So you have an emergency, but the insurance company is claiming that it wasn’t medically necessary. This is their retaliation to the No Surprises Act, which was passed January 2022. The health insurance companies are now claiming that many ambulance trips are not needed. In fact, the National Association of EMS, emergency medical physicians, they have been warned
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Hospital billing advocacy can help you determine whether a denied medical claim should be corrected, appealed, reduced, or paid before the balance moves deeper into collections. A hospital statement can look final even when it contains coding problems, missing insurance adjustments, duplicate charges, or an unresolved coverage issue. Paying too quickly may close off opportunities
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I hope I helped you with some information today. When it comes to college insurance, premiums may be included in tuition, but loan interest can still be high. Specialized care can be expensive, especially if it’s off-campus, and many plans may end during academic breaks or after graduation. It’s important to read the policy carefully to
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I’m here to help you with all issues related to medical bills. Medical Insurance Advocacy, my company, helps you navigate the system, review medical records, and negotiate with providers and health insurance companies. I’ve been in the health insurance industry for 35 years and have been very successful in overturning cases. I was recently featured on Fox News
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Scripts for negotiation conversations can help you stay calm, ask better questions, and avoid agreeing to pay a denied medical bill before you understand what happened. A billing representative or collector may sound certain that the balance is yours. Yet the claim could contain coding errors, missing records, uncredited insurance payments, or charges that qualify
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A medical provider has to give you a good faith estimate of your costs before you receive services, and you can dispute a bill if it is significantly higher than that estimate. I recently had a case where a dentist told my client the bill would be $8,000, but they were actually charged $22,000. By referencing
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Here are different reasons you can dispute a bill. You can dispute a bill if you received care and did not have or did not use your health insurance to pay for it. You can also dispute it if, before receiving care, you told the provider you would not be using insurance. Another situation is if you
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When to settle vs fight a denied medical bill depends on one critical question: Is the balance legitimate, or are you being pressured to pay before the claim has been properly reviewed? A fast settlement may end collection calls, but it can also make you pay for an insurance error, illegal surprise charge, or inflated
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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 providers or facilities. I recently handled a case where a client went to the emergency room and, after being denied three times, I reduced the bill
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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 to challenge the bill, and in some cases, your provider may need to reduce it. For example, if an ambulance takes you to the emergency room
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