Congress is currently scrutinizing Medicare Advantage plans. I had a new case this week where a patient was being discharged from the hospital because of issues with her insurance coverage. She was having complications with her pacemaker, and the insurance company initially would not authorize a visit with her cardiologist. When I received the call, I […]
Medicare Advantage Plan Refuses Care Read More »
Understanding how to dispute hospital collections can help you stop the pressure, protect your credit, and reduce the amount you owe. Many people believe that once a hospital sends a bill to collections, it’s too late to fix the situation. The truth is, you still have powerful rights and options. Medical debt in collections creates
Hospital Debt in Collections? Step-by-Step Dispute Guide Read More »
I hope you’re having a fantastic day. When I started in the health insurance industry in the claims department, I became a claims supervisor within a short time. During my training, I learned very quickly how companies approach denying claims. It shouldn’t be driven by shareholder interests when people’s health and financial stability are at stake. Unfortunately,
A $32,000 Medical Claim Overturned Read More »
I hope your day is going great. When it comes to medical bills being denied by your insurance company, the numbers are staggering. According to the Kaiser Family Foundation, we now have over $220 billion in medical debt, and about 25% of people who need treatment simply can’t afford it. Fortunately, some nonprofit hospitals offer financial assistance
How Non-Profit Hospitals Help With Health Care Read More »
Knowing the right documents for insurance claim approval can mean the difference between getting paid and facing thousands in unexpected medical debt. Many claims are denied not because the treatment wasn’t necessary, but because paperwork was incomplete or submitted incorrectly. The good news is that you can take control of this process. Denied claims often
Insurance Claim Documentation Checklist to Prevent Denials Read More »
Good afternoon. I spoke with a client the other day who lives in Texas. He has a dental policy, and believe it or not, he was denied coverage for a routine teeth cleaning. Can you imagine being told it’s not medically necessary to clean your teeth? If you need assistance with any of your claim denials, please
Did Your Dental Coverage Deny Your Cleaning Bill? Read More »
You know, I’ve been absolutely shocked that some companies are limiting treatment for autistic children. There was a recent case where the New York State Attorney General forced an insurance carrier to pay a $1 million penalty for failing to provide proper coverage. What has been happening is that some insurance companies are denying claims to
Is AI Automatically Denying Claims for Autistic Children? Read More »
Learning how to dispute a medical bill in collections can stop the damage, reduce stress, and give you a real path forward. Many people feel powerless once a bill reaches collections, but the truth is you still have rights and options. The sooner you take action, the stronger your position becomes. Medical debt can affect
How to Dispute a Medical Bill in Collections and Protect Your Credit Read More »
I hope you’re having a fabulous day. You know, 99% of all enrollees who have a Medicare Advantage plan need to obtain prior authorization for many services. This most commonly applies to higher-cost treatments, including inpatient hospital stays, skilled nursing facility care, and chemotherapy. Medical providers are responsible for obtaining prior authorization. Patients should not be paying
Medical Claim Was Denied for This Reason Read More »
I hope you’re having a fantastic day. I’ve always been shocked by what insurers get away with. When I went into the health insurance industry as a claims analyst, within two weeks the company taught me how to deny claims. This is why I’m here to help you. If your claim is denied, you’re overcharged out of
The Challenge with Medicare Advantage Plans Read More »