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 had a recent case where this person went from a rehab to a hospital and back to another rehab. Again, this was a case where the commercial insurers are throwing people outta rehabs due to their limited time period of coverage. Everyone has. Everyone who has an advantage plan for Medicare is continuously thrown
Thrown Out of Rehab While on Medicare Read More »
Patients often find themselves overwhelmed by medical jargon, insurance complexities, and administrative hurdles. To effectively manage these challenges, many individuals choose to hire a healthcare advocate. These professionals serve as dedicated allies, guiding patients through the healthcare system to ensure they receive appropriate care and support. Understanding the Role of a Healthcare Advocate A healthcare
Why You Should Hire a Healthcare Advocate Today 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 to 1,200. 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
Duplicate Bills from Same Procedure? Read More »
Hello, my friends, one of my clients had a very severe burn when hot grease splashed on their wrist and they went to an urgent care, received a bill for over $15,000. When I looked at the procedure codes and was able to determine what the correct fees should have been according to those procedure
$15,000 Medical Bill for Severe Burns Reduced Read More »
The U.S. healthcare system is a patchwork of disconnected billing systems, coding procedures, and third-party payment networks. Providers input codes, insurers process them with automated systems, and the patient ends up holding the bag for any mismatches or oversights. Hidden Causes Behind Sky-High Bills CPT and ICD coding errors that inflate charges Out-of-network providers billing
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One of my clients had food poisoning. It was so bad that they were collapsing at home and wound up going to an emergency room. The ER did not have a contract with the insurance company, and my client was billed $11,000. I negotiated the bill down and they only needed to pay $1,100 10%
Food Poison $11,000 Medical Bill Down to $1,100 Read More »
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 case recently where the emergency room wasn’t paid and the insurance company believed that the condition
Bee Sting Leads to Emergency Room Bill Not Covered by Insurance Read More »
Even the most legitimate claims—routine checkups, necessary surgeries, pre-authorized procedures—can be rejected. This isn’t just inconvenient; it can delay care, create financial pressure, and leave patients footing bills they thought were covered. The Hidden Triggers Behind Denied or Underpaid Claims Incorrect or missing CPT/ICD codes Lack of prior authorization despite provider verification “Experimental” treatment designations
How Health Insurance Claim Advocates Win Appeals Read More »
Have you ever been hospitalized and received a bill for a doctor that you never saw? I recently overturned a case where the doctor was charging over $5,000, and believe it or not, that doctor never saw the patient. When looking at the medical records, we were able to prove that the doctor never performed
Got a Bill from a Doctor You’ve Never Seen Read More »