One of the major issues causing high premiums on our pharmaceutical drugs is due to research and development. The question is: why are drug prices lower in other countries? Outside the US, the countries pay for the manufacturing cost of the drug and a very small profit on the cost of manufacturing. But here in the United States, […]
Why Drug Prices Are Cheaper in Other Countries Read More »
Are you now appealing an ERISA claim denial? What was the reason for your denial? Very often, the State Department of Insurance and the attorney general for your state will not assist you with your appeal. You need to find out which Department of Labor to reach out to. Once you have that information, send your appeal to that
Erisa Claim Denial? Read More »
The difference between Medical Billing advocate, coder, and biller can mean the difference between paying thousands—or paying nothing—when your claim gets denied. Most people don’t realize they’re calling the wrong professional until it’s too late. If you’ve ever opened a shocking bill or received a denial letter, you already know how fast confusion turns into
Medical Billing Advocate vs Coder vs Biller Explained Read More »
I hope you’re having a fantastic day. I was reading an article recently that said, “The devil is in the details.” But you know what? The strength is in the essentials. Our healthcare system is complicated, and you don’t want to be caught off guard or taken advantage of. Many people call me to help them evaluate
Why America’s Health Care System is Sick Read More »
Artificial intelligence is changing many parts of the insurance industry, and unfortunately, some people feel they are not receiving the treatment they need because of automated claim decisions. If you’re having problems getting approval for care, or if your claims are being denied, please call MedWise. I’m here to help you navigate the process and advocate
Is AI Causing More Medical Claim Denials? Read More »
Understanding how do insurance companies use diagnosis codes can help you prevent denials, reduce medical debt, and protect your financial future. Many patients are surprised to learn that one small coding detail can determine whether a claim is approved or rejected. The good news is that once you understand this process, you gain leverage and
Why Coding Errors Cause Medical Claim Rejections and How to Fix Them Read More »
When you go onto a website to purchase health insurance, please make sure you take a close look at the policy and understand exactly what it covers and what it does not cover. You might be purchasing a plan that will not cover your specific condition, or your medical providers may not be in the
Do This Before You Purchase Any Medical Insurance Policy Read More »
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 »