You know, over the years I have found that nearly half of respondents who experienced a delay in care following a coverage denial said that their health problems got worse as a result of those delays. Worry and anxiety among those experiencing delays are really universal. Nearly one in six reported cases indicate that care […]
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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
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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
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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
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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
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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
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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.
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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
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One of the issues I hear so much is people have no idea how to challenge a bill. I worked for two insurance companies that not only taught me all the steps on how to deny a claim, but I learned how to challenge a bill, handle appeals, and either overturn the cases or minimize
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When you know you have been billed much more than you should have, please call midwives. All too often people are taken advantage of on their medical bills. We recently decreased a bill from $1,200 down to $55. Remember, I’m here to help you. Thank you. https://vimeo.com/1117099552?share=copy
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