First-level vs second-level appeals can determine whether a denied medical claim gets paid or remains your financial responsibility. Many people across the United States give up after the first denial because they assume the insurance company has the final word. That assumption can become expensive very quickly. A denied claim does not always mean the
First-Level vs Second-Level Appeals for Denied Medical Claims Read More »
An insurance carrier told my client that they can submit their claims online. Okay. My client submits the claims online, six months go by, and the insurance carrier is not paying the claim reimbursement. My client finally realizes this, and when I spoke with the insurance carrier, they stated the paperwork was never submitted on
How I Saved Her $16,000 Read More »
Good afternoon. Every time you call your insurance carrier, ask for their response in writing. If by any chance they will not provide you with that information, ask who you’re speaking to, their first name and last name, their ID number, location, and keep notes of the entire conversation, including the date and time you spoke
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The top reasons claims get denied often have little to do with the patient’s actual medical condition. Across the United States, thousands of people open medical bills expecting coverage, only to discover their health insurance company rejected the claim for technicalities, missing information, authorization issues, or coding errors. That denial can quickly spiral into collection
Top Reasons Claims Get Denied and How to Fight Back Read More »
Hello, my friends. Have you ever heard of an SPD? Summary Plan Description. Ask for this information from your health insurance carrier. This description will help you to understand what you are covered and not covered for on your health insurance policy. When I am appealing your claims, this information will help me to better understand your
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Good faith estimate requires providers to provide uninsured or self-pay patients with a good faith estimate of the total cost of care before services are rendered. I recommend always asking in advance how much your procedure will cost, and you should never be billed more than that amount. Please ask for it in writing, and I’m here
What is a Good Faith Estimate Read More »
Understanding premiums, deductibles, and copays is the key to knowing why your insurance didn’t pay—and why your healthcare bills may be higher than expected. You pay your monthly premium, assume you’re covered, and then a bill shows up that doesn’t match your expectations. Or worse, your claim is denied and you’re left wondering what went
Premiums, Deductibles, and Copays Explained Read More »
When a student has college insurance, that policy is a primary insurer. Sometimes the parents or guardian might still have them on their policy, which would be secondary to the college health insurance policy. Here are the positives and negatives about college health insurance. College insurance, the advantages are. The policies are written according to what the
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To help you save a tremendous amount of money, request itemized bills to understand what you have been charged for. All too often, you’re charged for services that were never rendered, and that is why it’s so important that you keep a copy of your medical records. Recently, I saved a client over $10,000, since they were
Can Itemized Bills Save You Thousands? Read More »
Types of health insurance plans (HMO, PPO, EPO) can determine whether your claim gets paid—or denied—and most people only learn the difference after a costly mistake. You thought you were covered. Then the bill arrived, or worse, the claim was denied. Now you’re trying to understand rules that were never clearly explained. The reality is
Types of Health Insurance Plans Explained Read More »