge of Johnston and Spina, with combined experience of more than 50 years, would be beneficial to others. It was that initial idea which grew to become the Medical Bill Advisor Program.

The Medical Bill Advisors work under the “Ask Me Greeter” volunteer program at the hospital. “If the bills have to do with our hospital, we have staff in place to help with those questions,” Sinko said. “However, for medical bills from doctors’ offices, ambulance services and other hospitals, the Medical Bill Advisors are able to help.”

The service, which began in June of this year, is a free service and open to anyone.

One satisfied customer is Helen Pokomo. After recent surgery, Pokomo received a bill from her cardiologist for the reading of an EKG that had been done as a prescreening test. “I couldn’t understand why insurance would pay to have the test done, yet they wouldn’t pay to have it read,” said Pokomo.

She called the Medical Bill Advisor line and within an hour received a return call from Johnston confirming that the bill was not her responsibility and that payment from the insurance company would be made. “They were extremely helpful, and answered my question in a timely manner,” Pokomo said.

Calls to the Medical Bill Advisors are first answered by Sinko to be sure that the call is directed appropriately. In some cases, a phone consultation may be all that is necessary. If an in-person consultation is required, a meeting is arranged.

Johnston is happy to know that her expertise allows her to help others. “I feel sorry for these people,” she noted. “If you have not worked with Medicare or other insurances they can be difficult to understand.” She has assisted patients with various issues including billing errors and has also helped to differentiate between bills versus statements.

Johnston believes that she and Spina complement one another since each has experience with different insurances. She also notes that their combined years in the business and established contacts allow easier access to some insurance departments when following up on issues, as well as a level of “common sense” knowledge with regard to diagnoses and tests or charges. “Several of the insurance companies and offices I’ve contacted tell me they feel this program is a great idea,” said Spina.

For more information or to utilize the program,
call the MVH Concierge at 724-258-1444.