Behind every medical invoice is a complex system few understand—one designed more for compliance and profitability than patient clarity. At the center of it: automated billing codes, contracted rates, and insurance loopholes that often result in charges being passed on to unsuspecting patients. How the System Works (And Why It Doesn’t Work for You) Advocate
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You know, all too often people call me up with a procedure that they never expected to pay. On our policies, we have WellCare visits, which are usually handled annually. People come to me where they’re being charged for services they should not have been billed at all. All too often, I overturn those cases
Where You Charged for Your Annual Wellness Care Bill? Read More »
You know, sometimes people are so emotional about their condition. I often try to find them support groups and other social support to enable my clients to receive help with their physical and emotional conditions. You might even be interested in my latest book that came out, Apparently Different. These are the type of stories
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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
Insurance Claim Denied? Don’t Give Up! Steps to Get Denied Medical Claims Paid Read More »