MedicareBilling.ai is a Medicare billing review and appeal assistance service. We help Medicare patients and their families understand their bills, identify errors, and fight denials. We also offer services for healthcare providers, including denial recovery, RAC audit defense, and Medicare credentialing. We are not affiliated with Medicare or any government agency.
No. MedicareBilling.ai is an independent private company. We are not affiliated with, endorsed by, or connected to the Centers for Medicare & Medicaid Services (CMS), the federal Medicare program, or any Medicare Advantage insurance plan. We simply help patients navigate the Medicare billing system.
No. Our services do not constitute legal advice or legal representation. We help with Medicare billing review and administrative appeals. For complex legal matters, we recommend consulting with a qualified attorney. We can refer you to attorneys who specialize in Medicare cases if needed.
Yes! Many of our clients are adult children helping their parents with Medicare bills. With proper written authorization from your parent, we can work directly with you. We even have a dedicated page for caregivers: Help My Parent →
Medicare bills can contain errors, and many do. Common issues include duplicate charges, services you didn't receive, incorrect billing codes, and balance billing errors. Our bill review service analyzes your bill line-by-line to identify potential problems. Get your bill reviewed →
Even if you've paid, you may be entitled to a refund. Medicare allows timeframes for disputing charges, and we'll review whether errors can be corrected and money recovered. Contact us as soon as possible — timing matters.
Balance billing occurs when a provider charges you for the difference between what they bill and what Medicare pays. In some cases, this is illegal. There are protections under Medicare that limit what providers can charge you. If you believe you've been improperly balance billed, we can help you review and dispute the charges.
No. Reviewing a Medicare bill and disputing billing errors has absolutely no impact on your Medicare coverage or benefits. Billing disputes and coverage decisions are handled completely separately. Your Medicare benefits will remain exactly as they are.
Medicare has a five-level appeals process: (1) Redetermination by the Medicare contractor, (2) Reconsideration by a Qualified Independent Contractor, (3) Hearing before an Administrative Law Judge, (4) Review by the Medicare Appeals Council, and (5) Federal Court review. Most denials are resolved at Levels 1 and 2. We help at Levels 1 and 2. Learn more →
For most Medicare denials, you have 120 days from the date on your Medicare Summary Notice (MSN) to file a Level 1 appeal. For Medicare Advantage plans, you typically have 60 days. Don't wait — missing the deadline means losing your right to appeal.
Traditional Medicare appeals follow the federal process described above. Medicare Advantage plans have their own internal appeal process before involving Medicare contractors. MA appeals often move faster but have stricter deadlines. We handle both. Learn about MA appeals →
Not for Levels 1 and 2. Most Medicare appeals are administrative and don't require legal representation. These levels are where we specialize. For Level 3 (Administrative Law Judge) and beyond, legal representation becomes more valuable. We can connect you with attorneys who specialize in Medicare cases.
If Level 1 is denied, you can continue to Level 2 and beyond. Many people win at higher levels. We help you at Levels 1 and 2, and we can connect you with attorneys for Level 3+ if needed. The key is not giving up — many denials are overturned on appeal.
We offer three main services for healthcare practices: (1) Medicare Denial Recovery on contingency, (2) RAC Audit Defense, and (3) Medicare Credentialing & Enrollment. Learn more about provider services →
We work with most major EHRs including Athenahealth, Kareo, AdvancedMD, SimplePractice, DrChrono, eClinicalWorks, and more. We can often work with custom exports if your system isn't listed. Contact us to discuss your specific setup.
Yes. For provider engagements involving protected health information, we provide BAAs upon request. This is part of our commitment to HIPAA compliance for all parties.
For denial recovery, we charge 25% of the recovered amount. You pay nothing upfront. We only earn a fee if we successfully recover your denied claims. This aligns our incentives with yours — we're motivated to win.
