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 »
A case recently involved my client being in a hospital for emergency brain tumor surgery. They had a policy through the Affordable Care Act in New York State, and I could not believe that they were denying the claims. It took about 10 months to cover to turn the case over, but finally, the bill
Denied Medical Claim While on Health Marketplace Read More »
You know, much too often people purchase travel insurance and they come here, the United States. Every case that has come to me when the visitor is in the United States, they always wind up in emergency room and they’re hospitalized for a pre-existing condition, which is always an exclusion on the policy. I’ve recently
Medical Bill Reduced from $150,000 to $5,000 With Travel Insurance Read More »
I hope you’re having a fabulous day today. It is so difficult to fight for coverages when your company is so large and they have a self-funded, self-insured or risk plan. Many employers do not want to pay large claims for recent hired employees unless they are so well liked that the employer is willing
Are New Employees Covered by Self Insurance Coverage? Read More »
I recently had a case where surgery was required. None of the in-network providers were able to perform the services. It took four months, but we were finally able to get a single case agreement with an out of network provider, and the insurance company finally agreed to pay the in-network fees. If you ever
Out of Network Providers Can Still be Paid by Insurance Read More »
One of my recent clients was informed the provider was in network. They went for the surgery and later found out that the provider was really out of network and they were never covered. The fact that they were misinformed, I was able to get the bill from $29,000 down to zero due to their
Misinformed About What Medical Insurance Covers Read More »
Good afternoon, my friends, one of my clients had a pre-authorization for radiation due to rectal cancer. The bills were over $85,000, and even though she had pre-authorization, the insurance company did not want to pay it. Since the hospital at the time was out of network. The fact that there was pre-authorization, even though
$85,000 Pre-authorized Medical Bill Denied Read More »