Hospital price transparency helps Americans know the cost of a hospital item or service before receiving it. Starting January 1st, 2021, each hospital operating in the United States was required to provide clear, accessible pricing information online about the items and services they promote in two ways. The first was as a comprehensive machine-readable file […]
How to Shop and Compare Hospital Costs Read More »
You know, insurers are becoming increasingly adept in using technology to deny payment of medical claims and pressure their company physicians to deny care during prior authorization reviews. Doctors are reporting spending increasing amounts of time on the phone with insurance company physicians over denials of care for their patients, even when a pre-authorization is
Was Your Medical Claim Denied Even After pre-Authorization? Read More »
I recently had a phone call involving a person who fell down two flights of stairs. They had 25 stitches in their head. The case involved a hospital in California, and after entering through the emergency room, the insurer felt it was not medically necessary for her to be at the hospital. The bills were
ER Medical Bill Not Medical Necessary? Read More »
I hope you’re having a great day today. Well, let me tell you this one. Wow. You get stung by a bee and you have difficulty breathing. You got swelling of your throat or tongue, you got a rapid pulse, you are dizzy or fainting. Please go directly to the emergency room. I had a
Bee Sting Leads to Emergency Room Bill Not Covered by Insurance Read More »
Have you ever been billed multiple times for the same procedure for the same date of services? I recently was able to reduce the bill from $7,200 down to1,200. That’s the savings of $6,000 since they were billed so many times for the same day of service with the same procedure codes. Please call me if you need help. I’m here
Duplicate Bills from Same Procedure? Read More »
You’re preparing dinner for your family and ouch. You just cut yourself so deep. You need stitches, you wind up in urgent care, and you later find out that they’re outta network, so you receive a bill for $8,000. My client called me when this happened to them, and guess what? They only had to pay $500. Call me. I’m here
Out of Network Bill Not Paid? Read More »
When faced with high out-of-pocket costs, healthier individuals might opt out of necessary healthcare to avoid expenses, a behavior that insurers indirectly encouraged. This leads to a cycle of rising premiums and decreasing access to care. This is what is titled Adverse selection. What I see all too often is young people think, no worries. I am
High Out of Pocket Medical Costs Read More »
I have never seen this before. The policy did not cover for an MRI when we were able to prove the necessity for the MRI. The insurance company finally agreed and paid the claim. If you ever have any problems with any of your medical bills, please call me. I’m here to help you. https://vimeo.com/1092598745?share=copy#t=0
The Policy Did Not Cover MRI? Read More »
Some people purchase insurance policies that they think will cover everything. I had a case recently where the policy did not cover for any hospitalization. The original bill was $67,000 and thank you. After negotiations, I was able to bring it down to $6,000. That was a savings of $61,000. If you need help, I’m
Your Insurance Company Will Not Cover Everything Read More »
When people decide that they want to take a Medicare Advantage plan, they do not realize that so many hospitals are no longer accepting the Advantage plans. I recently had a case where the person was admitted to the hospital. The hospital was participating and accepted a Medicare Advantage plan, but within two days after
Are You Really Covered by Your Medicare Advantage Plan? Read More »