Your Medical Insurance Advocate
Media/Videos
These medical bills advocacy videos and case studies will help you save money on your health insurance and denied medical claims.
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Is The No Surprises Act Working
The No Surprises Act has been helpful in overturning cases and reducing fees when a patient is responsible for part of a bill. It provides protection against surprise bills from out-of-network
Instances When Your Provider Must Reduce Your Medical Bill
If a provider is unable to inform you about the cost of services in advance, or if the insurer claims the treatment was not medically necessary, you may have grounds
Will Your Medical Bill Increase if You Dispute It
No matter what the outcome of your bill is, your cost will not increase if you dispute the bill. When you receive care, there may be items or services your doctor
Is Your Case in Collections
I hope your day is as good as mine. If you have a case that is in collections while you are disputing a bill, your provider or facility cannot move your
If You’re Appealing a Case-Do This
If you’re appealing a case and you, your healthcare provider, or the facility can settle the payment amount before the dispute ends, you can move forward if both parties agree
How Your Insurance Works with the No Surprise Act
Your insurer may have decided not to pay part or all of your claim. If you think this decision violates the No Surprises Act, appeal your bill. Follow the process described in
Why Ask for an Itemized Bill When Denied Medical Claim
If you receive a balance bill or believe you are overcharged, request an itemized bill and dispute the charges. Ask the provider or hospital for an itemized bill with all billing
Saved Over $13,000 With This
If your dispute was decided in your favor, but the provider is still billing you or has even sent your bill to collections, I highly recommend you reach out to
How I Had a $9,000 Medical Bill Written Off
I hope you’re having a fantastic afternoon. Eighty percent of medical claims are incorrect. There are often errors where procedures appear on your bill that never occurred, or you might find
What is an Insurance Claim Denial?
Have you ever gone to the doctor, submitted your claim, and got a letter saying your insurance won’t pay? That is a denial. It means your insurer has rejected the claim,
The Most Common Reasons for Denied Medical Bill Claims
Why do claims get denied? The most common reasons include missing information, incorrect billing codes, lack of pre-authorization, or service being out of network. Sometimes, the insurer simply doesn’t believe
Out of Network Air Ambulance Services
The No Surprises Act prevents surprise bills for emergency services, even if received from an out-of-network provider or facility. It limits out-of-network cost-sharing for non-emergency services received at an in-network facility,
A $54,000 Medical Bill Written Off After Denial
When a provider considers your procedure to be necessary and the insurance company says, “Hey, it wasn’t medically necessary,” you have to fight to make sure that the insurer does
Confused by Insurance Jargon
Denial letters are full of insurance jargon, but don’t let that intimidate you. Look for the reason for the denial. It’s usually listed by a code. And check your explanation of benefits,
Getting Denied Is Not the End
Getting denied isn’t the end of the road. You have the right to appeal. That means asking the insurer to reconsider the decision. Start by calling the insurer to understand the denial.
Why You Always Want a Pre Approval Letter
Many services require pre-authorization from your insurance company. That means your doctor has to get approval before doing a test or procedure. If that doesn’t happen, your claim could be denied, even
How Long Do You Have to File An Appeal
Don’t wait if you’ve been denied. Lost insurance plans give you 120 days, or about six months, to file an appeal. Direct Medicare is 12 months. It used to be 24
College Students Must Prove What?
Students in college are normally able to purchase health insurance through their university. I’ve handled many cases involving college health insurance. I must say, the health carriers are very suspicious when the
Having Medicare Advantage Plan Issues
Recently, several Medicare Advantage plans have exited the market, including Premera and the Blue Cross Blue Shield of Kansas City. Also, others have reduced their service areas, such as Aetna
Why Patient Insurance Oversight is Necessary
Okay, you have received pre-authorization for appendicitis. You undergo the surgery, but now your insurance carrier, who approved the surgery, says it wasn’t medically necessary. The bills were over $30,000. I’m asked
Is Your Insurance Plan Fully Funded?
One of the misconceptions people experience is whether your health insurance plan is a fully funded plan or if it’s an ERISA plan. This is usually important information that you need
Why a Letter of Medical Necessity May Save You Thousands
Medical claims that require pre-approvals or claims involving newly developed drugs or treatment, and many types of behavioral health treatment may require a letter of medical necessity from the treating
$26,500 Claim Paid for This Reason
A recent case that I worked on involved a medical bill denial for $26,500. Believe it or not, the insurance carrier made an error thinking it was a totally different policy
Is AI Automatically Denying Your Medical Claims
Too often the medical claims are denied when your insurance carrier’s AI, artificial intelligence, looks at the diagnosis and medical procedures on your submitted medical bill and they decide to
Reduced Bill from $8,500 to a $250 Deductible
Hello, my friends. Was your claim inaccurately processed by your health insurance carrier? Call MedWise to help overturn your case. This past week, my client’s bill for stitches in an emergency room
Dispute Resolution for Self Paying Individuals
Hello, everybody. I hope you’re having a fabulous day. Dispute resolution establishes a process for solving billing disputes between patients, providers, and insurance plans, and particularly for uninsured or self-paying individuals.
Has Your Claim Been Incorrectly Denied
Has your claim been incorrectly denied? Believe it or not, if your claim does not have the Federal Tax ID number and the NPI number, the National Provider Identification number,
Has Your Health Insurance Been Incorrectly Terminated?
Has your health insurance been incorrectly terminated? Too many times you are paying your health insurance premium and there’s an error on behalf of your insurance carrier. Your insurance carrier did
What To Do if Your Claim is Denied
Consumers should be encouraged to file formal appeals when they believe their claims are wrongfully rejected or processed. Insurance companies are usually required to provide a clear process for this. If
Suspect Your Were Overcharged?
If you ever have any suspicion that you’re being overcharged, negotiate with the providers in the billing department. It’s always best to look at the Medicare rates according to the procedure