Many health insurers require a review of claims or prior authorization requests by a nurse and a doctor, both employed by the insurer. Recent media investigations have found that some insurance company doctors are not incentivized to spend the time needed to scrutinize patients’ medical records and follow guidelines for making informed decisions about approving […]
Unfair Review of Claims for Medical Bills Read More »
A fee-for-service medical cost arrangement exists in the United States. The more services doctors perform, the higher their incomes. Just as patients have an incentive to overconsume, doctors have an incentive to overprovide. If you’re having difficulties paying your medical bills, call me. I’m the owner of Medwise. We save individuals thousands of dollars on
Incentives for Over Providing Services Read More »
Evaluating the medical billing advocate success rate for MedWise Insurance Advocate requires looking past the numbers everyone else quotes. You’re facing a mountain of medical debt, feeling cornered by jargon-filled letters and relentless phone calls. The question isn’t just about winning; it’s about how much you truly save and whether the fight is worth the
The Truth: Medical Billing Advocate Success Rates Read More »
I hope you’re having a great day. Think about people’s billing disputes and denials of coverage. What emerges is that many realize positive outcomes when they appeal decisions they perceive to be in error. Yet only half of those who believe that they were erroneously billed or denied care actually challenge the decision or have
Billing Disputes and Denials of Medical Coverage Read More »
I hope you’re having a fantastic day. The responsibility of appealing may not be clear between the patients, the providers, or between the employers and the employees, and the documentation requirements to appeal can create additional barriers. As a beneficiary, you have a right to appeal your insurer’s decision. Due to artificial intelligence, all too
Who’s Responsible for the Medical Appeal Process? Read More »
That bill you’re staring at feels like a betrayal. This essential guide to surprise medical billing laws is for anyone who has felt that gut punch of a medical bill they never saw coming. You did everything right—you went to an in-network facility—but now you’re facing a financial threat from a ghost provider you never
Read this Guide to Surprise Medical Billing Laws FIRST Read More »
Hospital upcoding, which is claiming a higher level of patient severity in order to obtain a higher insurance payment, is a major issue. One study estimates that increased upcoding relative to a decade earlier was associated with $14.6 billion in hospital payments. I have people calling me about this, where they feel that they were
What is Hospital Upcoding Read More »
You know Americans are sick of the health insurance companies who steal our money and our lives. The more profits that the insurance companies make, the more extra cash is available to distribute to shareholders as dividends and buybacks, and generally the higher the stock price, the greater the potential for higher top executive pay.
How Top CEOs in Medical Fields Make More Money Read More »
The frustration is suffocating. When it comes to filing a complaint against a health insurance company, you’re not just fighting a denial; you’re battling a system designed to exhaust you. The endless phone trees, the vague explanations, the soul-crushing bureaucracy—it feels intentional. This guide isn’t about simply filling out forms. It’s about turning their own
How to Win at Filing a Complaint Against a Health Insurance Company Read More »
An illness can destroy an entire family, leaving them bankrupt and homeless, with the repercussions of that sudden fall into poverty echoing down through generations. Most Americans have no idea that the US is quite literally the only country in the developed world that doesn’t define healthcare as an absolute right for all of its
Don’t Let Medical Bills Bankrupt Your Family Read More »