I work daily with people facing one of the most frustrating aspects of healthcare: the dreaded insurance denial. Receiving a letter stating your medical claim won’t be paid can induce panic, anger, and confusion. You followed the rules, you saw the doctor, maybe you even got pre-approval – yet here you are, potentially facing a […]
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You incur a traumatic brain injury and wind up in a subacute care facility. Now you are no longer making sufficient progress, which I’m really sorry when that happens, and your insurer decides to no longer cover you. I recently had a case where I was able to help the person with their health insurance
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Well, you’re about to have surgery. Everything is scheduled for you in advance. Your insurance company has already approved you, but now at the last minute, you’re being contacted by the surgeon’s office explaining your insurance carrier will not cover you for the surgery. I recently had a case like this and with my advice
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If you’ve ever looked closely at a medical bill or an Explanation of Benefits (EOB), you’ve likely seen lines filled with five-digit numbers. These aren’t random sequences; they are crucial codes that dictate how, and if, healthcare services get paid. Specifically, many of these are CPT codes, and errors involving them are a significant, yet
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Many people are reaching out to me when everything was scheduled for their surgery, and they undergo the procedure. Six to 12 months later go by, and now the insurer is asking for the money back. There are a lot of different reasons why this is occurring. If this happens to you, please call me.I’m
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I’ve had many cases in the past five years involving people working after the age of 65. If your employer has less than 20 employees, when you turn 65, there’s a good chance you’re going to have to go directly onto Medicare, part A and part B. I always recommend people to contact Medicare three
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For years, I’ve helped clients navigate the complex world of health insurance. One of the most disheartening moments for any patient is receiving that notice: “Your claim has been denied.” It can feel like a final judgment, leaving you facing unexpected and often significant medical bills. But here’s something I emphasize constantly, based on years
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Feeling lost or outraged when you look at a hospital bill? You’re not alone, and help is here! Watch this crucial interview with Edison Guzman and insurance advocate Adria Gross to uncover the secrets hospitals might not want you to know. Learn exactly what to demand on your bill (using specific codes!) to verify every
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One of my clients was told he had to have heart surgery. He went through multiple tests and when he went back to the cardiologist, he was recommended multiple times to have heart surgery. It was very confusing since he was able to walk more than three miles a day and never was out of
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As the founder of Medwise Insurance Advocacy, I’ve spent years helping countless individuals navigate the often-turbulent waters of healthcare costs. One of the most common and stressful situations people face is figuring out how to pay medical bills, especially unexpected or large ones. The sticker shock from a hospital stay or complex procedure can be
Struggling with Medical Bills? You Have Options Read More »