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# Medical Bill Advocate

We Give a Hoot About Your Claim

## Sitemaps

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## Posts

- [In The News](https://www.medicalinsuranceadvocacy.com/in-the-news/) - Need a Medical Healthcare Claim Advocate and Medical Bill Advocate? We Audit, Evaluate & Analyze Medical Insurance Claims, Liens and Denied Insurance Claims
- [Negotiating Out-of-Network Charges After a Claim Denial](https://www.medicalinsuranceadvocacy.com/negotiating-out-of-network-charges-after-a-claim-denial/) - negotiate out-of-network charges
- [Discount Strategies for Uninsured Patients With Medical Bills](https://www.medicalinsuranceadvocacy.com/discount-strategies-for-uninsured-patients-with-medical-bills/) - Discover discount strategies for uninsured patients, including self-pay reductions, charity care, bill negotiation, and safer payment options.
- [Charity Care Qualification After a Denied Medical Claim](https://www.medicalinsuranceadvocacy.com/charity-care-qualification-after-a-denied-medical-claim/) - Learn how charity care qualification works after an insurance denial, what documents hospitals require, and how to apply for financial assistance.
- [Hospital Financial Assistance Programs](https://www.medicalinsuranceadvocacy.com/hospital-financial-assistance-programs/) - Learn how hospital financial assistance programs may reduce a denied medical bill, who qualifies, what documents you need, and how to apply.
- [Setting Up Payment Plans for Denied Medical Bills](https://www.medicalinsuranceadvocacy.com/setting-up-payment-plans-for-denied-medical-bills/) - Need help with denied medical bills? Learn how to appeal the claim, reduce the balance, and create an affordable payment plan without hidden surprises.
- [Cash Pay vs Insurance Pricing After a Claim Denial](https://www.medicalinsuranceadvocacy.com/cash-pay-vs-insurance-pricing-after-a-claim-denial/) - Compare cash pay vs insurance pricing after a denied medical claim. Learn what to review before appealing, negotiating, or paying the bill.
- [Negotiating Medical Bills Effectively After a Denied Claim](https://www.medicalinsuranceadvocacy.com/negotiating-medical-bills-effectively-after-a-denied-claim/) - Learn how to negotiate medical bills after an insurance denial, identify billing errors, appeal the claim and request professional advocacy help.
- [If You're Appealing a Case-Do This](https://www.medicalinsuranceadvocacy.com/if-youre-appealing-a-case-do-this/) - If you’re appealing a case and you, your healthcare provider, or the facility can settle the payment amount before the dispute ends, you can move forward if both parties agree to a reduced bill or to pay the agreed amount in full. If you and your provider or facility reach an agreement, be sure to notify
- [How Your Insurance Works with the No Surprise Act](https://www.medicalinsuranceadvocacy.com/how-your-insurance-works-with-the-no-surprise-act/) - Your insurer may have decided not to pay part or all of your claim. If you think this decision violates the No Surprises Act, appeal your bill. Follow the process described in your health insurance plan’s documents and the denial notices. Learn more about your rights under the No Surprises Act. If you receive a bill and have
- [Why Ask for an Itemized Bill When Denied Medical Claim](https://www.medicalinsuranceadvocacy.com/why-ask-for-an-itemized-bill-when-denied-medical-claim/) - If you receive a balance bill or believe you are overcharged, request an itemized bill and dispute the charges. Ask the provider or hospital for an itemized bill with all billing codes listed. Your billing codes should be five-digit procedure codes. Make sure you’re not relying on a hospital bill that only shows three to five numbers or
- [Saved Over $13,000 With This](https://www.medicalinsuranceadvocacy.com/saved-over-13000-with-this/) - If your dispute was decided in your favor, but the provider is still billing you or has even sent your bill to collections, I highly recommend you reach out to MedWize, my company. We will review your situation and let you know what the next steps should be. A case like this happened recently, where I saved
- [How I Had a $9,000 Medical Bill Written Off](https://www.medicalinsuranceadvocacy.com/how-i-had-a-9000-medical-bill-written-off/) - I hope you’re having a fantastic afternoon. Eighty percent of medical claims are incorrect. There are often errors where procedures appear on your bill that never occurred, or you might find duplicate charges or incorrect charges. Please contact me if this happens to you. I recently had a case where a client was being billed $9,000, and
- [What is an Insurance Claim Denial?](https://www.medicalinsuranceadvocacy.com/what-is-an-insurance-claim-denial/) - Have you ever gone to the doctor, submitted your claim, and got a letter saying your insurance won’t pay? That is a denial. It means your insurer has rejected the claim, either for a service they say isn’t covered or for some other reason. It doesn’t always mean you’re stuck with the bill, but it does mean
- [The Most Common Reasons for Denied Medical Bill Claims](https://www.medicalinsuranceadvocacy.com/the-most-common-reasons-for-denied-medical-bill-claims/) - Why do claims get denied? The most common reasons include missing information, incorrect billing codes, lack of pre-authorization, or service being out of network. Sometimes, the insurer simply doesn’t believe the service was medically necessary. Knowing these reasons can help you spot errors and avoid denials before they even happen. Please call me. I’m here to
- [Out of Network Air Ambulance Services](https://www.medicalinsuranceadvocacy.com/out-of-network-air-ambulance-services/) - The No Surprises Act prevents surprise bills for emergency services, even if received from an out-of-network provider or facility. It limits out-of-network cost-sharing for non-emergency services received at an in-network facility, such as hospitals or ambulatory surgical centers. It also prohibits balance billing for air ambulance services, even if they are out-of-network. Please call me. I’m here
- [A $54,000 Medical Bill Written Off After Denial](https://www.medicalinsuranceadvocacy.com/a-54000-medical-bill-written-off-after-denial/) - When a provider considers your procedure to be necessary and the insurance company says, “Hey, it wasn’t medically necessary,” you have to fight to make sure that the insurer does not pass the cost to you. If you can prove that it was medically necessary, your denied claim should be paid. I recently had a case where
- [Confused by Insurance Jargon](https://www.medicalinsuranceadvocacy.com/confused-by-insurance-jargon/) - Denial letters are full of insurance jargon, but don’t let that intimidate you. Look for the reason for the denial. It’s usually listed by a code. And check your explanation of benefits, your EOB, it’s called. You have to understand the exact reason, which will help you determine your next steps, whether it’s correcting an error, appealing a
- [Getting Denied Is Not the End](https://www.medicalinsuranceadvocacy.com/getting-denied-is-not-the-end/) - Getting denied isn’t the end of the road. You have the right to appeal. That means asking the insurer to reconsider the decision. Start by calling the insurer to understand the denial. Then submit an appeal, usually in writing, with all the supporting documents. Be polite, clear, and timely. You would be surprised how many denials are overturned.
- [Why You Always Want a Pre Approval Letter](https://www.medicalinsuranceadvocacy.com/why-you-always-want-a-pre-approval-letter/) - Many services require pre-authorization from your insurance company. That means your doctor has to get approval before doing a test or procedure. If that doesn’t happen, your claim could be denied, even if you really needed that care. Always ask if your service needs pre-approval to avoid unexpected bills. I recommend you get the approval in writing from your
- [How Long Do You Have to File An Appeal](https://www.medicalinsuranceadvocacy.com/how-long-do-you-have-to-file-an-appeal/) - Don’t wait if you’ve been denied. Lost insurance plans give you 120 days, or about six months, to file an appeal. Direct Medicare is 12 months. It used to be 24 months, now only 12. And some plans allow you even less time than 120 days. Mark your calendar, keep records, and act quickly. Missing the deadline
- [Filing Complaints Against Providers/Insurers After Denied Claims](https://www.medicalinsuranceadvocacy.com/filing-complaints-against-providers-insurers-after-denied-claims/) - Learn how filing complaints against providers/insurers may help with denied medical claims, billing disputes, and health insurance problems.
- [Medical Debt Collection Laws and Your Patient Rights](https://www.medicalinsuranceadvocacy.com/medical-debt-collection-laws-and-your-patient-rights/) - Learn how medical debt collection laws affect denied medical claims, collection notices, credit reporting, and patient rights in the United States.
- [State vs Federal Regulations for Health Insurance Claims](https://www.medicalinsuranceadvocacy.com/state-vs-federal-regulations-for-health-insurance-claims/) - Learn how state vs federal regulations affect denied medical claims, insurance appeals, and patient rights across the United States.
- [HIPAA Privacy Rules Explained for Insurance Claims and Appeals](https://www.medicalinsuranceadvocacy.com/hipaa-privacy-rules-explained-for-insurance-claims-and-appeals/) - Learn HIPAA privacy rules explained in simple terms, including how medical records, health insurance, and denied medical claims are handled.
- [Peer-to-Peer Review Process for Denied Medical Claims](https://www.medicalinsuranceadvocacy.com/peer-to-peer-review-process-for-denied-medical-claims/) - Learn how the peer-to-peer review process works, why treatments get denied, and how patients can challenge denied medical claims successfully.
- [Writing a Strong Appeal Letter for Denied Medical Claims](https://www.medicalinsuranceadvocacy.com/writing-a-strong-appeal-letter-for-denied-medical-claims/) - Learn how writing a strong appeal letter can improve your chances of overturning denied medical claims and fighting health insurance denials successfully.
- [First-Level vs Second-Level Appeals for Denied Medical Claims](https://www.medicalinsuranceadvocacy.com/first-level-vs-second-level-appeals-for-denied-medical-claims/) - Learn the difference between first-level vs second-level appeals, how insurance appeals work, and when to seek help for denied medical claims.
- [Top Reasons Claims Get Denied and How to Fight Back](https://www.medicalinsuranceadvocacy.com/top-reasons-claims-get-denied-and-how-to-fight-back/) - Learn the top reasons claims get denied, how to appeal denied medical claims, and when to contact a medical billing advocate for help.
- [College Students Must Prove What?](https://www.medicalinsuranceadvocacy.com/college-students-must-prove-what/) - Students in college are normally able to purchase health insurance through their university. I’ve handled many cases involving college health insurance. I must say, the health carriers are very suspicious when the students are submitting claims, and very often, the college student, with each and every claim, has to prove that they are the insured. I couldn’t believe
- [Having Medicare Advantage Plan Issues](https://www.medicalinsuranceadvocacy.com/having-medicare-advantage-plan-issues/) - Recently, several Medicare Advantage plans have exited the market, including Premera and the Blue Cross Blue Shield of Kansas City. Also, others have reduced their service areas, such as Aetna and Humana. Prior to the annual enrollment period in 2024, many for-profit health plans signaled their intent to slow growth or even contract membership due to
- [Why Patient Insurance Oversight is Necessary](https://www.medicalinsuranceadvocacy.com/why-patient-insurance-oversight-is-necessary/) - Okay, you have received pre-authorization for appendicitis. You undergo the surgery, but now your insurance carrier, who approved the surgery, says it wasn’t medically necessary. The bills were over $30,000. I’m asked to help my client with their bills. It took quite a few months, but I was able to get the claim paid. These are just a
- [Is Your Insurance Plan Fully Funded?](https://www.medicalinsuranceadvocacy.com/is-your-insurance-plan-fully-funded/) - One of the misconceptions people experience is whether your health insurance plan is a fully funded plan or if it’s an ERISA plan. This is usually important information that you need to be aware of. When appealing your case, the question is whether to appeal with your health insurance carrier or to go to the Department of
- [Why a Letter of Medical Necessity May Save You Thousands](https://www.medicalinsuranceadvocacy.com/why-a-letter-of-medical-necessity-may-save-you-thousands/) - Medical claims that require pre-approvals or claims involving newly developed drugs or treatment, and many types of behavioral health treatment may require a letter of medical necessity from the treating doctor before the claim is approved. Claimants should be aware that their physicians are ready and willing to back up their claims. You do not want to
- [$26,500 Claim Paid for This Reason](https://www.medicalinsuranceadvocacy.com/26500-claim-paid-for-this-reason/) - A recent case that I worked on involved a medical bill denial for $26,500. Believe it or not, the insurance carrier made an error thinking it was a totally different policy that doesn’t cover for pregnancy. I was so happy to realize their error and have their claim paid. If you need help, please call me. Thank you.
- [Is AI Automatically Denying Your Medical Claims](https://www.medicalinsuranceadvocacy.com/is-ai-automatically-denying-your-medical-claims/) - Too often the medical claims are denied when your insurance carrier’s AI, artificial intelligence, looks at the diagnosis and medical procedures on your submitted medical bill and they decide to deny it. MedWise is passionate about helping those facing wrongful denials and coverage issues. This is happening right now at a high percentage of submitted claims. I
- [Reduced Bill from $8,500 to a $250 Deductible](https://www.medicalinsuranceadvocacy.com/reduced-bill-from-8500-to-a-250-deductible/) - Hello, my friends. Was your claim inaccurately processed by your health insurance carrier? Call MedWise to help overturn your case. This past week, my client’s bill for stitches in an emergency room went from $8,500 down to their deductible of $250. Please call me. I’m here to help you. Thank you. Adria Gross See Full Bio
- [Dispute Resolution for Self Paying Individuals](https://www.medicalinsuranceadvocacy.com/dispute-resolution-for-self-paying-individuals/) - Hello, everybody. I hope you’re having a fabulous day. Dispute resolution establishes a process for solving billing disputes between patients, providers, and insurance plans, and particularly for uninsured or self-paying individuals. MedWise will help you to dispute any of your medical bills. Please call me. I’m here to help you. Adria Gross See Full Bio
- [Has Your Claim Been Incorrectly Denied](https://www.medicalinsuranceadvocacy.com/has-your-claim-been-incorrectly-denied/) - Has your claim been incorrectly denied? Believe it or not, if your claim does not have the Federal Tax ID number and the NPI number, the National Provider Identification number, on the claim, the insurance company will not pay your claim. It makes me so angry when the claim is submitted incorrectly and now you, the
- [Has Your Health Insurance Been Incorrectly Terminated?](https://www.medicalinsuranceadvocacy.com/has-your-health-insurance-been-incorrectly-terminated/) - Has your health insurance been incorrectly terminated? Too many times you are paying your health insurance premium and there’s an error on behalf of your insurance carrier. Your insurance carrier did not code receipt of your monthly premium, and now your claims are being denied. Call MedWise and we will straighten out the error and make sure
- [What To Do if Your Claim is Denied](https://www.medicalinsuranceadvocacy.com/what-to-do-if-your-claim-is-denied/) - Consumers should be encouraged to file formal appeals when they believe their claims are wrongfully rejected or processed. Insurance companies are usually required to provide a clear process for this. If your claims are being denied, it’s always best to hire a professional to help you. I wrote a book, “Solve Curing Your Medical Insurance Problems,” to
- [Suspect Your Were Overcharged?](https://www.medicalinsuranceadvocacy.com/suspect-your-were-overcharged/) - If you ever have any suspicion that you’re being overcharged, negotiate with the providers in the billing department. It’s always best to look at the Medicare rates according to the procedure codes that is on your itemized bill. Very often, you’re able to get a discount if you can prove that the provider is billing you a
- [How I Saved Her $16,000](https://www.medicalinsuranceadvocacy.com/how-i-saved-her-16000/) - 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
- [Always Ask for the Response in Writing](https://www.medicalinsuranceadvocacy.com/always-ask-for-the-response-in-writing/) - 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
- [Always Ask for the SPD](https://www.medicalinsuranceadvocacy.com/always-ask-for-the-spd/) - 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
- [Premiums, Deductibles, and Copays Explained](https://www.medicalinsuranceadvocacy.com/premiums-deductibles-and-copays-explained/) - Understand premiums, deductibles, and copays—and why your medical bills may be higher than expected. Learn how to take control today. Call MedWise: 845-238-2532
- [Types of Health Insurance Plans Explained](https://www.medicalinsuranceadvocacy.com/types-of-health-insurance-plans-explained/) - Learn HMO, PPO, and EPO plan differences and how they impact denied claims and healthcare bills. Take control of your coverage today. Call MedWise: 845-238-2532
- [Understanding CPT, ICD-10, and HCPCS Codes](https://www.medicalinsuranceadvocacy.com/understanding-cpt-icd-10-and-hcpcs-codes/) - Learn how CPT, ICD-10, and HCPCS codes impact your medical bills and denied claims—and what to do if something looks wrong. Call MedWise at 845-238-2532.
- [How the U.S. Healthcare Payment System Works](https://www.medicalinsuranceadvocacy.com/how-the-u-s-healthcare-payment-system-works/) - Learn how the U.S. healthcare payment system works and what to do when claims are denied or bills seem wrong. Take control today. Call MedWise at 845-238-2532.
- [Medical Billing Advocate vs Coder vs Biller Explained](https://www.medicalinsuranceadvocacy.com/medical-billing-advocate-vs-coder-vs-biller-explained/) - Learn the difference between a medical billing advocate, coder, and biller—and who to call when your claim is denied. Call MedWise at 845-238-2532
- [What is a Good Faith Estimate](https://www.medicalinsuranceadvocacy.com/what-is-a-good-faith-estimate/) - 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
- [College Insurance Pros and Cons](https://www.medicalinsuranceadvocacy.com/college-insurance-pros-and-cons/) - 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
- [Can Itemized Bills Save You Thousands?](https://www.medicalinsuranceadvocacy.com/can-itemized-bills-save-you-thousands/) - 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
- [Unfair Medical Charges Eat Away Your Coverage](https://www.medicalinsuranceadvocacy.com/unfair-medical-charges-eat-away-your-coverage/) - Unfair medical charges can arise from various issues, including billing errors, surprise bills from network providers, and inflated charges. To address these issues, you can start by examining your insurance coverage, contacting your provider and insurance company, and disputing the bill by hiring MedWise. I recently reduced a bill from $37,000 down to $4,000. Call me. I’m here
- [The Best Chance You'll Have at Overturning Your Case](https://www.medicalinsuranceadvocacy.com/the-best-chance-youll-have-at-overturning-your-case/) - You are now about to dispute a bill which you received from a collection agency. You need to request verification from the agency, and I recommend you submit a complaint to the Consumer Financial Protection Bureau and the Centers for Medicare and Medicaid Services. By making a complaint with those departments and/or hiring a medical advocate
- [Infertility Bill Claims Unpaid?](https://www.medicalinsuranceadvocacy.com/infertility-bill-claims-unpaid/) - If you come across an unfair medical bill, the first thing you need to do is examine your insurance coverage. Review your plan, understand your deductibles, your co-pays, your co-insurance, and out-of-pocket maximum. I very often overturn cases by proving the policy covers for specific types of procedures. I recently had a case involving infertility and was
- [No Surprises Act Explained](https://www.medicalinsuranceadvocacy.com/no-surprises-act-explained/) - The No Surprises Act became effective January 1st of 2022, and it protects consumers from surprise medical bills for emergency services and non-emergency services. It limits out-of-network cost-sharing and establishes a dispute resolution process for billing disagreements. This includes protections for uninsured and self-pay individuals who can request a good faith estimate of medical costs and
- [Why Drug Prices Are Cheaper in Other Countries](https://www.medicalinsuranceadvocacy.com/why-drug-prices-are-cheaper-in-other-countries/) - One of the major issues causing high premiums on our pharmaceutical drugs is due to research and development. The question is: why are drug prices lower in other countries? Outside the US, the countries pay for the manufacturing cost of the drug and a very small profit on the cost of manufacturing. But here in the United States,
- [Erisa Claim Denial?](https://www.medicalinsuranceadvocacy.com/erisa-claim-denial/) - Are you now appealing an ERISA claim denial? What was the reason for your denial? Very often, the State Department of Insurance and the attorney general for your state will not assist you with your appeal. You need to find out which Department of Labor to reach out to. Once you have that information, send your appeal to that
- [Why Coding Errors Cause Medical Claim Rejections and How to Fix Them](https://www.medicalinsuranceadvocacy.com/why-coding-errors-cause-medical-claim-rejections-and-how-to-fix-them/) - Discover how coding affects coverage and how to challenge denied medical bills.
- [Hospital Debt in Collections? Step-by-Step Dispute Guide](https://www.medicalinsuranceadvocacy.com/hospital-debt-in-collections-step-by-step-dispute-guide/) - Learn how to dispute hospital collections, reduce medical debt, and protect your credit. Expert help available.
- [Insurance Claim Documentation Checklist to Prevent Denials](https://www.medicalinsuranceadvocacy.com/insurance-claim-documentation-checklist-to-prevent-denials/) - Learn which documents are required for insurance claim approval and how to avoid denials. Expert guidance available.
- [How to Dispute a Medical Bill in Collections and Protect Your Credit](https://www.medicalinsuranceadvocacy.com/how-to-dispute-a-medical-bill-in-collections-and-protect-your-credit/) - Learn how to dispute medical bills in collections, reduce debt, and protect your credit. Expert guidance available.
- [How to Check if Insurance Covers Something Before You Get a Denial](https://www.medicalinsuranceadvocacy.com/how-to-check-if-insurance-covers-something-before-you-get-a-denial/) - Learn how to check insurance coverage, avoid denied claims, and protect your finances. Expert tips and guidance.
- [Medical Bill Negotiation Service Pricing: How Much Does It Cost?](https://www.medicalinsuranceadvocacy.com/medical-bill-negotiation-service-pricing-how-much-does-it-cost/) - Learn how medical bill negotiation services charge, potential savings, and why a medical billing advocate can reduce your healthcare costs.
- [Sign Up for a Medical Bill Review Service and Reduce Your Healthcare Debt](https://www.medicalinsuranceadvocacy.com/sign-up-for-a-medical-bill-review-service-and-reduce-your-healthcare-debt/) - Overwhelmed by medical debt? Learn why signing up for a medical bill review service can save thousands and stop collections.
- [Free Consultation for Medical Bill Denial Could Save You](https://www.medicalinsuranceadvocacy.com/free-consultation-for-medical-bill-denial-could-save-you/) - Struggling with denied claims? A free consultation for medical bill denial may reveal powerful options. Don’t wait—call today and take control now.
- [Why America's Health Care System is Sick](https://www.medicalinsuranceadvocacy.com/why-americas-health-care-system-is-sick/) - I hope you’re having a fantastic day. I was reading an article recently that said, “The devil is in the details.” But you know what? The strength is in the essentials. Our healthcare system is complicated, and you don’t want to be caught off guard or taken advantage of. Many people call me to help them evaluate
- [Is AI Causing More Medical Claim Denials?](https://www.medicalinsuranceadvocacy.com/is-ai-causing-more-medical-claim-denials/) - Artificial intelligence is changing many parts of the insurance industry, and unfortunately, some people feel they are not receiving the treatment they need because of automated claim decisions. If you’re having problems getting approval for care, or if your claims are being denied, please call MedWise. I’m here to help you navigate the process and advocate
- [Do This Before You Purchase Any Medical Insurance Policy](https://www.medicalinsuranceadvocacy.com/do-this-before-you-purchase-any-medical-insurance-policy/) - When you go onto a website to purchase health insurance, please make sure you take a close look at the policy and understand exactly what it covers and what it does not cover. You might be purchasing a plan that will not cover your specific condition, or your medical providers may not be in the
- [Medicare Advantage Plan Refuses Care](https://www.medicalinsuranceadvocacy.com/medicare-advantage-plan-refuses-care/) - Congress is currently scrutinizing Medicare Advantage plans. I had a new case this week where a patient was being discharged from the hospital because of issues with her insurance coverage. She was having complications with her pacemaker, and the insurance company initially would not authorize a visit with her cardiologist. When I received the call, I
- [A $32,000 Medical Claim Overturned](https://www.medicalinsuranceadvocacy.com/a-32000-medical-claim-overturned/) - I hope you’re having a fantastic day. When I started in the health insurance industry in the claims department, I became a claims supervisor within a short time. During my training, I learned very quickly how companies approach denying claims. It shouldn’t be driven by shareholder interests when people’s health and financial stability are at stake. Unfortunately,
- [How Non-Profit Hospitals Help With Health Care](https://www.medicalinsuranceadvocacy.com/how-non-profit-hospitals-help-with-health-care/) - I hope your day is going great. When it comes to medical bills being denied by your insurance company, the numbers are staggering. According to the Kaiser Family Foundation, we now have over $220 billion in medical debt, and about 25% of people who need treatment simply can’t afford it. Fortunately, some nonprofit hospitals offer financial assistance
- [Did Your Dental Coverage Deny Your Cleaning Bill?](https://www.medicalinsuranceadvocacy.com/did-your-dental-coverage-deny-your-cleaning-bill/) - Good afternoon. I spoke with a client the other day who lives in Texas. He has a dental policy, and believe it or not, he was denied coverage for a routine teeth cleaning. Can you imagine being told it’s not medically necessary to clean your teeth? If you need assistance with any of your claim denials, please
- [Is AI Automatically Denying Claims for Autistic Children?](https://www.medicalinsuranceadvocacy.com/is-ai-automatically-denying-claims-for-autistic-children/) - You know, I’ve been absolutely shocked that some companies are limiting treatment for autistic children. There was a recent case where the New York State Attorney General forced an insurance carrier to pay a $1 million penalty for failing to provide proper coverage. What has been happening is that some insurance companies are denying claims to
- [Medical Claim Was Denied for This Reason](https://www.medicalinsuranceadvocacy.com/medical-claim-was-denied-for-this-reason/) - I hope you’re having a fabulous day. You know, 99% of all enrollees who have a Medicare Advantage plan need to obtain prior authorization for many services. This most commonly applies to higher-cost treatments, including inpatient hospital stays, skilled nursing facility care, and chemotherapy. Medical providers are responsible for obtaining prior authorization. Patients should not be paying
- [The Challenge with Medicare Advantage Plans](https://www.medicalinsuranceadvocacy.com/the-challenge-with-medicare-advantage-plans/) - I hope you’re having a fantastic day. I’ve always been shocked by what insurers get away with. When I went into the health insurance industry as a claims analyst, within two weeks the company taught me how to deny claims. This is why I’m here to help you. If your claim is denied, you’re overcharged out of
- [Denied Medical Coverage for Recommended Care?](https://www.medicalinsuranceadvocacy.com/denied-medical-coverage-for-recommended-care/) - Hello, my friends. Coverage denials can lead to significant delays in getting care while patients and their doctors go through the appeal process. Almost three out of five people who reported that their insurer denied coverage for recommended care said they experienced delays in receiving treatment as a result. If this happens to you, MedWise is here
- [Frustrated By Medical Insurance Denials?](https://www.medicalinsuranceadvocacy.com/frustrated-by-medical-insurance-denials/) - Hello, my friends. You know, many people have been mistreated by insurers, or their loved ones have. When you’re frustrated by denials and get no assistance from the insurance company, it’s time to call me. I have overturned 95% of the cases that come my way. I’m the owner of MedWise Insurance Advocacy. Please call me. Thank you. Adria
- [Your Insurance Company Needs Arm Twisting?](https://www.medicalinsuranceadvocacy.com/your-insurance-company-needs-arm-twisting/) - Hello, my friends. Have you or a family member been denied essential care to the point of permanent disability or even death? I used to work for two insurance companies, and within two weeks, they taught me how to deny claims. After that, I also learned how to challenge the insurance carrier and advocate for patients. Please call
- [Financial Ruins from Denied Medical Claims](https://www.medicalinsuranceadvocacy.com/financial-ruins-from-denied-medical-claims/) - Good afternoon. I hope you’re having a great day. Are you now in financial ruin because your medical claim was denied by your health insurance carrier? Many times, insurance companies deny claims even though, according to your policy, you should be covered. If this happens to you, please call me at MedWise. I’m Adria, and I’m here to help
- [Your Insurance Company Broke Their Promise to Cover You?](https://www.medicalinsuranceadvocacy.com/your-insurance-company-broke-their-promise-to-cover-you/) - Hello, everybody. You know, I’ve got to tell you, it is absolutely terrible that we’re in a position where our claims are denied and we become frustrated to the point of screaming before getting a satisfactory outcome. Insurance companies make these promises that you’re going to be covered. You go for treatment, you get the bill, and
- [Higher Medical Insurance Premiums?](https://www.medicalinsuranceadvocacy.com/higher-medical-insurance-premiums/) - Hello my friends. I can remember the day when someone didn’t want to report an accident or injury because their insurance premiums might go up. Now, even if you make no claims, insurance premiums continue to rise at an alarming rate. Ask your insurance carrier what you’re covered for and what you’re not covered for, and always ask
- [How to Appeal Your Denied Medical Claims](https://www.medicalinsuranceadvocacy.com/how-to-appeal-your-denied-medical-claims/) - You know, if your medical bill is denied, please challenge the health insurance carrier. Many people do not understand that they have the right to overturn the case despite the ACA’s rules. For insurance companies to handle appeals and standardized appeal processes, 40% of those who did not challenge their denial reported that they did not
- [How to Get Your Claim Paid: Insurance Denial Appeal Help](https://www.medicalinsuranceadvocacy.com/how-to-get-your-claim-paid-insurance-denial-appeal-help/) - Need insurance denial appeal help? Learn to assemble a dossier of evidence with a Letter of Medical Necessity that your insurance company cannot ignore. Get the framework.
- [How to Find Patient Advocate Agencies Accepting New Clients](https://www.medicalinsuranceadvocacy.com/how-to-find-patient-advocate-agencies-accepting-new-clients/) - Stop searching for patient advocate agencies accepting new clients the wrong way. Our guide reveals a new method to find the right help now. Learn the smarter strategy.
- [Adria Gross vs Contingency Fee Medical Bill Lawyer: Truth](https://www.medicalinsuranceadvocacy.com/adria-gross-vs-contingency-fee-medical-bill-lawyer-truth/) - Your decision in Adria Gross vs contingency fee medical bill lawyer could save you thousands. Understand the hidden costs of contingency fees. Make the smarter choice now.
- [Why the Difference Between a Copay and Coinsurance Matters](https://www.medicalinsuranceadvocacy.com/why-the-difference-between-a-copay-and-coinsurance-matters/) - Learn the critical difference between a copay and coinsurance to finally stop surprise medical bills. This one insight puts you in control. Discover the secret now.
- [How Adria Gross Patient Advocate Beats Insurance Denials](https://www.medicalinsuranceadvocacy.com/how-adria-gross-patient-advocate-beats-insurance-denials/) - Go behind the scenes with Adria Gross, patient advocate. Discover the evidence-based process she uses to overturn denials and slash medical bills. See her method now!
- [Need a Hospital Bill Negotiation Company? Read this First!](https://www.medicalinsuranceadvocacy.com/need-a-hospital-bill-negotiation-company-read-this-first/) - Choosing a hospital bill negotiation company? Find one that audits for errors first. Our guide shows you how professionals dismantle unfair bills. Get the guide!
- [Denied? Get a Medical Claim Appeal Service for Hire](https://www.medicalinsuranceadvocacy.com/denied-get-a-medical-claim-appeal-service-for-hire/) - Don't risk your appeal. Our guide to finding a medical claim appeal service for hire shows you the questions to ask to ensure you choose a real expert. Read more!
- [Don't Waste a Free Consultation with a Medical Billing Advocate](https://www.medicalinsuranceadvocacy.com/dont-waste-a-free-consultation-with-a-medical-billing-advocate/) - Most people waste their free consultation with a medical billing advocate. Learn the red flags to watch for and the key documents you need to prepare. Get the guide!
- [Why Medical Billing Advocate Services for Cancer Patients?](https://www.medicalinsuranceadvocacy.com/why-medical-billing-advocate-services-for-cancer-patients/) - Expert medical billing advocate services for cancer patients can lift the financial burden. Let a specialist handle the fight so you can focus on healing. Get help now.
- [Powerful Alternatives to Hiring a Medical Claims Lawyer](https://www.medicalinsuranceadvocacy.com/powerful-alternatives-to-hiring-a-medical-claims-lawyer/) - Discover powerful alternatives to hiring a medical claims lawyer. Learn why a medical billing advocate is often faster & more effective for denied claims. See how!
- [The Truth: Medical Billing Advocate Success Rates](https://www.medicalinsuranceadvocacy.com/the-truth-medical-billing-advocate-success-rates/) - Uncover the true medical billing advocate success rate for MedWise Insurance Advocate. We reveal the hidden metric that matters more than any percentage. Find out now!
- [Read this Guide to Surprise Medical Billing Laws FIRST](https://www.medicalinsuranceadvocacy.com/read-this-guide-to-surprise-medical-billing-laws-first/) - Our guide to surprise medical billing laws is your weapon against illegal bills. Learn the loopholes they use and how to fight back effectively. Take control now!
- [How to Win at Filing a Complaint Against a Health Insurance Company](https://www.medicalinsuranceadvocacy.com/how-to-win-at-filing-a-complaint-against-a-health-insurance-company/) - Most people make critical errors when filing a complaint against a health insurance company. This guide reveals the secrets to avoid them. Get the insights now!
- [Prior Authorization Denial, What to Do Next](https://www.medicalinsuranceadvocacy.com/prior-authorization-denial-what-to-do-next/) - Got a prior authorization denial what to do next? Don't just appeal. The secret to a fast reversal is a peer-to-peer review. Overturn their decision now!
- [Difference Between in-network and out-of-network Charges SCAM](https://www.medicalinsuranceadvocacy.com/difference-between-in-network-and-out-of-network-charges-scam/) - The real difference between in-network and out-of-network charges is a hidden trap called balance billing. Learn how to beat the system. Read our guide now!
- [Understanding My Rights as a Patient with Medical Bills NOW](https://www.medicalinsuranceadvocacy.com/understanding-my-rights-as-a-patient-with-medical-bills-now/) - 80% of medical bills have errors. Proper understanding my rights as a patient with medical bills can save you thousands. Learn how to fight back and win!
- [Use These Tips for Negotiating Medical Bills with a Hospital](https://www.medicalinsuranceadvocacy.com/use-these-tips-for-negotiating-medical-bills-with-a-hospital/) - Our expert tips for negotiating medical bills with a hospital go beyond the basics. Uncover the secrets to a fair price and win your negotiation. Learn how!
- [Claim Denied? How to Write a Medical Claim Appeal Letter](https://www.medicalinsuranceadvocacy.com/claim-denied-how-to-write-a-medical-claim-appeal-letter/) - Feeling powerless after a denial? Learn how to write a medical claim appeal letter with our expert guide. We reveal the secrets to getting your claim approved.
- [The Hospital Price Transparency Law](https://www.medicalinsuranceadvocacy.com/the-hospital-price-transparency-law/) - 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 provide. However, as of July 9th, 2024, only 16.7% of hospitals nationwide comply with the hospital price transparency rule. You should know in advance what the fees are, and
- [Frustration for Denied Insurance Claims Escalate](https://www.medicalinsuranceadvocacy.com/frustration-for-denied-insurance-claims-escalate-2/) - Americans are crushed by skyrocketing premiums, crippling medical debt, and denial of care, which devastates millions of lives. It should be no surprise that frustration has reached a boiling point, igniting a widespread demand for real systemic change. Ordinary people understand that insurance companies don’t exist to protect their health, but to maximize profits for
- [Out of Network Medical Bill Reduced from $6,000 to $240](https://www.medicalinsuranceadvocacy.com/out-of-network-medical-bill-reduced-from-6000-to-240/) - We are literally the only developed country in the world with an entire multi-billion dollar for-profit health insurance industry. Some hospitals are not for-profit, and I wish it was the same for the health insurance companies. The for-profit health insurance industry has attached itself to us like a giant bloodsucking tick. I recently worked with
- [The Colonoscopy That Was Almost Not Covered](https://www.medicalinsuranceadvocacy.com/the-colonoscopy-that-was-almost-not-covered-2/) - I hope you’re having a fantastic day. You know, Medicare Advantage is often touted as beneficial, but most people believe it to be a scam. It’s particularly harmful to those with severe health issues. These plans often deny necessary care and delay treatments, jeopardizing patient health. Ultimately, the United States healthcare system’s reliance on private
- [Got a Bill from a Doctor You've Never Seen](https://www.medicalinsuranceadvocacy.com/got-a-bill-from-a-doctor-youve-never-seen-2/) - Have you ever been hospitalized and received a bill for a doctor you never saw? I recently overturned a case where the doctor was charging over $5,000, but that doctor never saw the patient. When looking at the medical records, we were able to prove that the doctor never performed any services, and they finally
- [Doctor Recommends an MRI?](https://www.medicalinsuranceadvocacy.com/doctor-recommends-an-mri/) - Your doctor recommends an MRI. Your insurance carrier will not provide pre-authorization. Call Medwise. We are here to get you the services you’re entitled to. Thank you. Adria Gross See Full Bio
- [Where Does Insurance Company CEO Salaries Come From?](https://www.medicalinsuranceadvocacy.com/where-does-insurance-company-ceo-salaries-come-from/) - The multiple giant insurance companies feed finances to the executives of the insurance company as well as the stockholders. Much of that money and the pay for the multiple senior executives at the insurance companies, who almost all make over a million dollars a year, came from saying no to people who file claims for
- [Deceptive Practices in Self-Funding Insurance Plan](https://www.medicalinsuranceadvocacy.com/deceptive-practices-in-self-funding-insurance-plan/) - Please be careful when choosing a medical insurance carrier policy. There are deceptive practices in the marketplace, but the government has a limited role when it comes to self-funding, self-insured ERISA plans, which are controlled by private insurers. If you know you should be covered but are being denied, please fight for your rights. I
- [Self Employed Individuals Health Insurance](https://www.medicalinsuranceadvocacy.com/self-employed-individuals-health-insurance/) - Consider a self-employed individual choosing a health plan from the health insurance marketplace without subsidy eligibility. They might select a silver plan costing about a thousand dollars monthly, thinking it covers in-network doctor visits with a reasonable copay. However, a visit to the doctor may reveal a $200 charge because the deductible was not met.
- [Profits in Insurance Industry Are Booming](https://www.medicalinsuranceadvocacy.com/profits-in-insurance-industry-are-booming/) - Profits in the insurance industry are booming. UnitedHealthcare’s operating profit margin was about 5.8% on revenues of $281.4 billion in 2023. Insured individuals not only pay high premiums, but they also face deductibles, copays, and unexpected bills. Insurers exploit the system by enrolling primarily young, healthy individuals, and they manipulate costs, largely enabled by policies
- [Eligibility for Health Savings Accounts](https://www.medicalinsuranceadvocacy.com/eligibility-for-health-savings-accounts/) - I received many calls involving HSAs. A Health Savings Account (HSA) is a tax-advantaged savings account that allows you to set aside money to pay for qualified medical expenses such as deductibles, copayments, coinsurance, acupuncture, ambulance costs, doctor’s visits, hearing aids, prescription drugs, psychological therapy, psychiatric care, and qualified long-term care services. To be eligible
- [How to Challenge a Billing Error](https://www.medicalinsuranceadvocacy.com/how-to-challenge-a-billing-error/) - One of my clients reported a billing error to me and we challenged the insurance carrier and the medical provider. You need to be aware of your right to challenge a bill. We recently decreased a bill from $4,500 down to $100. Please call me. Remember, I’m here to help you. Thank you. Adria Gross
- [Was Your Health Service Supposed to be Free?](https://www.medicalinsuranceadvocacy.com/was-your-health-service-supposed-to-be-free/) - Have you received a medical bill or are you being charged a copayment in the past year for a service you thought should have been free or covered by your insurance carrier? If you receive a bill for a health service you thought was free or should have been covered by your health insurance carrier,
- [Didn't Schedule the Medical Procedure Within the Pre Authorization Period?](https://www.medicalinsuranceadvocacy.com/didnt-schedule-the-medical-procedure-within-the-pre-authorization-period/) - I hope you’re having a fabulous day today. A coverage denial may say the needed care was not provided as a result of not scheduling the services needed within the time period you were originally preauthorized by your insurance carrier. What they do is they send in that you might need pre-authorization, and they give
- [How the ACA Works for Claim Denials](https://www.medicalinsuranceadvocacy.com/how-the-aca-works-for-claim-denials/) - The Affordable Care Act (ACA) granted people the right to appeal decisions made by their health insurers regardless of their insurance type or state of residence. The law also established rules for how insurance companies should handle initial appeals and allows insurers to request a reconsideration of decisions to deny payment. If an insurer upholds
- [Are Insurers Deliberately Denying Claims](https://www.medicalinsuranceadvocacy.com/are-insurers-deliberately-denying-claims/) - Insurers are motivated to avoid paying for care. Many insurers appear to be utilizing increasingly aggressive tactics to do so, deploying technology and applying pressure to company physicians to scrutinize services recommended by patients’ physicians, and often to deny coverage, leaving patients with unexpected bills or delays in care. You need care, and if you’re
- [What Service Do Private Insurance Companies Provide](https://www.medicalinsuranceadvocacy.com/what-service-do-private-insurance-companies-provide/) - Hello my friends. What service do private insurers provide in return for the fees they collect? Again, what service do private insurers provide in return for the fees that they collect? You may not realize the extent to which the insurance companies are exposing themselves to the delay and deny strategies. Private insurance is often
- [What Increases Medical Care Costs](https://www.medicalinsuranceadvocacy.com/what-increases-medical-care-costs/) - The lack of health coverage produces negative consequences. For instance, an individual avoiding upfront medical costs might end up in the emergency room where treatment is much more expensive. This not only increases healthcare costs for everyone but also places a heavier load on public resources and spreads illness. Make sure you have a good
- [Delay of Care Due to Care Denials](https://www.medicalinsuranceadvocacy.com/delay-of-care-due-to-care-denials/) - You know, over the years I have found that nearly half of respondents who experienced a delay in care following a coverage denial said that their health problems got worse as a result of those delays. Worry and anxiety among those experiencing delays are really universal. Nearly one in six reported cases indicate that care
- [Unfair Review of Claims for Medical Bills](https://www.medicalinsuranceadvocacy.com/unfair-review-of-claims-for-medical-bills/) - Many health insurers require a review of claims or prior authorization requests by a nurse and a doctor, both employed by the insurer. Recent media investigations have found that some insurance company doctors are not incentivized to spend the time needed to scrutinize patients’ medical records and follow guidelines for making informed decisions about approving
- [Incentives for Over Providing Services](https://www.medicalinsuranceadvocacy.com/incentives-for-over-providing-services/) - A fee-for-service medical cost arrangement exists in the United States. The more services doctors perform, the higher their incomes. Just as patients have an incentive to overconsume, doctors have an incentive to overprovide. If you’re having difficulties paying your medical bills, call me. I’m the owner of Medwise. We save individuals thousands of dollars on
- [Billing Disputes and Denials of Medical Coverage](https://www.medicalinsuranceadvocacy.com/billing-disputes-and-denials-of-medical-coverage/) - I hope you’re having a great day. Think about people’s billing disputes and denials of coverage. What emerges is that many realize positive outcomes when they appeal decisions they perceive to be in error. Yet only half of those who believe that they were erroneously billed or denied care actually challenge the decision or have
- [Who's Responsible for the Medical Appeal Process?](https://www.medicalinsuranceadvocacy.com/whos-responsible-for-the-medical-appeal-process/) - I hope you’re having a fantastic day. The responsibility of appealing may not be clear between the patients, the providers, or between the employers and the employees, and the documentation requirements to appeal can create additional barriers. As a beneficiary, you have a right to appeal your insurer’s decision. Due to artificial intelligence, all too
- [What is Hospital Upcoding](https://www.medicalinsuranceadvocacy.com/what-is-hospital-upcoding/) - Hospital upcoding, which is claiming a higher level of patient severity in order to obtain a higher insurance payment, is a major issue. One study estimates that increased upcoding relative to a decade earlier was associated with $14.6 billion in hospital payments. I have people calling me about this, where they feel that they were
- [How Top CEOs in Medical Fields Make More Money](https://www.medicalinsuranceadvocacy.com/how-top-ceos-in-medical-fields-make-more-money/) - You know Americans are sick of the health insurance companies who steal our money and our lives. The more profits that the insurance companies make, the more extra cash is available to distribute to shareholders as dividends and buybacks, and generally the higher the stock price, the greater the potential for higher top executive pay.
- [Don't Let Medical Bills Bankrupt Your Family](https://www.medicalinsuranceadvocacy.com/dont-let-medical-bills-bankrupt-your-family/) - An illness can destroy an entire family, leaving them bankrupt and homeless, with the repercussions of that sudden fall into poverty echoing down through generations. Most Americans have no idea that the US is quite literally the only country in the developed world that doesn’t define healthcare as an absolute right for all of its
- [How to Challenge Your Medical Bill](https://www.medicalinsuranceadvocacy.com/how-to-challenge-your-medical-bill/) - One of the issues I hear so much is people have no idea how to challenge a bill. I worked for two insurance companies that not only taught me all the steps on how to deny a claim, but I learned how to challenge a bill, handle appeals, and either overturn the cases or minimize
- [Was Your Medical Bill Much Higher Than it Should Have?](https://www.medicalinsuranceadvocacy.com/was-your-medical-bill-much-higher-than-it-should-have/) - When you know you have been billed much more than you should have, please call midwives. All too often people are taken advantage of on their medical bills. We recently decreased a bill from $1,200 down to $55. Remember, I’m here to help you. Thank you. Adria Gross See Full Bio
- [How to Shop and Compare Hospital Costs](https://www.medicalinsuranceadvocacy.com/how-to-shop-and-compare-hospital-costs/) - 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
- [Was Your Medical Claim Denied Even After pre-Authorization?](https://www.medicalinsuranceadvocacy.com/was-your-medical-claim-denied-even-after-pre-authorization/) - 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
- [ER Medical Bill Not Medical Necessary?](https://www.medicalinsuranceadvocacy.com/er-medical-bill-not-medical-necessary-2/) - 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
- [Bee Sting Leads to Emergency Room Bill Not Covered by Insurance](https://www.medicalinsuranceadvocacy.com/bee-sting-leads-to-emergency-room-bill-not-covered-by-insurance-2/) - 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
- [Duplicate Bills from Same Procedure?](https://www.medicalinsuranceadvocacy.com/duplicate-bills-from-same-procedure-2/) - 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
- [Out of Network Bill Not Paid?](https://www.medicalinsuranceadvocacy.com/out-of-network-bill-not-paid-2/) - 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
- [High Out of Pocket Medical Costs](https://www.medicalinsuranceadvocacy.com/high-out-of-pocket-medical-costs/) - 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
- [Your Ally: Medical Billing Advocate for Cancer Treatment Bills](https://www.medicalinsuranceadvocacy.com/your-ally-medical-billing-advocate-for-cancer-treatment-bills/) - Don't fight the financial battle alone. A medical billing advocate for cancer treatment bills is your ally. Learn how they lower costs so you can focus on healing.
- [Top Rated Patient Advocates for Claim Denials: Don't Hire Yet](https://www.medicalinsuranceadvocacy.com/top-rated-patient-advocates-for-claim-denials-dont-hire-yet/) - Stop before you hire. This guide reveals how to truly vet top rated patient advocates for claim denials. Learn what to look for to avoid a costly mistake.
- [Patient Advocate vs Medical Billing Advocate: Read This First](https://www.medicalinsuranceadvocacy.com/patient-advocate-vs-medical-billing-advocate-read-this-first/) - Hiring the wrong help is a costly error. Our guide on patient advocate vs medical billing advocate clarifies the critical differences. Don't make a mistake.
- [The Policy Did Not Cover MRI?](https://www.medicalinsuranceadvocacy.com/the-policy-did-not-cover-mri/) - 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. Adria
- [Your Insurance Company Will Not Cover Everything](https://www.medicalinsuranceadvocacy.com/your-insurance-company-will-not-cover-everything/) - 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
- [Are You Really Covered by Your Medicare Advantage Plan?](https://www.medicalinsuranceadvocacy.com/are-you-really-covered-by-your-medicare-advantage-plan/) - 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
- [Denied Medical Claim While on Health Marketplace](https://www.medicalinsuranceadvocacy.com/denied-medical-claim-while-on-health-marketplace/) - 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
- [Medical Bill Reduced from $150,000 to $5,000 With Travel Insurance](https://www.medicalinsuranceadvocacy.com/medical-bill-reduced-from-150000-to-5000-with-travel-insurance/) - 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
- [Are New Employees Covered by Self Insurance Coverage?](https://www.medicalinsuranceadvocacy.com/are-new-employees-covered-by-self-insurance-coverage/) - 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
- [Out of Network Providers Can Still be Paid by Insurance](https://www.medicalinsuranceadvocacy.com/out-of-network-providers-can-still-be-paid-by-insurance/) - 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
- [Misinformed About What Medical Insurance Covers](https://www.medicalinsuranceadvocacy.com/misinformed-about-what-medical-insurance-covers/) - 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
- [$85,000 Pre-authorized Medical Bill Denied](https://www.medicalinsuranceadvocacy.com/85000-pre-authorized-medical-bill-denied/) - 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
- [Rehab for Drugs and Alcohol $70,000 Bill Denied](https://www.medicalinsuranceadvocacy.com/rehab-for-drugs-and-alcohol-70000-bill-denied/) - I had a recent case where my client wound up in a rehab for drugs and alcohol. They told my client that they would be at this facility for two weeks and believe it or not, they were demanding $70,000. That means the cost was $35, $35,000 per week. I could not believe that prior
- [Coma Patient with a $300,000 CoPay?](https://www.medicalinsuranceadvocacy.com/coma-patient-with-a-300000-copay/) - I have to tell you this story. You have a traumatic brain injury and you wind up being in a coma for two months. Your commercial insurer informs your family that you will. They will definitely cover you, but after you leave the facility, you get a bill for over $300,000, which the provider claims
- [$6,000 Podiatry Bill Reduced to $750](https://www.medicalinsuranceadvocacy.com/6000-podiatry-bill-reduced-to-750/) - I hope this never happens to you. You have a really bad injury to your big toe. You go to a podiatrist who explains to you that the bill should be no more than $2,000. You go home and what do you do? You get a bill in the mail for 6,500, not 2000. I
- [ER Medical Bill Not Medical Necessary?](https://www.medicalinsuranceadvocacy.com/er-medical-bill-not-medical-necessary/) - 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
- [Thrown Out of Rehab While on Medicare](https://www.medicalinsuranceadvocacy.com/thrown-out-of-rehab-while-on-medicare/) - 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
- [Duplicate Bills from Same Procedure?](https://www.medicalinsuranceadvocacy.com/duplicate-bills-from-same-procedure/) - 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
- [$15,000 Medical Bill for Severe Burns Reduced](https://www.medicalinsuranceadvocacy.com/15000-medical-bill-for-severe-burns-reduced/) - 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
- [Food Poison $11,000 Medical Bill Down to $1,100](https://www.medicalinsuranceadvocacy.com/food-poison-11000-medical-bill-down-to-1100/) - 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%
- [Bee Sting Leads to Emergency Room Bill Not Covered by Insurance](https://www.medicalinsuranceadvocacy.com/bee-sting-leads-to-emergency-room-bill-not-covered-by-insurance/) - 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
- [Got a Bill from a Doctor You've Never Seen](https://www.medicalinsuranceadvocacy.com/got-a-bill-from-a-doctor-youve-never-seen/) - 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
- [$9,400 Medical Bill Reduced to $200](https://www.medicalinsuranceadvocacy.com/9400-medical-bill-reduced-to-200/) - Do you have a very high deductible and you cannot afford to pay your medical bills? I had a case recently for $9,400 and thank you. Was able to bring it down to 200. Please call Medwise. I’m here to help you. Thank you. Adria Gross See Full Bio
- [If Your Medical Bill Should Have Been Paid Here's What to Do](https://www.medicalinsuranceadvocacy.com/if-your-medical-bill-should-have-been-paid-heres-what-to-do/) - Have you been denied on a medical bill which you should have been paid? I recently had a case for an emergency room where the insurer felt it wasn’t medically necessary to go to the emergency room. When we discussed the severity of the case and how my client was unable to go to an
- [Out of Network Bill Not Paid?](https://www.medicalinsuranceadvocacy.com/out-of-network-bill-not-paid/) - 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 out of network, so you receive a bill for $8,000. My client called me when this happened to them, and guess what? They only had
- [Will COBRA Cover You Over Age 65?](https://www.medicalinsuranceadvocacy.com/will-cobra-cover-you-over-age-65/) - So you’re over 65 years old and you’re working for an employer who has over 20 employees. Now you’re about to retire and you’re applying for Cobra. The question is, will Cobra cover you? Because you are now over the age of 65, please call me and let’s discuss the next steps you should take.
- [Frustration for Denied Insurance Claims Escalate](https://www.medicalinsuranceadvocacy.com/frustration-for-denied-insurance-claims-escalate/) - Americans are crushed by skyrocketing premiums, crippling the medical debt and denial of care that really this devastates millions of lives. It should be no surprise that frustration has reached a boiling point, igniting a fierce, widespread demand for real systemic change. Ordinary people are clear that insurance companies don’t exist to protect their health,
- [The Colonoscopy That Was Almost Not Covered](https://www.medicalinsuranceadvocacy.com/the-colonoscopy-that-was-almost-not-covered/) - You know, Medicare Advantage is often touted as as beneficial, but most people believe it to be a scam. It’s particularly, particularly harmful to those with severe health issues. These plans often deny necessary care and delay treatments, jeopardizing patient health. Ultimately, the United States healthcare system’s reliance on private insurers and their administrative complexities
- [Navigating Healthcare Challenges: The Story of Adria Gross](https://www.medicalinsuranceadvocacy.com/navigating-healthcare-challenges-the-story-of-adria-gross/) - In this episode, we hear the compelling story of Adria Gross, a nationally recognized medical insurance advocate and author, who has transformed her life challenges into advocacy for individuals struggling with medical insurance claims.
- [Why Every Texan Needs a Medical Advocate Texas Today](https://www.medicalinsuranceadvocacy.com/why-every-texan-needs-a-medical-advocate-texas-today/) - Take control of your care with a trusted medical advocate Texas who knows the system and fights for what’s fair in your medical journey.
- [Hospital Billing Advocate Secrets Doctors Don’t Tell You](https://www.medicalinsuranceadvocacy.com/hospital-billing-advocate-secrets-doctors-dont-tell-you/) - A hospital billing advocate helps you fight billing errors, reduce costs, and deal with insurers—don’t overpay for care you didn’t get. Learn how to get help.
- [Why Hospital Based Billing vs Professional Billing Matters](https://www.medicalinsuranceadvocacy.com/why-hospital-based-billing-vs-professional-billing-matters/) - Discover the real cost differences between hospital based billing vs professional billing and how it could impact your medical expenses more than you think.
- [Hire a Medical Billing Advocate to Cut Hidden Costs](https://www.medicalinsuranceadvocacy.com/hire-a-medical-billing-advocate-to-cut-hidden-costs/) - Don’t face medical bills alone. Hire a medical billing advocate to help you lower costs, challenge errors, and get peace of mind every step of the way.
- [Why You Should Hire a Healthcare Advocate Today](https://www.medicalinsuranceadvocacy.com/why-you-should-hire-a-healthcare-advocate-today/) - Learn why thousands now hire a healthcare advocate to fight insurance denials, decode billing, and protect their health rights with expert precision.
- [Cut Medical Costs with a Healthcare Billing Advocate](https://www.medicalinsuranceadvocacy.com/cut-medical-costs-with-a-healthcare-billing-advocate/) - Overwhelmed by medical bills? A healthcare billing advocate can analyze charges, appeal insurance issues, and cut thousands from what you owe.
- [How Health Insurance Claim Advocates Win Appeals](https://www.medicalinsuranceadvocacy.com/how-health-insurance-claim-advocates-win-appeals/) - Discover how health insurance claim advocates navigate denials, resolve claim disputes, and protect your rights with expert-level knowledge and strategy.
- [How a Health Insurance Billing Advocate Saves You Big](https://www.medicalinsuranceadvocacy.com/how-a-health-insurance-billing-advocate-saves-you-big/) - A health insurance billing advocate can fight denied claims, fix costly errors, and negotiate charges—saving you time, money, and endless stress.
- [Why You Need a Health Insurance Advocate Right Now](https://www.medicalinsuranceadvocacy.com/why-you-need-a-health-insurance-advocate-right-now/) - Struggling with your insurance company? A health insurance advocate can handle the battle for you. Here’s what they do and why they’re worth every penny.
- [Health Advocate Bill Saver Can Slash Your Medical Bills](https://www.medicalinsuranceadvocacy.com/health-advocate-bill-saver-can-slash-your-medical-bills/) - Use Health Advocate Bill Saver to review, dispute, and cut down costly medical bills with expert support. Here's how it works and why it pays to use it.
- [How to Dispute Medical Bill Collections Like a Pro](https://www.medicalinsuranceadvocacy.com/how-to-dispute-medical-bill-collections-like-a-pro/) - Dispute medical bill collections the right way with expert tips on validation, negotiation, and credit protection for patients facing aggressive billing.
- [Can You Sue a Medical Billing Company for Overcharges?](https://www.medicalinsuranceadvocacy.com/can-you-sue-a-medical-billing-company-for-overcharges/) - Wondering can you sue a medical billing company? Learn when legal action is justified, what laws protect you, and how to fight back against unfair charges.
- [New Jersey Medical Billing Advocates Expose Hidden Fees](https://www.medicalinsuranceadvocacy.com/new-jersey-medical-billing-advocates-expose-hidden-fees/) - Confused by medical bills? New Jersey medical billing advocates offer expert help to lower costs, fix errors, and win coverage battles with insurers.
- [New York Medical Billing Advocates Can Slash Your Bill](https://www.medicalinsuranceadvocacy.com/new-york-medical-billing-advocates-can-slash-your-bill/) - New York medical billing advocates help patients fight overcharges, reduce costs, and understand complex bills. Here's how they can help you save big.
- [Can You Negotiate Health Care Bills? 7 Tricks That Work](https://www.medicalinsuranceadvocacy.com/can-you-negotiate-health-care-bills-7-tricks-that-work/) - Can you negotiate health care bills with hospitals or insurers? Yes—discover insider strategies to lower what you owe and avoid common billing traps.
- [Why the Best Medical Bill Advocate Saves You Thousands](https://www.medicalinsuranceadvocacy.com/why-the-best-medical-bill-advocate-saves-you-thousands/) - Discover how the best medical bill advocate can help you cut costs, fight denied claims, and decode confusing charges with expert precision.
- [What Advocates for Insurance Benefits Know That You Don’t](https://www.medicalinsuranceadvocacy.com/what-advocates-for-insurance-benefits-know-that-you-dont/) - Discover how advocates for insurance benefits can fight denied claims, lower your bills, and unlock the coverage you’ve already paid for—without the stress.
- [Advocate Health Care Billing Secrets Every Patient Should Know](https://www.medicalinsuranceadvocacy.com/advocate-health-care-billing-secrets-every-patient-should-know/) - Discover how advocate health care billing works, common billing traps, and the insider tactics to dispute and lower your medical costs fast.
- [Who's Processing Your Medical Bills?](https://www.medicalinsuranceadvocacy.com/whos-processing-your-medical-bills/) - In a conversation between Edison Guzman and Adria Gross of MedWise Insurance Advocacy, they discuss the significant impact of who processes medical bills. Adria highlights that when third-party billing companies handle claims, especially those paid on a percentage basis (a common practice outside of states like New York), it becomes exceedingly difficult for patients to
- [How to Appeal a Medical Claim Denial](https://www.medicalinsuranceadvocacy.com/how-to-appeal-a-medical-claim-denial/) - 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
- [How CPT Code Errors Can Lead to Medical Claim Denials](https://www.medicalinsuranceadvocacy.com/how-cpt-code-errors-can-lead-to-medical-claim-denials/) - 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
- [Insurance Claim Denied? Don't Give Up! Steps to Get Denied Medical Claims Paid](https://www.medicalinsuranceadvocacy.com/insurance-claim-denied-dont-give-up-steps-to-get-denied-medical-claims-paid/) - 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
- [Struggling with Medical Bills? You Have Options](https://www.medicalinsuranceadvocacy.com/struggling-with-medical-bills-you-have-options/) - As the founder of Medwise Insurance Advocacy, I’ve spent years helping countless individuals navigate the often-turbulent waters of healthcare costs. One of the most common and stressful situations people face is figuring out how to pay medical bills, especially unexpected or large ones. The sticker shock from a hospital stay or complex procedure can be
- [Overwhelmed by Medical Bills? You're Not Alone](https://www.medicalinsuranceadvocacy.com/overwhelmed-by-medical-bills-youre-not-alone/) - For years, through Medwise Insurance Advocacy, I’ve dedicated my career to helping patients navigate the often confusing and overwhelming world of medical bills and health insurance. If you’ve ever opened a medical bill and felt your heart sink, confused by codes, charges, and jargon you don’t understand, please know: you are certainly not alone. The
- [Unexpected Medical Bills May Not be Real](https://www.medicalinsuranceadvocacy.com/unexpected-medical-bills-may-not-be-real/) - Did you receive an unexpected bill in the mail after you thought all your claims were processed? Some medical providers are bought out by a new company and that new company might feel that you owed additional money. I had a case like this, uh, recently where my client’s claims were all taken care of, and
- [Emergency Room Charges of $9,500 Dropped to $1,800](https://www.medicalinsuranceadvocacy.com/emergency-room-charges-of-9500-dropped-to-1800/) - I worked on a case recently where the maximum charges for the emergency room should have been no more than a thousand dollars.The hospital was paid 90 509,500 and they were still billing my client for an additional $1,800. When I reached out to the billing of the emergency room charges that were $1,800, believe it
- [Where You Charged for a Medical Bill You've Already Paid?](https://www.medicalinsuranceadvocacy.com/where-you-charged-for-a-medical-bill-youve-already-paid/) - You know, I help people to make sure that once they have paid a claim, they never pay it again. Too often people are charged multiple times for one individual bill and they do not realize that they have already paid it. I recently worked with a client who didn’t realize they had paid out $8,000 for
- [Anesthesiolgist Bill Not Covered](https://www.medicalinsuranceadvocacy.com/anesthesiolgist-bill-not-covered/) - Have you received the bill for anesthesiology after being covered for pregnancy and delivery? If they never informed you that the provider was out of network and now you’re being charged a tremendous bill, please reach out to MedWise because there’s a great chance that we will either get your bill reduced to a very small
- [Air Ambulance Charges Not Covered](https://www.medicalinsuranceadvocacy.com/air-ambulance-charges-not-covered/) - Have you recently received an air ambulance bill for thousands of dollars? All too often people receive air ambulance charges, which should be covered on their policy. I recently overturned an air ambulance bill for $75,000. The laws change in 2020 and they have no right to overbill you at all, please call me. I’m here to help you.
- [Your Explanation of Benefits](https://www.medicalinsuranceadvocacy.com/your-explanation-of-benefits/) - Hello, my friends. Did this ever happen to you? You have been in a situation where your explanation of benefits indicates you have a zero balance, but the medical provider is still billing you for tens of thousands of dollars. I recently overturned a case where the explanation of benefits said my client owed zero,
- [Are You Really Responsible for Those Medical Bills?](https://www.medicalinsuranceadvocacy.com/are-you-really-responsible-for-those-medical-bills/) - Have you received multiple bills being in a hospital? Are you questioning whether or not you are really responsible to pay these bills? Very often people receive their explanation of benefits and feel that they have to pay for additional services. I had a client recently who looked at their explanation of benefits for $6,000. Guess what? They
- [Have You Ever Challenged Your Denied Claim](https://www.medicalinsuranceadvocacy.com/have-you-ever-challenged-your-denied-claim/) - Have you ever challenged your denied claim? Reach out to Medwise and we will negotiate fair payment plans. Many times you might think that you’re responsible to pay this bill, but all too often I look at the charges and determine that they should be covered on your policy.Recently I had a case where the client was
- [Is Balanced Billing Legal?](https://www.medicalinsuranceadvocacy.com/is-balanced-billing-legal/) - Have you ever been balance billed? That is illegal. If you have met your deductibles for the year, I recently overturned a case where my client was being balance billed for $16,000. Please call me if you have any suspicion that they’re charging you too much. I’m here to help you. Thank you. Adria Gross See Full
- [What if the Emergency Room Provider Is Out of Network?](https://www.medicalinsuranceadvocacy.com/what-if-the-emergency-room-provider-is-out-of-network/) - Have you recently received a bill from an emergency room group of providers because they were out of network a week ago? I received a claim for over $26,000 because the providers in the emergency room were out of network. If this happens to you, please reach out to me.I reduce that bill from $26,000
- [Do You Know Your Medical Policy's Benefits?](https://www.medicalinsuranceadvocacy.com/do-you-know-your-medical-policys-benefits/) - Very often people do not realize what the benefits are on their policies. The policy might cover you for other services besides just the bill for a specific procedure code. Please reach out to Med Midwife, so look at your entire policy and explanation of benefits. Many cases where the claims are partially paid and
- [MedWise Resolves Medical Claims Bills for You](https://www.medicalinsuranceadvocacy.com/medwise-resolves-medical-claims-bills-for-you/) - Medwise continuously resolves medical bill disputes. Very often when the insurance company looks at the bill, it’s immediately denied. Medwise examines the charges, and most of the cases that Medwise handles are resolved, saving my clients thousands of dollars. Please remember me, Medwise, I’m here to help you.Thank you. Adria Gross See Full Bio
- [Don't be Afraid to Ask Your Medical Provider a Question](https://www.medicalinsuranceadvocacy.com/dont-be-afraid-to-ask-your-medical-provider-a-question/) - You know, all too often seniors are frightened to ask questions to their medical providers before every visit. It’s best that you think about the questions you plan on asking your medical provider. Patients need to be educated about their legal rights. If something doesn’t seem right, and especially if you feel that you’re being
- [Are You Still Covered for Your Doctor?](https://www.medicalinsuranceadvocacy.com/are-you-still-covered-for-your-doctor/) - You know, all clients need to be educated on the doctors, hospitals and treatment that they are covered for. So often you might see a list of doctors and hospitals, which are no longer covered on your policy. One of my recent clients was in an emergency room and the pathologist was charging my client
- [CT Scan Bill Reduced from $18,000 to $400](https://www.medicalinsuranceadvocacy.com/ct-scan-bill-reduced-from-18000-to-400/) - My friends too often when people come to me as they’re realizing that they had been charged $18,000 for a CT scan. When looking at your charges, very often they’re erroneous and you are being gouged on your bill. I recently saved my client tons of money by reducing his CT scan bill of $18,000 down to
- [Are You Sure Your Medical Bill is Accurate?](https://www.medicalinsuranceadvocacy.com/are-you-sure-your-medical-bill-is-accurate/) - Are you sure your bill is accurate? Much too often people are double and triple billed for services. Some of the services are very often not even supposed to be charged. Reach out to MEDWISE for accuracy on your bills. Midwives saves tons of money for people on their medical charges. I recently had a case where one procedure code
- [Where You Charged for Your Annual Wellness Care Bill?](https://www.medicalinsuranceadvocacy.com/where-you-charged-for-your-annual-wellness-care-bill/) - 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
- [Can Support Groups Help With Your Medical Condition?](https://www.medicalinsuranceadvocacy.com/can-support-groups-help-with-your-medical-condition/) - 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
- [Traumatic Brain Injury Medical Bills](https://www.medicalinsuranceadvocacy.com/traumatic-brain-injury-medical-bills/) - 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
- [What to do if Your Surgeon is Not Covered by Insurance](https://www.medicalinsuranceadvocacy.com/what-to-do-if-your-surgeon-is-not-covered-by-insurance/) - 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
- [What If Your Insurer Ask for Their Money Back](https://www.medicalinsuranceadvocacy.com/what-if-your-insurer-ask-for-their-money-back/) - 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
- [What You Need to Know About Insurance Before Turning 65](https://www.medicalinsuranceadvocacy.com/what-you-need-to-know-about-insurance-before-turning-65/) - 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
- [Decoding Your Hospital Bill - Understanding CPT Codes, EOBs, and Overcharges](https://www.medicalinsuranceadvocacy.com/decoding-your-hospital-bill-understanding-cpt-codes-eobs-and-overcharges/) - Feeling lost or outraged when you look at a hospital bill? You’re not alone, and help is here! Watch this crucial interview with Edison Guzman and insurance advocate Adria Gross to uncover the secrets hospitals might not want you to know. Learn exactly what to demand on your bill (using specific codes!) to verify every
- [Heart Surgery Recommendation Was Not Necessary](https://www.medicalinsuranceadvocacy.com/heart-surgery-recommendation-was-not-necessary/) - One of my clients was told he had to have heart surgery. He went through multiple tests and when he went back to the cardiologist, he was recommended multiple times to have heart surgery. It was very confusing since he was able to walk more than three miles a day and never was out of
- [Do This to Know What's Covered in Your Policy](https://www.medicalinsuranceadvocacy.com/do-this-to-know-whats-covered-in-your-policy/) - Insurance companies very often give you a brochure or it’s like a six to 10 page, so-called policy, which describes what’s covered and what’s not covered on the policy. On that six to 10 page, so-called policy, there will be a list of coverages and exclusions. It’s so important to look at the entire insurance
- [Need a Second Opinion for Orthopedic Surgeon?](https://www.medicalinsuranceadvocacy.com/need-a-second-opinion-for-orthopedic-surgeon/) - Years ago I had a baker cyst on my right knee. I went to an orthopedic doctor who drained my knee three times. The fluid kept on coming back. He recommended that I see an orthopedic surgeon. They were about to do surgery and I met up with a doctor friend of mine who is
- [$52,000 Overturned After 3 Times Denied Medical Claim](https://www.medicalinsuranceadvocacy.com/52000-overturned-after-3-times-denied-medical-claim/) - I have to tell you many times I have people come to me where they know that their medical bill should be covered. According to the health insurance policy, very often the policy indicates that you should be covered for a certain procedure, but the insurance companies deliberately deny your claim. I was educated on
- [Knowing Your Patients Rights Saves Over $34,000](https://www.medicalinsuranceadvocacy.com/knowing-your-patients-rights-saves-over-34000/) - Being a patient advocate, I’m always concerned about patient’s rights and protect them from unfair billing practices. If I see a case where there are issues with medical billing, I always step in to help my clients. I recently overturned a case where my client was being charged an excessive amount by an emergency room,
- [How I Reduced a Medical Bill from $40,000 to $2,000](https://www.medicalinsuranceadvocacy.com/how-i-reduced-a-medical-bill-from-40000-to-2000/) - You know, being in the health insurance industry for over 30 years, I am quite successful in negotiating medical bills. In many cases, I normally get 80% off the bill, and sometimes you might be responsible for no charges whatsoever. I recently reduced a bill from $40,000 down to $2,000. Please reach out to me.
- [Why You Need to Read Your Insurance Policy](https://www.medicalinsuranceadvocacy.com/why-you-need-to-read-your-insurance-policy/) - You know, it’s so important that you take the time to read your insurance policy. When I was working for two insurance companies, I helped write those insurance policies. You truly need to know what’s covered and what’s not covered. If you ever have any questions and have no idea what your policy really means,
- [What to do If Emergency Room is Out of Network](https://www.medicalinsuranceadvocacy.com/what-to-do-if-emergency-room-is-out-of-network-2/) - You know I recently spoke to a friend who works for a major corporation on her policy. Every emergency room visit is considered to be out of network. Instead of going to an emergency room, the insured’s must go to an urgent care facility. She went to the local urgent care facility and then was
- [$29,000 for Two Emergency Room Visits?](https://www.medicalinsuranceadvocacy.com/29000-for-two-emergency-room-visits/) - A recent case I worked on the client was charged for two of emergency room visits a total of 29,000 when I looked at the reasonable customer charges I realize that my client only had to pay $800 out of $29,000 medical practice are gouging much too often and I am here to help you
- [What to do If Emergency Room is Out of Network](https://www.medicalinsuranceadvocacy.com/what-to-do-if-emergency-room-is-out-of-network/) - I recently spoke to a friend who works for a major corporation on her policy every emergency room visit is considered to be out of network instead of going to an emergency room the insurance must go to an urgent care facility and then was sent to the emergency room when I was able to
- [How $50,000 in Medical Debt Went Down to $0](https://www.medicalinsuranceadvocacy.com/how-50000-in-medical-debt-went-down-to-0/) - One of my clients have denied claim with the original charges were over $50,000 when I was able to prove that those charges should be covered according to the wording of the health insurance policy my client wound up always zero out of $50,000 any questions you have please call me I’m here to help
- [How Medical Claim Laws Will Affect You in the Future](https://www.medicalinsuranceadvocacy.com/how-medical-claim-laws-will-affect-you-in-the-future/) - The healthcare landscape is constantly evolving, and with it, the laws governing medical claims. As a patient, it’s essential to stay informed about these changes to ensure you receive the care and coverage you deserve. Medwise Insurance Advocacy is here to help you navigate the complexities of medical claim laws and understand how they may
- [Getting Medically Covered When Traveling Outside of the Country](https://www.medicalinsuranceadvocacy.com/getting-medically-covered-when-traveling-outside-of-the-country/) - Traveling outside of the country can be a great way to experience new cultures and see new places. However, it is important to be aware of the potential risks associated with traveling abroad, including the risk of medical emergencies. If you are planning a trip outside of the country, it is important to make sure
- [How to Get Your Medical Bills Paid After a Denial of Benefits](https://www.medicalinsuranceadvocacy.com/how-to-get-your-medical-bills-paid-after-a-denial-of-benefits/) - Receiving a denial of benefits for your medical bills can be a frustrating and confusing experience. However, it is important to remember that you have rights as a patient, and there are steps you can take to get your bills paid. Understanding the Denial Process Before you can take action, it is important to understand
- [Why You Need a Medical Billing Advocate When Insurance Says "No"](https://www.medicalinsuranceadvocacy.com/why-you-need-a-medical-billing-advocate-when-insurance-says-no/) - Navigating the labyrinth of medical billing can feel like deciphering an alien language. One minute you’re recovering from a procedure, the next you’re staring at a denial letter from your insurance company, leaving you bewildered and, frankly, terrified. At MedWise Insurance Advocacy, we understand the frustration and confusion that comes with denied medical claims. That’s
- [Reducing Your Medical Bills](https://www.medicalinsuranceadvocacy.com/reducing-your-medical-bills/) - This interview focuses on ways to reduce medical bills, as discussed in Adria Gross’s book. Edison Guzman introduces the topic, emphasizing its relevance given the new administration and potential changes in healthcare policies. Adria Gross, as an expert in medical insurance advocacy, shares her insights on various strategies to lower medical expenses. Medical Billing Advocacy
- [What's the Best Type of Drug Plan for You and Your Family?](https://www.medicalinsuranceadvocacy.com/whats-the-best-type-of-drug-plan-for-you-and-your-family/) - In today’s world, understanding your health insurance can feel like deciphering a complex code. When it comes to drug plans, the confusion only deepens. That’s why we sat down with Adria Guzman of Math Wise Insurance Advocacy to shed some light on this crucial topic. Adria’s expertise in navigating the intricacies of medical insurance is
- [The Power of Price Transparency - Taking Control of Your Healthcare Costs](https://www.medicalinsuranceadvocacy.com/the-power-of-price-transparency-taking-control-of-your-healthcare-costs/) - Healthcare costs can be unpredictable and often feel opaque. You might know you need a procedure, but have no idea what it will actually cost until you receive a surprise bill weeks later. This lack of price transparency has left many patients feeling helpless. However, the landscape is changing. Increased awareness and new regulations are
- [Using a Health Savings Account (HSA) or Flexible Spending Account (FSA)](https://www.medicalinsuranceadvocacy.com/using-a-health-savings-account-hsa-or-flexible-spending-account-fsa/) - Healthcare expenses can be a significant burden, but there are tools available to help you manage these costs effectively. Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) are tax-advantaged savings accounts that allow you to set aside money for qualified medical expenses. At Medwise Insurance Advocacy, we understand the importance of maximizing your healthcare
- [Negotiating Medical Bills: Tips and Tricks for Lowering Your Healthcare Costs](https://www.medicalinsuranceadvocacy.com/negotiating-medical-bills-tips-and-tricks-for-lowering-your-healthcare-costs/) - Medical bills can be a significant source of stress, especially when they seem unexpectedly high or contain errors. At Medwise Insurance Advocacy, we empower you to take control of your healthcare finances. Negotiating medical bills is often possible, and this blog post will provide valuable tips and tricks to help you lower your out-of-pocket expenses.
- [What to Do When Your Insurance Denies a Claim](https://www.medicalinsuranceadvocacy.com/what-to-do-when-your-insurance-denies-a-claim/) - Receiving a claim denial from your health insurance company can be frustrating and confusing. It can feel like a roadblock in accessing necessary medical care. At Medwise Insurance Advocacy, we understand the stress and uncertainty that come with claim denials. This blog post will provide a step-by-step guide on what to do when your insurance
- [Understanding Deductibles, Co-pays, and Coinsurance](https://www.medicalinsuranceadvocacy.com/understanding-deductibles-co-pays-and-coinsurance/) - Navigating the world of health insurance can feel like deciphering a foreign language. Terms like “deductible,” “co-pay,” and “coinsurance” are frequently used, but their meanings are often misunderstood. At Medwise Insurance Advocacy, we believe that understanding these key concepts is crucial for managing your healthcare expenses effectively. This blog post will break down these terms
- [Common Medical Billing Errors to Watch Out For](https://www.medicalinsuranceadvocacy.com/common-medical-billing-errors-to-watch-out-for/) - Medical billing can be a minefield of codes, jargon, and potential errors. At Medwise Insurance Advocacy, we understand how frustrating and overwhelming it can be to decipher medical bills and ensure their accuracy. This blog post will highlight some of the most common medical billing errors to watch out for, empowering you to take control
- [Navigating In-Network vs. Out-of-Network Costs](https://www.medicalinsuranceadvocacy.com/navigating-in-network-vs-out-of-network-costs/) - Healthcare costs can be confusing, especially when it comes to understanding the difference between in-network and out-of-network providers. At Medwise Insurance Advocacy, we’re dedicated to helping you navigate these complexities and make informed decisions about your healthcare. This blog post will explain the distinctions between in-network and out-of-network costs, empowering you to minimize your out-of-pocket
- [Decoding Your EOB (Explanation of Benefits)](https://www.medicalinsuranceadvocacy.com/decoding-your-eob-explanation-of-benefits/) - At Medwise Insurance Advocacy, we understand that navigating the world of medical bills and insurance can be overwhelming. One of the most confusing, yet essential, documents you’ll encounter is the Explanation of Benefits (EOB). It’s not a bill itself, but rather a breakdown of how your insurance company processed a claim. Think of it as
- [Why Medical Insurance Companies Deny Claims](https://www.medicalinsuranceadvocacy.com/why-medical-insurance-companies-deny-claims/) - In this insightful interview, Edison Guzman speaks with Adria Gross, founder of Medwise Insurance Advocacy, about the challenges and solutions surrounding denied medical claims. Adria shares her expertise as a former insurance claims processor who now helps individuals fight back against unjust claim denials. The discussion begins with common reasons for claim denials, including procedural
- [Tips for Reversing Health Insurance Claims Denials](https://www.medicalinsuranceadvocacy.com/tips-for-reversing-health-insurance-claims-denials/) - By Heather Sullivan – Published December 9, 2024 10:27am CST – Sullivan’s Smart Sense FOX 26 Houston The murder of UnitedHealthcare CEO Brian Thompson, and the suspicion that it may have been over insurance claim denials, is shining a new spotlight on the issue. There’s no way to know what percentage of health insurance claims are denied, as carriers are
- [Overcoming Medical Insurance Denial](https://www.medicalinsuranceadvocacy.com/overcoming-medical-insurance-denial/) - If you’ve ever received a medical insurance denial, you know the frustration, confusion, and stress it can bring. A denied insurance claim, especially for essential medical care, can disrupt not only your financial stability but also your peace of mind. At Medwise Insurance Advocacy, we have dedicated over 25 years to helping individuals and families
- [Navigating Insurance Claims with Confidence](https://www.medicalinsuranceadvocacy.com/navigating-insurance-claims-with-confidence/) - If you’ve ever faced a challenging insurance claim, you know how complex and overwhelming the process can be. From confusing jargon to lengthy paperwork and frustrating denials, dealing with insurance claims can quickly become a full-time job. That’s where an insurance claim advocate comes in—a trained professional with expertise in navigating the claims process, ensuring
- [Understanding Insurance Denials](https://www.medicalinsuranceadvocacy.com/understanding-insurance-denials/) - As the CEO and founder of MedWise Insurance Advocacy, I have dedicated my career to assisting individuals in overcoming these challenges. Drawing from over 25 years of experience in the insurance industry, I understand the intricacies of medical billing and the frustration that comes with claim denials. Understanding Insurance Denials Insurance claim denials occur for
- [Why Consult a Health Insurance Advocate?](https://www.medicalinsuranceadvocacy.com/why-consult-a-health-insurance-advocate/) - Even with comprehensive coverage, many individuals find themselves facing significant out-of-pocket expenses. This is where a health insurance advocate becomes invaluable, guiding patients through the intricate healthcare system and ensuring they receive the benefits they’re entitled to. Understanding the Role of a Health Insurance Advocate A health insurance advocate is a professional dedicated to assisting
- [The Role of a Healthcare Advocate is to Reduce or Eliminate Medical Bills](https://www.medicalinsuranceadvocacy.com/the-role-of-a-healthcare-advocate-is-to-reduce-or-eliminate-medical-bills/) - A healthcare advocate serves as a vital ally, guiding patients through medical processes, ensuring their rights are upheld, and facilitating effective communication between patients and healthcare providers. Understanding the Role of a Healthcare Advocate A healthcare advocate is a professional dedicated to assisting patients in various aspects of their healthcare journey. Their responsibilities include: Educating
- [Why An Insurance Claims Advocate Serves as a Crucial Ally](https://www.medicalinsuranceadvocacy.com/why-an-insurance-claims-advocate-serves-as-a-crucial-ally/) - An insurance claims advocate serves as a crucial ally, guiding policyholders through the claims process, ensuring fair treatment, and maximizing entitled benefits. Understanding the Role of an Insurance Claims Advocate An insurance claims advocate is a professional dedicated to assisting policyholders in managing and resolving insurance claims. Their responsibilities include: Claims Management: Overseeing the entire
- [Can a Medical Billing Advocate Help With Bills?](https://www.medicalinsuranceadvocacy.com/can-a-medical-billing-advocate-help-with-bills/) - A medical billing advocate serves as a crucial ally, assisting patients in understanding and managing their medical expenses, ensuring accuracy, and advocating for fair treatment within the healthcare system. Understanding the Role of a Medical Billing Advocate A medical billing advocate is a professional dedicated to assisting patients with various aspects of medical billing and
- [Do You Know the Role of a Patient Advocate?](https://www.medicalinsuranceadvocacy.com/do-you-know-the-role-of-a-patient-advocate/) - A patient advocate serves as a crucial ally, guiding individuals through the healthcare system, ensuring their rights are upheld, and facilitating effective communication between patients and healthcare providers. Understanding the Role of a Patient Advocate A patient advocate is a professional dedicated to assisting patients in various aspects of their healthcare journey. Their responsibilities include:
- [Understanding the Role of a Health Insurance Advocate](https://www.medicalinsuranceadvocacy.com/understanding-the-role-of-a-health-insurance-advocate/) - The Role of a Health Insurance Advocate helps navigate the complexities of health insurance. This can be daunting, especially when unexpected medical bills arise. Even with comprehensive coverage, many individuals find themselves facing significant out-of-pocket expenses. This is where a health insurance advocate becomes invaluable, guiding patients through the intricate healthcare system and ensuring they
- [Medical Bill Issues](https://www.medicalinsuranceadvocacy.com/medical-bill-issues/) - Hello everyone. Hydrocephalus is water on the brain, and many times it occurs as a result of an injury. If you’re having issues with your medical charges or coverage for medication, please reach out to Medwise. We are here to help you with all of your medical bills. Thank you so much. Adria Gross See Full Bio
- [Pre-Authorization Surgery Not Covered](https://www.medicalinsuranceadvocacy.com/pre-authorization-surgery-not-covered/) - You have pre-authorization for a surgery. It just so happens that the doctor has an emergency and is not able to perform the surgery as scheduled. You go back to the hospital 10 days later, and the surgery is performed. However, because the surgery was not performed on the original scheduled date, the insurance company
- [Can Your State Buy Out Your Medical Bills](https://www.medicalinsuranceadvocacy.com/can-your-state-buy-out-your-medical-bills/) - The state of Rhode Island is suggesting using federal COVID-19 funds to pay off unpaid outstanding medical bills. Under the proposal, the state could purchase the debt for pennies on the dollar using American Rescue Plan Act funds and then eliminate the debt entirely for certain Rhode Island residents. New York City has also been
- [Whats a Zebra in Medical Terms?](https://www.medicalinsuranceadvocacy.com/whats-a-zebra-in-medical-terms/) - One of the chapters in my book, Apparently Different, involves a doctor who, after years of twisting his neck while performing colonoscopies—looking at the patient, then the machine—wound up with a severe condition called Barrett’s esophagus. It took quite a long time to determine his condition. This condition is considered a “zebra,” a medical term
- [Does Your Health Care Bill Hurt Your Credit?](https://www.medicalinsuranceadvocacy.com/does-your-health-care-bill-hurt-your-credit/) - Healthcare bills won’t harm your credit as long as you don’t wait too long to settle them. Most of the time, you’re dealing directly with the medical provider, and they aren’t likely to report your payment activity—or lack thereof—to the credit bureaus. This means that while you owe the provider, your credit report will not
- [$85,000 Childbirth Bill Reduced to $5,000](https://www.medicalinsuranceadvocacy.com/85000-childbirth-bill-reduced-to-5000/) - A recent client of mine gave birth to her child, which initially cost her $85,000. This was a premature baby, and the hospitals and doctors were taking advantage of her situation. The family was paying $25 a month, and when I was able to prove that she would never be able to pay that $85,000,
- [Lyme Disease Medical Bill Reimbursement Help](https://www.medicalinsuranceadvocacy.com/lime-disease-medical-bill-reimbursement-help/) - If you haven’t heard yet, Apparently Different is my new book that came out recently. I have a client in the book who wound up with a debilitating life due to Lyme disease. I helped this client in receiving reimbursement for her medical bills. If you need help with denied claims, please call me, Adria. I’m
- [$10,000 Emergency Room Just for Medicine](https://www.medicalinsuranceadvocacy.com/10000-emergency-room-just-for-medicine/) - I don’t know if this has ever happened to you, but have you ever received a bill from an emergency room for over $10,000, and all they did in that emergency room was give you medication? I’ve had many cases like this, and in this particular case, I was able to get a major reduction
- [Emergency Room 3 Day Visit Denies $27,000 Bill](https://www.medicalinsuranceadvocacy.com/emergency-room-3-day-visit-denies-27000-bill/) - It was the middle of the night, and a patient goes to an emergency room in excruciating pain. The ER could not diagnose the condition. My client was kept in the hospital for three days, and the insurance company said there was no need for her to be at the hospital. Even though she went
- [Explanation of Benefits Letter Denies Your Claim](https://www.medicalinsuranceadvocacy.com/explanation-of-benefits-letter-denies-your-claim/) - You are treated and preauthorized for a medical procedure. You go to the hospital where the procedure will take place. They perform the procedure, but then you receive an explanation of benefits from the insurance company stating that the procedure was not medically necessary. I recently overturned a case where the bill was $28,000, and the
- [Denied Medical Claim Because of Non-Preauthorization](https://www.medicalinsuranceadvocacy.com/denied-medical-claim-because-of-non-preauthorization/) - Have you ever been in a situation where you were never informed that a pre-authorization was required? Well, this claim was denied because my client did not have pre-authorization. If this happens to you, please reach out to Medwise. I recently overturned a case that was over $60,000. Please call me, Adria at Medwise Insurance
- [Twisted Intestine $150,000 Bill Reduced to $10,000](https://www.medicalinsuranceadvocacy.com/twisted-intestine-150000-bill-reduced-to-10000/) - You know, it took quite a bit of time, but my client who had a twisted intestine with a medical debt of over $150,000—I was finally able to prove that there was no way my client could afford to pay that amount. Thank goodness, I brought her bill down to $10,000. She took a loan
- [Emergency Room for $8,000 Turns to Zero](https://www.medicalinsuranceadvocacy.com/emergency-room-for-8000-turns-to-zero/) - My client in California went to the emergency room and received a bill for over $5,000. But believe it or not, every month she received a bill that added additional charges of over a thousand dollars a month. Her policy was Medicaid, and when I was able to prove that she could not afford the
- [Out of Network Hospital Bills Denied](https://www.medicalinsuranceadvocacy.com/out-of-network-hospital-bills-denied/) - You vomit and have diarrhea. You go to the emergency room, and the hospital does all these medical tests on you. You were in the hospital for three days only being treated, and now the hospital is saying to you that they were out of network. Wow. I was able to overturn the case and save
- [$60,000 Breast Cancer Bills Down to $2,100](https://www.medicalinsuranceadvocacy.com/60000-breast-cancer-bills-down-to-2100/) - I recently had a case where my client had breast cancer, and her bills were over $60,000. Her oncologist was fighting, not accepting a lower amount. When I was able to prove that there was no way she would be able to afford to pay this bill, we went from $60,000 to $2,100. So if you
- [Over $2500 Medical Debt Reduced to Zero Within 3 Weeks](https://www.medicalinsuranceadvocacy.com/over-2500-medical-debt-reduced-to-zero-within-3-weeks/) - Hello, my friends. You know, my client had a debt of over $2,500. She didn’t know where to turn. When she came to me, I was able to determine that the $2,500 should never have been charged. So within three weeks, I brought her bills down to zero. Please call me if you need help. Adria, Medwise
- [$400,000 Cancer Bills Reduced to $19,000](https://www.medicalinsuranceadvocacy.com/400000-cancer-bills-reduced-to-19000/) - I recently had a client with bills over $400,000 involving cancer. I was so excited to be able to reduce that bill down to $19,000, which is being paid over a three-year period. If you ever need help, please call me, Adrian at Medwise Insurance Advocacy. Thank you. Adria Gross See Full Bio
- [$135,000 Medical Bill Was Finally Settled Down to $20,000](https://www.medicalinsuranceadvocacy.com/135000-medical-bill-was-finally-settled-down-to-20000/) - One of my clients recently had a bill for $135,000. This was a faith-based coverage, which, of course, is not handled through an insurance company. It was a long, drawn-out fight to get this settled, but thankfully, the hospital agreed to $20,000, and my client was able to get funding from his family to pay
- [New Book Apparently Different Released](https://www.medicalinsuranceadvocacy.com/new-book-apparently-different-released/) - For those of you who don’t know, I recently published a new book titled Apparently Different. My new book, Apparently Different, is available on Amazon. Just go to amazon.com, type in Apparently Different, and you can read the description. If you’re interested, you can purchase it there. Everybody knows someone with a disability who has
- [Water Skiing Accident Turns Into Denied Medical Charges](https://www.medicalinsuranceadvocacy.com/water-skiing-accident-turns-into-denied-medical-charges/) - One of the chapters in my book, Apparently Different, is titled A Prisoner in My Own Body from Traumatic Brain Injury. My client was water skiing at the age of 16 and wound up injuring themselves, becoming, I hate to say this, partially paralyzed, and believe it or not, they even went into a coma. I hope
- [Medical Bills for Rape Were Written Off Because of This](https://www.medicalinsuranceadvocacy.com/medical-bills-for-rape-were-written-off-because-of-this/) - I have to say this is one of the worst stories I ever heard. My client was raped, and the bills were over $82,000. The case went to court, and finally, the judge she went before felt so sorry for her. They were able to arrange for the bill to be written off, and it
- [Surgery for Large Intestine Medical Bill Denied Was Approved After This](https://www.medicalinsuranceadvocacy.com/surgery-for-large-intestine-medical-bill-denied-was-approved-after-this/) - I had a client who had a very serious infection in her large intestines. The surgery was performed, which her insurance company said wasn’t medically necessary. The bills were over $60,000, and when I was able to prove that it was medically necessary and what could happen to my client if the procedure was never
- [Need Help With Surgery Bills Watch this](https://www.medicalinsuranceadvocacy.com/need-help-with-surgery-bills-watch-this/) - Have you ever heard of spina bifida? It’s a birth defect in which a developing baby’s spinal cord fails to develop properly. It occurs when a developing baby’s spinal cord fails to develop or close properly while it’s in the womb. There is no cure for spina bifida, but there are treatments for related conditions. Spina
- [Car Accident Medical Claims Not Paid](https://www.medicalinsuranceadvocacy.com/car-accident-medical-claims-not-paid/) - You know, you ride a bike, and please God, may this never happen to you—have a very bad car accident. So due to that accident, this is what I’ve seen happening: You lose your job. You do not have any health insurance. If this ever happens to you, please reach out to Medwise, and I am sure
- [Mental Health Facility Coverage Denied](https://www.medicalinsuranceadvocacy.com/mental-health-facility-coverage-denied/) - You know, I have seen so many denials for mental health. Very often, someone is unable to receive 24-hour facility coverage, and sometimes even when it comes to outpatient therapy, some insurance companies refuse to cover the services. If you are in that position, please call me, and let’s try to get those claims paid. I’ll
- [140 Mile and Hour Car Crash Turns into Thousands in Denied Medical Bills](https://www.medicalinsuranceadvocacy.com/140-mile-and-hour-car-crash-turns-into-thousands-in-denied-medical-bills/) - You know, I’ll tell you, chapter 12 in my book, Apparently Different, speaks about an individual who was in a 140-mile-per-hour car crash. He was going 140 miles an hour. And let me just tell you, I hope that you always try to be a good driver and never drink or use drugs while driving.
- [Congenital Defect Bills Not Being Paid](https://www.medicalinsuranceadvocacy.com/congenital-defect-bills-not-being-paid/) - I was introduced many years ago by an attorney to someone who’s in my book, Apparently Different. She was an attorney who wound up having epilepsy. I myself, due to an insect bite, lived with epilepsy for almost 25 years. But luckily, thank you Lord, I had a left temporal lobectomy and was then taught how to
- [Epilepsy Patient Taught to Deny Medical Claims](https://www.medicalinsuranceadvocacy.com/epilepsy-patient-taught-do-deny-medical-claims/) - I was introduced many years ago by an attorney to someone who’s in my book, Apparently Different. She was an attorney who wound up having epilepsy. I myself, due to an insect bite, lived with epilepsy for almost 25 years. But luckily, thank you Lord, I had a left temporal lobectomy and was then taught how to
- [Major Brain Damage Medical Bills Denied](https://www.medicalinsuranceadvocacy.com/major-brain-damage-medical-bills-denied/) - You know, insufficient oxygen can cause major brain damage. Someone in my book, Apparently Different, experienced that issue, which caused this person to have cerebral palsy. Please think about Medwise if you’re having problems with any of your medical bills or you’re looking for doctors. I’m here to help you, and hopefully, this will not happen to
- [Is Artificial Intelligence Denying Your Medical Bills](https://www.medicalinsuranceadvocacy.com/is-artificial-intelligence-denying-your-medical-bills/) - I recently spoke on a major topic involving AI, artificial intelligence, which almost immediately denies medical bills. It is truly awful that insurance companies decide whether or not they want to pay a bill according to your diagnosis. Too many times people wind up in a hospital, are admitted, and then claims are denied. If this ever happens
- [Over $200000 in Fraudulent Medical Bills Waived](https://www.medicalinsuranceadvocacy.com/over-200000-in-fraudulent-medical-bills-waived/) - Hi, my friends. You know, I couldn’t believe this case. My client owed over $200,000 when I was able to prove all of this fraud billing from the hospital. I discussed it with the hospital, and they finally backed off and gave my client a zero balance. Please, if you have any problems with your bills, call me. I’m
- [Take Health Care into Your Own Hands - Hire Medical Bill Advocate](https://www.medicalinsuranceadvocacy.com/take-health-care-into-your-own-hands-hire-medical-bill-advocate/) - Take Health Care into Your Own Hands - Hire Medical Claim Advocate Learn more about how the Affordable Care Act is improving health care where you live and take health care into your own hands. Hire A Medical Bill Advocate. The Affordable Care Act in Your State Find Insurance and Coverage Options Get Help with a
- [How the Health Care Law Benefits You](https://www.medicalinsuranceadvocacy.com/how-the-health-care-law-benefits-you/) - http://www.healthcare.gov/law/information-for-you/benefits.html How the Health Care Law Benefits You The Affordable Care Act forces insurance companies to play by the rules, prohibiting them from dropping your coverage if you get sick, billing you into bankruptcy because of an annual or lifetime limit, or, soon, discriminating against anyone with a pre-existing condition. All Americans will have the
- [Alzheimer's Awareness in Cresshill, NJ](https://www.medicalinsuranceadvocacy.com/alzheimers-awareness-in-cresshill-nj/) - November 17-22 This first time event in Cresskill will provide information and resources to educate the public about the challenges Alzheimer's disease and other forms of dementia poses to afflicted individuals and their families.There will be a variety of trainings, educational seminars and resources to help raise awareness. All are free and open to the
- [What Does Adria Gross Do as a Medical Insurance Advocate?](https://www.medicalinsuranceadvocacy.com/what-does-adria-gross-do-as-a-medical-insurance-advocate/) - In this interview, Edison Guzman speaks with Adria Gross, a seasoned health insurance expert and founder of Medwise Insurance Advocacy. Adria shares insights from her 30+ years of experience in the health insurance industry, starting from her time working for insurance companies where she learned how claims were denied. Over time, she transitioned to becoming
- [What You Can Do If Your Medical Bills Are Denied](https://www.medicalinsuranceadvocacy.com/what-you-can-do-if-your-medical-bills-are-denied/) - In this interview, Edison Guzman speaks with Adria Gross, an insurance advocate, about navigating medical claim denials. Adria explains the common reasons for denials, such as insurance companies rejecting claims without proper review or doctors submitting bills late. She outlines the steps individuals should take when faced with a denial, including contacting the insurance company
- [From Denying Claims to Patient Advocate, Adria Gross on Navigating Medical Insurance](https://www.medicalinsuranceadvocacy.com/from-denying-claims-to-patient-advocate-adria-gross-on-navigating-medical-insurance/) - Interview Participants: Edison Guzman (interviewer) and Adria Gross from Medical Insurance Advocacy (interviewee). Adria’s Background: Worked for two insurance companies where she was trained to deny claims. Gained extensive knowledge about insurance policies, including coverage details, premiums, deductibles, and copays. Transitioned from working within insurance companies to advocating for individuals with denied claims. Services Offered
- [Understanding "Deductible," "Co-Pay," and "Co-Insurance"](https://www.medicalinsuranceadvocacy.com/understanding-deductible-co-pay-and-co-insurance-2/) - Health insurance can be a lifesaver in a medical emergency, but understanding the terms and conditions of your policy can feel like navigating a maze.
- [Leveraging Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs)](https://www.medicalinsuranceadvocacy.com/leveraging-health-savings-accounts-hsas-and-flexible-spending-accounts-fsas/) - Two financial tools that can help you manage healthcare expenses are Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs).
- [Is Mental Health Coverage Included in My Insurance Plan?](https://www.medicalinsuranceadvocacy.com/is-mental-health-coverage-included-in-my-insurance-plan/) - Mental health is increasingly recognized as an essential aspect of overall well-being, yet many people are uncertain about whether their insurance plans provide adequate coverage.
- [Is Emergency Medical Care Covered When Traveling Abroad](https://www.medicalinsuranceadvocacy.com/is-emergency-medical-care-covered-when-traveling-abroad/) - Traveling can be one of life's greatest joys, but it's important to remember that emergency medical care can happen, even when you're abroad.
- [How to Verify if a Doctor or Medical Facility is In-Network](https://www.medicalinsuranceadvocacy.com/how-to-verify-if-a-doctor-or-medical-facility-is-in-network/) - Finding a healthcare provider that aligns with your medical facility needs is only half the battle when navigating the complex world of health insurance.
- [How to Lower Your Monthly Health Insurance Premiums](https://www.medicalinsuranceadvocacy.com/how-to-lower-your-monthly-health-insurance-premiums/) - Finding an affordable health insurance plan without compromising the quality of coverage can be a tricky endeavor. Learn strategies to optimize your insurance costs.
- [How to Determine if a Medical Procedure or Medication is Covered](https://www.medicalinsuranceadvocacy.com/how-to-determine-if-a-medical-procedure-or-medication-is-covered/) - Knowing what is and isn't covered in your medical procedure can save you from unexpected medical bills and ensure that you're getting the most out of your insurance.
- [How Does Your Health Insurance Plan Handle Pre-existing Conditions?](https://www.medicalinsuranceadvocacy.com/how-does-your-health-insurance-plan-handle-pre-existing-conditions-2/) - Understanding how your health insurance plan handles pre-existing conditions is crucial, especially if you or a family member have a chronic illness that needs ongoing care.
- [Filing a Medical Insurance Claim](https://www.medicalinsuranceadvocacy.com/filing-a-medical-insurance-claim-2/) - Understanding the process of filing a medical insurance claim is essential for ensuring you receive the benefits you're entitled to.
- [Documentation Needed for Filing a Medical Insurance Claim](https://www.medicalinsuranceadvocacy.com/documentation-needed-for-filing-a-medical-insurance-claim-2/) - Filing a medical insurance claim can be a daunting process, if you're not sure what paperwork you need. This is the documentation needed when filing a claim.
- [Do I Need a Referral to See a Specialist?](https://www.medicalinsuranceadvocacy.com/do-i-need-a-referral-to-see-a-specialist-2/) - One common question many people have is whether they need a referral from a primary care physician (PCP) to consult a specialist.
- [Denied Insurance Claim? Don’t Panic](https://www.medicalinsuranceadvocacy.com/denied-insurance-claim-dont-panic-2/) - Discovering that your insurance claim has been denied can be disheartening, especially when you're relying on it to cover medical expenses.
- [How Prescription Drug Coverage Works in Your Insurance Plan](https://www.medicalinsuranceadvocacy.com/how-prescription-drug-coverage-works-in-your-insurance-plan/) - Understanding how prescription drug coverage works in your health insurance plan can be like solving a complex puzzle to comprehend your healthcare coverage.
- [Changing Your Primary Care Physician- What You Need to Know](https://www.medicalinsuranceadvocacy.com/changing-your-primary-care-physician-what-you-need-to-know/) - Choosing a primary care physician (PCP) is a critical decision that impacts your overall healthcare experience. The good news is that most insurance plans offer it.
- [Appealing an Insurance Company Decision](https://www.medicalinsuranceadvocacy.com/appealing-an-insurance-company-decision-2/) - At some point, many of us will face the frustrating situation of having an insurance claim denied or a medical service deemed "not covered" by our healthcare policy.
- [Adding a Family Member to Your Insurance Policy](https://www.medicalinsuranceadvocacy.com/adding-a-family-member-to-your-insurance-policy-2/) - Whether you've just gotten married, welcomed a new baby, or have other family changes, you may find yourself wondering how to add a family member to your existing insurance policy.
- [Colonoscopy Charged $7,000 and Reduced to $0](https://www.medicalinsuranceadvocacy.com/colonoscopy-charged-7000-and-reduced-to-0/) - You’re going to a colonoscopy at the office of your doctor and the office says to you, it’s covered on your plan and you do not need to pay any money at all. I just overturn a case where they were informed there would be no fee but was charged over $7,000. Please get that
- [Double Payment on Medical Bills and Can't Get a Refund?](https://www.medicalinsuranceadvocacy.com/double-payment-on-medical-bills-and-cant-get-a-refund/) - Are you in a situation where you paid your medical provider when having a procedure at their office, but now you receive a bill in the mail for those services you already paid for? You call your doctor or billing company and they won’t admit that they were double paid. Don’t allow them to pull
- [Prepaid Medical Procedure Reduced by 50%](https://www.medicalinsuranceadvocacy.com/prepaid-medical-procedure-reduced-by-50/) - You prepaid your medical procedure for $7,700 for that same procedure. You get a bill in the mail only for $15,000. I hear about these cases so many times and luckily when I have proof of payments, I will make sure that you do not owe them any more money. On that one case, I
- [Can't Understand Your Explanation of Benefits?](https://www.medicalinsuranceadvocacy.com/cant-understand-your-explanation-of-benefits/) - Are you having a difficult time understanding your explanation of benefits and the reason for the denials on your bill for over a hundred thousand dollars? I used to write the policies for the insurance companies and was taught how to deny claims on behalf of the insurance companies. I normally reduce the medical bills
- [PCOS Coverage Non-Existent](https://www.medicalinsuranceadvocacy.com/pcos-coverage-non-existent/) - Good morning everybody. Have you ever heard of Cushing’s syndrome? It’s a pituitary irregularity. The sad thing is that there’s no cure for it. It also goes under the condition title, polycystic ovarian syndrome, which has the initials PCOS. Many conditions keep people from being covered according to our health insurance policies. I hate to
- [If COBRA Is Not Paying Your Medical Bills Do This](https://www.medicalinsuranceadvocacy.com/if-cobra-is-not-paying-your-medical-bills-do-this/) - I hope this never ever happens to you. You leave a job and now you have Cobra, but they’re not paying your bills. If this happens to you, call me. I know all about it, and I guarantee you when I get my teeth into that case, your bills are gonna be paid. Thank you.
- [Medicare Advantage Double Coverage Ends in Double Payment](https://www.medicalinsuranceadvocacy.com/medicare-advantage-double-coverage-ends-in-double-payment/) - I hope this never happens to you. I received a phone call where someone worked for two different companies and wound up, believe it or not, having two different Medicare Advantage plans. The other crazy part about that, it was the same insure one of the plans was requesting back $200,000. The crazy thing is
- [What If the Insurance Company Wants Their Money Back?](https://www.medicalinsuranceadvocacy.com/what-if-insurance-company-wants-money-back/) - I hope you’re having a fantastic day after your bills were paid due to an injury. Has the insurance company ever asked you for the money back? Very often I receive cases which involve coordination of benefits. I understand how confusing this can be and if this ever happens to you, please reach out to
- [Saved over $80,000 in Severe Depression Medical Bills](https://www.medicalinsuranceadvocacy.com/saved-over-80000-in-severe-depression-medical-bills/) - I hope everything’s going well for you. Janet, a client of mine who’s in my recent book, apparently different discusses how we should treat a person who is apparently different. Janet has had years of depression, which causes severe mental health. She has a borderline personality disorder, but I have to tell you this, her
- [$250,000 Insurance Claim Denied When Turned Age 65?](https://www.medicalinsuranceadvocacy.com/250000-insurance-claim-denied-when-turned-age-65/) - I recently received a phone call from an attorney where the health insurance carrier never informed the patient that at the age of 65 they needed to switch over to Medicare. So here’s a case where the person paid over $250,000, which the insurance company kept. Well, I could think about how incredibly unfair it
- [Mix Up With Overlapping Insurance](https://www.medicalinsuranceadvocacy.com/mix-up-with-overlapping-insurance/) - I hope you’re having a fabulous day. Too many times I have seen cases where there’s a mix up on one medical insurer overlapping another one. So I recently had a situation where my client paid over $20,000 in double premiums for these two that were overlapping. If this ever happens to you, call me.
- [Need Your Major Insurance Company to Pay](https://www.medicalinsuranceadvocacy.com/need-your-major-insurance-company-to-pay/) - Now you’re sick and you need a major medical test, but your insurance company doesn’t wanna pay for it. I help people when matters like this happen. Please think of me, Adria Gross Medwise Insurance advocacy. They’re not paying. Call me. Thanks. Adria Gross See Full Bio
- [Bipolar Depression Claims](https://www.medicalinsuranceadvocacy.com/bipolar-depression-claims/) - I hope everybody’s having a great day out there. I have to say bipolar depression occurs much too often. I have helped many people who have that disorder. If your claims are being denied on mental health issues, please call me Adria, Medwise Insurance Advocacy. I’m here to help you. Thank you. Adria Gross See
- [Having Problems Getting the Generic Drug](https://www.medicalinsuranceadvocacy.com/having-problems-getting-the-generic-drug/) - I hope you’re having a wonderful day today. All too often you may need a medication and they only want to provide you with the generic drug. If you’re having problems where you are unable to take that generic drug, please reach out to me. I will help you. I have great relationships with the
- [Are You Paying Double Medical Premiums on Social Security](https://www.medicalinsuranceadvocacy.com/are-you-paying-double-medical-premiums-on-social-security/) - It’s, I hope you’re having a fantastic day today. You know, very often when you begin to receive Social Security, you’ve already been paying out your premium for Medicare. Well, let me tell you this. There has been major confusion where whoever your insurer is, you might be paying double monthly premium. Please reach out
- [ACL Surgery Was Overcharged Until This](https://www.medicalinsuranceadvocacy.com/acl-surgery-was-overcharged-until-this/) - I recently overturned a case where the person had ACL surgery on the knee, and even though all the bills were paid, they were still asking for additional money. We don’t want this to happen to you. If anything like this occurs, whatever surgery it is, and now they’re asking you for more money where
- [Unpaid Claims for PANDA](https://www.medicalinsuranceadvocacy.com/unpaid-claims-for-panda/) - Too many times I have received unpaid claims for Panda. People come to me when it’s not being paid. Panda stands for Pediatric Autoimmune Neuropsych Psychiatric Disorders, and it’s associated with strep infections. Too often insurance companies do not wanna pay claims for that condition. If that happens to you or even other conditions, please
- [Disability Does Not Define a Person](https://www.medicalinsuranceadvocacy.com/disability-does-not-define-a-person/) - In my new book that just came out, apparently different is a chapter titled Disability Does Not Define a Person. A gentleman calls me one day involving his client, Mr. Santini. Here was a situation where after serving in the military falling a hundred feet and waking up after the injury, he severely damaged his
- [Normal or Autism Spectrum Insurance Bills](https://www.medicalinsuranceadvocacy.com/normal-or-autism-spectrum-insurance-bills/) - I just published a new book called Apparently Different, and there’s a chapter in my book, which involves Jesse Sine. Jesse himself has written two books. Both books involve discussing what it’s like to be normal versus what it’s like to have Asperger’s. I received many phone calls with people who have an autism spectrum
- [Medicare Advantage Plans Are not Accepted by 75% of Doctors](https://www.medicalinsuranceadvocacy.com/medicare-advantage-plans-are-not-accepted-by-75-of-doctors/) - You know, 50% of the doctors and hospitals no longer accept the Medicare Advantage plans. You have only one Medicare card if you have the Medicare Advantage plans. But the issue is if you wind up in a rehab and if they’re using AI at the insurance company, artificial intelligence, within three days after you
- [A Little Love Inspires Everyone](https://www.medicalinsuranceadvocacy.com/a-little-love-inspires-everyone/) - Hello, everybody in my book apparently Different. There’s a chapter about Allison Murphy. The title of the chapter is Allie. A Little Love Inspires everyone. I’ve known Allie since she was an infant. She and my son were both in early intervention. Allie was born with cerebral palsy. She has been in a wheelchair her
- [Why Medicare May Not Cover Your Rehab Expenses](https://www.medicalinsuranceadvocacy.com/why-medicare-may-not-cover-your-rehab-expenses/) - I hope you’re having a fabulous day. So you’re in the hospital and now you need to go to a rehab when you leave the hospital. So please make sure that the hospital had you in the hospital as an inpatient for three midnights or more. If you do not have three midnights in a
- [What is Outpatient Under Observation](https://www.medicalinsuranceadvocacy.com/what-is-outpatient-under-observation/) - You are a senior, but make sure that when you wind up in a hospital, you are an inpatient for at least two midnights or more. Otherwise, you’ll be considered an outpatient under observation and will not be covered for your hospitalization. Please call me if you know anybody who this happens to. I’m here
- [Medical Bill Issues? Here's How to Get Them Down to $0](https://www.medicalinsuranceadvocacy.com/medical-bill-issues-heres-how-to-get-them-down-to-0/) - Are you having medical bill issues? Has your case been sent to a collection agency? If we work together and I’m unable to prove that you are unable to afford the bills, I will get your bills either down to zero or not too much above it. I just worked on a case where I
- [New Book Apparently Different](https://www.medicalinsuranceadvocacy.com/new-book-apparently-different/) - Hi everybody, please by my book, apparently different. There are so many incredible stories of people, many of which have been clients of mine. A very kind young gentleman while he was in his late teens, early twenties, started getting tumors multiple times a day. And it was all because of a cancerous tumor growing
- [Neurological Lime Disease Insurance Claims](https://www.medicalinsuranceadvocacy.com/neurological-lime-disease-insurance-claims/) - I worked with a gentleman who was considered the Jeopardy king, and he’s in my book that recently came out. Apparently different. He was Jeopardy’s King on the Jeopardy Tournament of Champions, but I’m sorry to say this. He wound up having neurological Lyme disease. He was on so many different medications and went to
- [Massive Brain Tumor Medical Bills](https://www.medicalinsuranceadvocacy.com/massive-brain-tumor-medical-bills/) - In my book, apparently different, just recently published, I discussed my own experience having epilepsy while writing my book. I met with an educator, Janet Schiff. The chapter that is about her is titled, whatever Happened to Me, to My White Picket Fence, my Brain Injury From My Massive Brain Tumor. Janet writes, the white
- [Adria Goldman Gross, Serial Author And Medical Insurance Advocate Featured On Platform Geared To Kindness & Compassion](https://www.medicalinsuranceadvocacy.com/adria-goldman-gross-serial-author-and-medical-insurance-advocate-featured-on-platform-geared-to-kindness-compassion/) - Apparently DIFFERENT highlights the human need for understanding, acceptance and compassion. Newark, NJ (1888PressRelease) May 14, 2024 – Adria Goldman Gross, President and CEO of Medwise Insurance Advocacy, and serial author, has just published her third book ‘Apparently DIFFERENT.’ ISBN #: 978-1-9772-0051-8, Recently, Adria was featured in the article, “Embracing Empathy: A Conversation on Kindness and Compassion.”
- [Dental Coverage Not Covering?](https://www.medicalinsuranceadvocacy.com/dental-coverage-not-covering/) - I hope all is well with you today. Dental coverage is very limited. Most policies will never cover you for more than $3,500. It’s best to discuss the fees and get it in writing before procedure is performed. Many people come to me with bills over $35,000. Some dental providers are willing to reduce the
- [Reasonable and Customary Charges Reduce Bill from Over $100,000 to $11,000](https://www.medicalinsuranceadvocacy.com/reasonable-and-customary-charges-reduce-bill-from-over-100000-to-11000/) - My friends, one of my clients went for surgery and they were never informed in advance that it was an out-of-network provider. The doctor was charging over a hundred thousand dollars and when I looked at the reasonable customary charges, I was able to get the bill reduced from a hundred thousand down to 11,000.
- [PPO or HMO?](https://www.medicalinsuranceadvocacy.com/ppo-or-hmo/) - Good morning, everybody. I gotta tell you, I worked with a client who thought they had a PPO rather than HMO. You really need to understand your policy and realize what you are covered for and what you’re not covered for. Uh, the person was in a 24 hour psych facility and the fact that
- [Emergency Room Expense Not Medically Necessary and Not Covered?](https://www.medicalinsuranceadvocacy.com/emergency-room-expense-not-medically-necessary-and-not-covered/) - Hopefully this will never happen to you, but your appendix burst and then you go to the emergency room, but your insurer is not paying your bill. They’re claiming it wasn’t medically necessary. Please call me and I’m sure that I can help you retrieve money for your claim. I had a client who needed
- [Got Hurt at Work With No Workers Comp Insurance?](https://www.medicalinsuranceadvocacy.com/got-hurt-at-work-with-no-workers-comp-insurance/) - I hope you’ve had a fabulous day today and this didn’t happen to you. So you’re at work and you fall off a ladder. You don’t have workers’ comp, and your insurance company doesn’t wanna pay the claim. So if this happens to you, please call me and Medwise will help you. Believe it or
- [Medical Claims Not Being Processed by Your Insurance Carrier?](https://www.medicalinsuranceadvocacy.com/medical-claims-not-being-processed-by-your-insurance-carrier/) - I hope you’re having a fabulous say so. You have sent a stack of bills to your health insurance carrier, but your claims are not being processed, and you have made multiple phone calls to the insurance company. If this happens to you, please call me. I’m very successful in getting your claims processed by
- [Emergency Room Bills and No Insurance?](https://www.medicalinsuranceadvocacy.com/emergency-room-bills-and-no-insurance/) - Good afternoon, so you have no insurance and you wind up in an emergency room. If this happens to you, please reach out to Medwise. I am sure I will a be able to get a reduction for you. Believe it or not, I recently saved a client over $75,000, so if you need help,
- [Overwhelmed With Medical Bills and Charges?](https://www.medicalinsuranceadvocacy.com/overwhelmed-with-medical-bills-and-charges/) - If you were overwhelmed with your medical bills and you need assistance, whether it be filing your claims or you’re all confused, please reach out to Medwise. We can certainly help you with your medical bills and charges. Saving you so much time and effort. Adria, Medwise Insurance Advocacy. Thank you. Adria Gross See Full
- [Does Employer Health Insurance Cover You Out of the Country?](https://www.medicalinsuranceadvocacy.com/does-employer-health-insurance-cover-you-out-of-the-country/) - If you are still under the age of 65 and working and receiving health insurance from your employer, I’m able to help people when they’re out of the country to be covered for their services. Many employers have terrific policies, which will cover you when you’re on vacation or you’re out for business. And if
- [Are Critical Illness Policies Worth It?](https://www.medicalinsuranceadvocacy.com/are-critical-illness-policies-worth-it/) - I was wondering if you ever heard of someone who has a critical illness policy. Those policies are gonna cost you a lot less money, but sometimes the critical illness policies will not pay out your claims. So if you call me, I will help you work out either getting your claim paid or at
- [Need Assistance with Social Security Disability?](https://www.medicalinsuranceadvocacy.com/need-assistance-with-social-security-disability/) - Hello everyone. I hope this doesn’t happen to you, but if you need assistance to make your first request, first request for Social Security Disability. Believe it or not, medwise has helped many people with their applications. Um, call medwise. If you have worked for 10 years or 40 quarters, there’s one quarter a year.
- [Overcharged for Prescribed Medicine?](https://www.medicalinsuranceadvocacy.com/overcharged-for-prescribed-medicine/) - I hope you’re having a fantastic day. Are you being overcharged on your medicine expenses? All your prescription plans? medwise is usually able to find by performing extensive research to find a lower cost for your medicine. If you need assistance, please call me. I just saved someone over $1,800 on one prescription. My phone
- [Multiple Insurers and Confused Who Pays First?](https://www.medicalinsuranceadvocacy.com/multiple-insurers-and-confused-who-pays-first/) - Good day everyone. Many people are confused when they have multiple insurance carriers. You have to know who is your primary, who is your secondary, and who is your tertiary. If you are having issues understanding who should be paying first, please reach out to me. I’m sure I’ll be able to help you and
- [Not Getting Properly Reimbursed for Medical Bill Expenses?](https://www.medicalinsuranceadvocacy.com/not-getting-properly-reimbursed-for-medical-bill-expenses/) - Good day, I hope. I hope you’re having the most positive day ever. People come to me when it’s not too positive, so sometimes your health insurance carrier is not correct correctly processing your claims, and you are having problems getting reimbursed. So if this happens to you, please reach out to me. I recently
- [Out of Network Medical Bills Either Reduced or Written Off With This](https://www.medicalinsuranceadvocacy.com/out-of-network-medical-bills-either-reduced-or-written-off-with-this/) - Hi everyone. Uh, you’re in the hospital with colitis and the hospital and doctors are outta network. Please remember, out of network, think of Medwise. You might be able to either get your insurance company to cover the bill or get a major reduction on your charges. I recently saved, believe it or not, over
- [Can't Afford Your Huge Medical Debt?](https://www.medicalinsuranceadvocacy.com/cant-afford-your-huge-medical-debt/) - Good morning. I hope you’re doing great today. If you owe a huge medical debt on a hospital bill and you are unable to pay for it, please call me. I am so happy that I’ve been able to reduce bills to a very small amount and sometimes zero when this happens. Adria, Medwise Insurance
- [Overcharged on Your Medical Bills? Do This](https://www.medicalinsuranceadvocacy.com/overcharged-on-your-medical-bills-do-this/) - Hi everyone. Have you been unable to pay your, your price procedures that went towards the deductible? Very often, especially the beginning of the year, if you’re, if you haven’t seen a doctor, it goes directly to your deductible. If you have been overcharged, I frequently am able to get reductions on your bills.So even
- [Surprise Medical Bill?](https://www.medicalinsuranceadvocacy.com/surprise-medical-bill/) - I hope you’re having a terrific day today. If you have received a surprise medical bill, please call me. If someone is outta network and you’re in the emergency room, they have no right to charge you whatever they feel like. If the doctors are out of network and it’s an emergency, please remember you
- [At A Nursing Care Facility with Medicare Advantage Plan?](https://www.medicalinsuranceadvocacy.com/at-a-nursing-care-facility-with-medicare-advantage-plan/) - Hello everyone. Recently I received many phone calls for people who purchase a Medicare Advantage plan. Rather than having a Medicare coverage with a supplement and a prescription plan, I always tell people, you have one card or three cards. When people go into a rehab center and they have a Medicare Advantage plan, they’re
- [Have You Received a Medical Bill One to Five Years After Procedure?](https://www.medicalinsuranceadvocacy.com/have-you-received-a-medical-bill-one-to-five-years-after-procedure/) - I hope you’re having a terrific day. Uh, I just wanna tell you people reach out to me when they first receive a bill going back a year to five years after the procedure was provided. You might not be responsible for that bill. Last week I saved my client $25,000. So if you are in this
- [Out of Network Provider Not Submitted Your Medical Bills on Time?](https://www.medicalinsuranceadvocacy.com/out-of-network-provider-not-submitted-your-medical-bills-on-time/) - I hope you’re having a fabulous day. Have you been seen by an out of network provider who has not submitted your medical bills on time? If, you have not paid the provider yet and they have not submitted the bills, you might want to not even be responsible to pay the provider. I recently
- [Hip Replacement With Authorization Was Denied](https://www.medicalinsuranceadvocacy.com/hip-replacement-with-authorization-was-denied/) - I hope you’re having a great day. Uh, you know, one of my recent clients had hip replacement and there was pre-authorization for the hip replacement and it was supposed to be covered, but due to incorrect procedure codes, the bill for $85,000 was denied. The bills were being submitted by an outside billing company
- [Denied Medical Bills Over $90,000 Overturned](https://www.medicalinsuranceadvocacy.com/denied-medical-bills-over-90000-overturned/) - Hello everyone. I had a recent case where this person kept on receiving denied medical bills and they had excessive billing from the providers. To make things even worse, his insurance company changed over the time period when he was having these multiple procedures involving surgery. A couple of the providers were out of network
- [Out of Network Emergency Room Covered?](https://www.medicalinsuranceadvocacy.com/out-of-network-emergency-room-covered/) - I recently had a client who wound up in emergency room in a hospital, which was out of network since the ambulance took them right to the out-of-Network Emergency Room. I must say it took quite a period of time for me to overturn the case, but I was finally able to have the insurance
- [Rehab and $52,000 Hospital Bill Covered](https://www.medicalinsuranceadvocacy.com/rehab-and-52000-hospital-bill-covered/) - I hope you’re having enjoying yourselves and all is going well. Well, one of my clients was in an out of network hospital and wound up in a rehab here I was fighting for my client involving the hospital bill, and finally was able to have his insurer cover the entire hospital bill of $52,000.
- [Mental Health Outpatient Charges Covered](https://www.medicalinsuranceadvocacy.com/mental-health-outpatient-charges-covered/) - I had a recent case where a gentleman had $12,000 in mental health outpatient charges. The worst thing was he had no insurance. By us contacting the Department of Social Services, we were able to get Medicaid to pay off all his claims. If you ever need help, please call me Adria, Medwise Insurance Advocacy.
- [$23,000 Denied Medical Bill Overturned](https://www.medicalinsuranceadvocacy.com/23000-denied-medical-bill-overturned/) - I hope you’re having a great day. I recently overturned a case that was $23,000. This was an awful situation where the woman had been abused by her husband and since they had health insurance under her husband’s policy. For some odd reason the insurance company was not paying it. This case was sent to
- [Incorrect Billing Resulted in $2,000 Overcharge](https://www.medicalinsuranceadvocacy.com/incorrect-billing-resulted-in-2000-overcharge/) - I recently handled a claim where they felt the billing was incorrect. The mother gave birth to this little baby boy. She received a bill from a private office, which she never saw this provider while she was in the hospital, the bill was $2,000 and when we were able to prove that the services
- [Broken Jaw Medical Bill Denied Because Not Medically Necessary?](https://www.medicalinsuranceadvocacy.com/broken-jaw-medical-bill-denied-because-not-medically-necessary/) - I was recently able to help a family who had $35,000 worth of bills. They had a fall, broke their jaw, and believe it or not, this also involved multiple insurers. The insurers kept on denying the claims stating, even though she broke her jaw, it wasn’t necessary for her to have covered charges. Crazy.
- [Broken Jaw Medical Bill Denied Because Not Medically Necessary?](https://www.medicalinsuranceadvocacy.com/broken-jaw-medical-bill-denied-because-not-medically-necessary/) - I was recently able to help a family who had $35,000 worth of bills. They had a fall, broke their jaw, and believe it or not, this also involved multiple insurers. The insurers kept on denying the claims stating, even though she broke her jaw, it wasn’t necessary for her to have covered charges. Crazy.
- [Have a PPO Plan and Had a Baby?](https://www.medicalinsuranceadvocacy.com/have-a-ppo-plan-and-had-a-baby/) - I recently worked with a case where the person gave birth and since the provider was outta network, they were billing her only $15,000. I was able to prove by sufficient medical records and a review of the health insurance policy that she should have been covered for this provider, even though they were out
- [15 Providers Out of Network Denying Your Medical Claims?](https://www.medicalinsuranceadvocacy.com/15-providers-out-of-network-denying-your-medical-claims/) - I recently worked with a client who had 15 different providers, and this case was like around 270 to 300 claims. They were denied as out-of-network. She also had limited visits on her physical therapy. It took a tremendous amount of work, but I was able to prove that it was her, that she was
- [Who Covers When Multiple Insurance Policies?](https://www.medicalinsuranceadvocacy.com/who-covers-when-multiple-insurance-policies/) - I had a case recently involving three insurance companies. The insured was working as a New York City police, and his wife was covered under his plan it the beginning. The insurance companies would not speak with the other, the other ones, but when we had to go to a higher level, which we did
- [Wheelchair Medical Expense Not Covered?](https://www.medicalinsuranceadvocacy.com/wheelchair-medical-expense-not-covered/) - I was referred a client who was unable to get a wheelchair through his health insurance plan. It was interesting that the reason for that is the insurance company thought he had another insurance carrier when we were able to prove that he only had one health insurance policy. He was finally able to be
- [Hospital Bill Determined as Not Medically Necessary?](https://www.medicalinsuranceadvocacy.com/hospital-bill-determined-as-not-medically-necessary/) - I hope you’re having a beautiful day today. I had a case recently where the gentleman was in the hospital due to severe leg pain. He spent two nights at the hospital and was stuck with over $45,000 in medical bills. The insurance company was stating that the two nights at the hospital were not
- [How Does Your Health Insurance Plan Handle Pre-existing Conditions?](https://www.medicalinsuranceadvocacy.com/how-does-your-health-insurance-plan-handle-pre-existing-conditions/) - Understanding how your health insurance plan handles pre-existing conditions is crucial, especially if you or a family member have a chronic illness or a medical history that needs ongoing care. This blog post aims to guide you through the complexities of insurance coverage for pre-existing conditions, offering advice on what to look for and the
- [Filing a Medical Insurance Claim](https://www.medicalinsuranceadvocacy.com/filing-a-medical-insurance-claim/) - Dealing with medical issues can be stressful enough without adding the complexities of insurance paperwork. However, understanding the process of filing a medical insurance claim is essential for ensuring you receive the benefits you’re entitled to. In this comprehensive blog post, we’ll walk you through the steps of filing a medical insurance claim so that
- [Documentation Needed for Filing a Medical Insurance Claim](https://www.medicalinsuranceadvocacy.com/documentation-needed-for-filing-a-medical-insurance-claim/) - Filing a medical insurance claim can be a daunting process, especially when you’re not sure what paperwork you need. To help streamline this essential task, this blog post offers a comprehensive guide on the types of documentation you’ll need to gather when filing a claim. Why Proper Documentation Matters Incorrect or incomplete documentation can result
- [Do I Need a Referral to See a Specialist](https://www.medicalinsuranceadvocacy.com/do-i-need-a-referral-to-see-a-specialist/) - Navigating the healthcare landscape can be complicated, especially when you need specialized care. One common question many people have is whether they need a referral from a primary care physician (PCP) to consult a specialist. The answer varies depending on your insurance plan and healthcare needs. This blog post delves into the factors that determine
- [Denied Insurance Claim? Don’t Panic](https://www.medicalinsuranceadvocacy.com/denied-insurance-claim-dont-panic/) - Discovering that your insurance claim has been denied can be disheartening, especially when you’re relying on it to cover medical expenses. However, a denial isn’t necessarily the end of the road. Many denials can be successfully appealed, giving you another opportunity to secure coverage for your medical costs. This blog post outlines the essential steps
- [Prescription Drug Coverage-How it Works in Your Insurance Plan](https://www.medicalinsuranceadvocacy.com/prescription-drug-coverage-how-it-works-in-your-insurance-plan/) - Understanding how prescription drug coverage works in your health insurance plan can be a bit like solving a complex puzzle. Given the rising cost of medications, it’s crucial to comprehend this component of your healthcare coverage. This blog post aims to demystify the subject, giving you the knowledge you need to navigate prescription drug coverage
- [Understanding "Deductible," "Co-Pay," and "Co-Insurance"](https://www.medicalinsuranceadvocacy.com/understanding-deductible-co-pay-and-co-insurance/) - Health insurance can be a lifesaver in a medical emergency, but understanding the terms and conditions of your policy can feel like navigating a maze. Terms like “deductible,” “co-pay,” and “co-insurance” often pop up, creating confusion for many policyholders. In this blog post, we’ll demystify these common insurance terms so you can make informed decisions
- [Changing Your Primary Care Physician](https://www.medicalinsuranceadvocacy.com/changing-your-primary-care-physician/) - Choosing a primary care physician (PCP) is a critical decision that impacts your overall healthcare experience. However, there may be reasons you’d like to change your PCP, be it due to relocation, dissatisfaction, or a need for specialized care. The good news is that most insurance plans offer the flexibility to do so. In this
- [Appealing an Insurance Company Decision](https://www.medicalinsuranceadvocacy.com/appealing-an-insurance-company-decision/) - At some point, many of us will face the frustrating situation of having an insurance claim denied or a medical service deemed “not covered” by our healthcare policy. These decisions can have a significant financial and emotional impact, leaving us wondering what to do next. The good news is that you have the right to
- [Adding a Family Member to Your Insurance Policy](https://www.medicalinsuranceadvocacy.com/adding-a-family-member-to-your-insurance-policy/) - As life changes, so do your healthcare needs. Whether you’ve just gotten married, welcomed a new baby, or have other family changes, you may find yourself wondering how to add a family member to your existing insurance policy. This blog post aims to guide you through the various options, timing, and procedures involved in expanding
- [Case Overturned for Business Owner with No Workers Compensation](https://www.medicalinsuranceadvocacy.com/case-overturned-for-business-owner-with-no-workers-compensation/) - I recently overturned a case where my client was the owner of a company and he did not have workers compensation for himself. It’s not required by quite a few states, that the owner of a business not have worker’s comp. So, believe it or not, I was able to lower his medical bills from
- [Emergency Service for $186,000 Completely Covered with ERISA Plan](https://www.medicalinsuranceadvocacy.com/emergency-service-for-186000-completely-covered-with-erisa-plan/) - I had a case where this young boy had emergency brain surgery. The surgeon was billing my client $186,000. The doctor was out of network. So, the family, was having major problems. The sad thing was that there was an ERISA plan with their employer. The ERISA plans are different. The employer makes up all
- [If You're Considering Filing for Disability, You Need to Hear This](https://www.medicalinsuranceadvocacy.com/if-youre-considering-filing-for-disability-you-need-to-hear-this/) - Have you or anyone you know filed for disability? If you’re thinking about filing for disability,the most important thing is you need to be sure that you will be eligible.I recently had a case where my client had been on disability for over 10 years, and I was able to assist him to continue to
- [Overnight Medical Bill for $43,000 Fully Covered](https://www.medicalinsuranceadvocacy.com/overnight-medical-bill-for-43000-fully-covered/) - Hi everyone. I gotta share this story with you. A gentleman was experiencing major pain, which involved kidney stones. He was kept in the hospital overnight and the pill was $43,000. It involved two different insurance companies. Neither of them would pay saying it wasn’t medically necessary. And they’re also saying like, who’s really responsible.
- [What If You're Unable to use Generic Medication?](https://www.medicalinsuranceadvocacy.com/what-if-youre-unable-to-use-generic-medication/) - I hate to say this, but too often you are unable to be on a generic drug for your condition. If this happens to you, please ask your doctor to write a letter to fight for you to receive coverage for the correct medication. Sometimes your doctor will also need to reach out to your
- [Saved $600 Per Month for Compound Pharmacy Medication](https://www.medicalinsuranceadvocacy.com/saved-600-per-month-for-compound-pharmacy-medication/) - If you go to a compound pharmacy for medication and they do not submit the bill to your prescription plan, please do not ignore the possibility of receiving reimbursement for that compound medication. I recently was able to save my client $600 a month. They get medication every week, $150, $600 a month, so that
- [Not Covered After Being Told That You're Covered?](https://www.medicalinsuranceadvocacy.com/not-covered-after-being-told-that-youre-covered/) - A recent client was informed by the surgeon’s office prior to the surgery that my client was covered for this upcoming surgery. Well, guess what? He was not covered, so now they’re billing my client for only $80,000. When I discussed the situation with the medical Provider’s billing office, it took months, but we were
- [Covid Client Billed $54,000 With No Insurance Reduced to $0](https://www.medicalinsuranceadvocacy.com/covid-client-billed-54000-with-no-insurance-reduced-to-0/) - I recently had a Covid client. They were being billed $54,000, but the sad thing was they had no insurance, and at that point, even the government stopped covering the covid uh, patients. They, they stopped covering, I believe it was around February of 2022. But thank you, I was able to reduce the bill
- [$500,000 Medical Bill Reduced, Even When Insurance Payout Was Insufficient](https://www.medicalinsuranceadvocacy.com/500000-medical-bill-reduced-even-when-insurance-payout-was-insufficient/) - A recent client had an injury while sightseeing on a van. They had a fall and they sued the bus company and tour operator. My client received insufficient funds to pay all the medical bills, so thank you. I was able to reduce his bill from $500,000 down to a hundred thousand dollars. Now it
- [Couldn't Pay Insurance Premiums After Brain Surgery](https://www.medicalinsuranceadvocacy.com/couldnt-pay-insurance-premiums-after-brain-surgery/) - A recent client had brain surgery and they were so sick for a period of time, they couldn’t even read their mail and pay their health insurance, so now they’re at a point that they can back pay, and they reached out to me and when I was able to prove that my client was
- [Back Surgery Bill from $380,000 Down to $18,000](https://www.medicalinsuranceadvocacy.com/back-surgery-bill-from-380000-down-to-18000/) - I recently worked with an attorney where I was able to reduce the back surgeon’s bill from $380,000 down to 18,000. Come to me, Adrian Medwise Insurance Advocacy. I will save you a ton of money. Thank you. Adria Gross See Full Bio
- [Here's How an Out of Network Surgeon is Covered Under Your Insurance](https://www.medicalinsuranceadvocacy.com/heres-how-an-out-of-network-surgeon-is-covered-under-your-insurance/) - If you are interested in using a doctor who’s out of network, you need to be able to prove that nobody else is able to perform the surgery. Uh, and, and, and when we’re talking about the other people, you have to first look at your insurance, health insurance plan to see who’s listed who
- [Your Voice, Your Rights: How Medical Insurance Advocacy Can Make a Difference](https://www.medicalinsuranceadvocacy.com/your-voice-your-rights-how-medical-insurance-advocacy-can-make-a-difference/) - In today’s complex healthcare landscape, understanding and navigating the intricacies of medical insurance can be a daunting task for individuals and families. However, there is a powerful ally in the form of medical insurance advocacy that can make a significant difference. This essay explores the transformative potential of medical insurance advocacy, shedding light on its
- [Unveiling the Power of Medical Insurance Advocacy: A Comprehensive Guide](https://www.medicalinsuranceadvocacy.com/unveiling-the-power-of-medical-insurance-advocacy-a-comprehensive-guide/) - In today’s complex healthcare landscape, understanding and navigating medical insurance can be overwhelming for individuals and families. However, a beacon of hope exists in the form of medical insurance advocacy. This comprehensive guide aims to unveil the power of medical insurance advocacy, shedding light on its role, benefits, and the transformative impact it has on
- [Unlocking Access to Healthcare](https://www.medicalinsuranceadvocacy.com/unlocking-access-to-healthcare/) - Access to healthcare is a fundamental human right, yet numerous barriers often impede individuals from receiving the care they need. Medical insurance complexities, claim denials, and limited understanding of coverage options are just a few challenges that hinder access to healthcare services. However, medical insurance advocacy emerges as a powerful force that unlocks access to
- [Understanding the Claim Denial Process: How Advocates Can Help You Overcome Obstacles](https://www.medicalinsuranceadvocacy.com/understanding-the-claim-denial-process-how-advocates-can-help-you-overcome-obstacles/) - Dealing with claim denials can be frustrating and overwhelming for individuals navigating the complex world of medical insurance. However, insurance advocates play a vital role in helping patients understand the claim denial process and advocating for their rights. This article delves into the intricacies of the claim denial process, explores common reasons for denials, and
- [Strengthening Medical Insurance Advocacy through Partnerships](https://www.medicalinsuranceadvocacy.com/strengthening-medical-insurance-advocacy-through-partnerships/) - In the complex landscape of healthcare and insurance, collaboration is key to overcoming challenges and achieving meaningful change. Medical insurance advocacy is no exception. Collaborative partnerships between medical insurance advocates, healthcare providers, policymakers, and other stakeholders are instrumental in strengthening advocacy efforts, improving patient outcomes, and shaping a more patient-centered healthcare system. This blog post
- [Why Insurance Companies Deny Medical Claims](https://www.medicalinsuranceadvocacy.com/why-insurance-companies-deny-medical-claims/) - Hospital codes, such as Current Procedural Terminology (CPT) codes and International Classification of Diseases (ICD) codes, play a pivotal role in accurately documenting medical procedures and diagnoses. However, using incorrect hospital codes can have significant consequences, including claim denials by insurance companies. This article explores why insurance companies may deny medical claims when incorrect hospital
- [The Human Side of Insurance](https://www.medicalinsuranceadvocacy.com/the-human-side-of-insurance/) - The healthcare journey can be complex, overwhelming, and emotionally challenging for individuals and families. Amidst the complexities of insurance, medical insurance advocates emerge as a beacon of hope, providing personalized support and compassionate guidance. This article delves into the human side of insurance and highlights the invaluable role of medical insurance advocates in offering personalized
- [The Denial of Medical Claims by Insurance Companies: A Critical Examination](https://www.medicalinsuranceadvocacy.com/the-denial-of-medical-claims-by-insurance-companies-a-critical-examination/) - Medical insurance is designed to provide individuals with financial protection and access to necessary healthcare services. However, one of the most significant challenges faced by patients is the denial of medical claims by insurance companies. The denial of medical claims occurs when insurance companies refuse to reimburse policyholders for medical services, medications, or treatments. This
- [How Incorrect Medical Codes Can Lead to Denied Insurance Claims](https://www.medicalinsuranceadvocacy.com/how-incorrect-medical-codes-can-lead-to-denied-insurance-claims/) - In the realm of medical practices, accurate coding is crucial for successful insurance claims. Incorrectly assigning medical codes can have far-reaching consequences, potentially resulting in denied insurance claims. This article explores the significant impact of using incorrect medical codes in medical practices and highlights the importance of precise coding for a smooth claims process. Understanding
- [Securing a Brighter Healthcare Future: The Power of Insurance Advocacy](https://www.medicalinsuranceadvocacy.com/securing-a-brighter-healthcare-future-the-power-of-insurance-advocacy/) - In today’s complex healthcare landscape, navigating insurance systems and accessing quality care can be daunting for individuals and families. However, the power of insurance advocacy emerges as a transformative force, ensuring a brighter healthcare future for all. As an expert in the field, I firmly believe in the profound impact of insurance advocacy in securing
- [Protecting Patients' Interests: The Essential Role of Medical Insurance Advocacy](https://www.medicalinsuranceadvocacy.com/protecting-patients-interests-the-essential-role-of-medical-insurance-advocacy/) - In the complex world of healthcare, navigating the intricacies of medical insurance can be a daunting task for patients. However, there is a powerful ally in the form of medical insurance advocacy, dedicated to protecting patients’ interests and ensuring they receive the coverage and care they deserve. This essay delves into the essential role of
- [Maximizing Your Benefits: The Benefits of Medical Insurance Advocacy](https://www.medicalinsuranceadvocacy.com/maximizing-your-benefits-the-benefits-of-medical-insurance-advocacy/) - Medical insurance is a crucial component of accessing healthcare services, providing financial protection and coverage for medical expenses. However, understanding and maximizing the benefits of medical insurance can be a complex and challenging task. This essay explores the invaluable role of medical insurance advocacy in maximizing insurance benefits for individuals and families. By delving into
- [From Denial to Approval: How Insurance Advocates Fight for Your Claims](https://www.medicalinsuranceadvocacy.com/from-denial-to-approval-how-insurance-advocates-fight-for-your-claims/) - Dealing with the denial of an insurance claim can be a frustrating and disheartening experience for individuals seeking essential healthcare services. However, there is hope in the form of insurance advocates who fight tirelessly on behalf of patients to reverse claim denials and ensure that individuals receive the coverage they deserve. This essay explores the
- [Empathy, Expertise, and Results: The Three Pillars of Medical Insurance Advocacy](https://www.medicalinsuranceadvocacy.com/empathy-expertise-and-results-the-three-pillars-of-medical-insurance-advocacy/) - Medical insurance advocacy is a powerful force that supports patients in navigating the complex healthcare landscape. Insurance advocates, armed with empathy, expertise, and a drive for results, play a crucial role in ensuring individuals receive the coverage and care they deserve. This essay explores the three pillars of medical insurance advocacy and highlights how they
- [Embracing Diversity and Inclusion in Medical Insurance Advocacy](https://www.medicalinsuranceadvocacy.com/embracing-diversity-and-inclusion-in-medical-insurance-advocacy/) - Diversity and inclusion are fundamental principles that should be embraced in all aspects of society, including the field of medical insurance advocacy. Recognizing and valuing diversity within the advocacy landscape is essential for ensuring equitable access to healthcare and addressing the unique needs of diverse individuals and communities. This article explores the importance of embracing
- [Embracing Digital Transformation: The Evolution of Medical Insurance Advocacy](https://www.medicalinsuranceadvocacy.com/embracing-digital-transformation-the-evolution-of-medical-insurance-advocacy/) - In an era of rapid technological advancements, digital transformation has become a driving force in revolutionizing various industries, including healthcare. Medical insurance advocacy, a vital aspect of the healthcare system, has also undergone significant changes due to the advent of digital technologies. This article explores the evolution of medical insurance advocacy in the digital age,
- [Decoding Hospital Codes: Understanding Their Role in Medical Procedures and Insurance Claims](https://www.medicalinsuranceadvocacy.com/decoding-hospital-codes-understanding-their-role-in-medical-procedures-and-insurance-claims/) - Within the healthcare system, hospital codes play a crucial role in ensuring accurate documentation, billing, and reimbursement for medical procedures. These codes, such as Current Procedural Terminology (CPT) codes and International Classification of Diseases (ICD) codes, provide a standardized language that helps healthcare providers communicate the services rendered and enables insurance companies to process claims
- [Claim Rejections? No Problem: How Medical Insurance Advocacy Can Turn the Tables](https://www.medicalinsuranceadvocacy.com/claim-rejections-no-problem-how-medical-insurance-advocacy-can-turn-the-tables/) - Dealing with claim rejections can be a frustrating and overwhelming experience for individuals seeking healthcare coverage. However, the emergence of medical insurance advocacy has provided a powerful solution to help patients navigate the complexities of the insurance system and overcome claim rejections. This article explores how medical insurance advocacy can turn the tables on claim
- [How Insurance Advocates Bridge the Gap in Healthcare](https://www.medicalinsuranceadvocacy.com/how-insurance-advocates-bridge-the-gap-in-healthcare/) - Access to quality healthcare is a fundamental right, yet numerous barriers can hinder individuals from receiving the care they need. Insurance complexities, claim denials, and limited understanding of coverage options are just a few of the challenges patients face. However, insurance advocates emerge as powerful allies, bridging the gap in healthcare by breaking down barriers
- [$144,000 Medical Bill Reduced With No Health Insurance Plan](https://www.medicalinsuranceadvocacy.com/144000-medical-bill-reduced-with-no-health-insurance-plan/) - I’m working on a case that just came to me and the bill’s $144,000 and the client had no health insurance. He doesn’t have any health insurance at all. So very often when you approach the billing department for the medical provider, you will need to discuss the allowable amounts which are normally built because
- [What if it Wasn't Medical Necessary, But You're Billed?](https://www.medicalinsuranceadvocacy.com/what-if-it-wasnt-medical-necessary-but-youre-billed/) - I have to tell you right now I am receiving quite a few clients whose insurance company is saying it wasn’t medically necessary for you to be in the hospital, and you could have been there for two to seven evenings. You go to the emergency room, they admit you to the hospital, and they’re
- [$25,000 Medical Fee Reduced to $1,700 Due to the No Surprise Act](https://www.medicalinsuranceadvocacy.com/25000-medical-fee-reduced-to-1700-due-to-the-no-surprise-act/) - I don’t know if anybody heard about this, but January 1st, 2022, a new bill was passed. It’s called the No Surprise Act. It is a national, um, uh, act. Uh, and a doctor has no right to charge you for services if they didn’t tell you in advance that they were outta network and
- [Who's Responsible for Preauthorization for Your Medical Procedure?](https://www.medicalinsuranceadvocacy.com/whos-responsible-for-preauthorization-for-your-medical-procedure/) - if a provider does not have pre-authorization for services rendered, which are usually the following procedures, surgery when they’re, uh, doing a procedure and they have to put dye in you, MRI, CAT scan, and, and also involving many other services, your claim is going to be denied if you didn’t have pre-authorization. I recently
- [Outdated CPT Codes May Cost You Thousands](https://www.medicalinsuranceadvocacy.com/outdated-cpt-codes-may-cost-you-thousands/) - Believe it or not, some medical providers are still using outdated CPT or ICD nine codes. A C P T code is the procedure performed and the I C D nine codes are no longer in existence. Now they have these I C D 10 codes and the I C D is your diagnosis. The
- [What If Your Provider Does Not Send Out the Bill on Time to the Insurance Company?](https://www.medicalinsuranceadvocacy.com/what-if-your-provider-does-not-send-out-the-bill-on-time-to-the-insurance-company/) - Have you ever been in a situation where your provider did not send the bill out to the insurance company on time? Insurance company usually demand that they receive the bills for services within 3, 4, 6, 9 or 12 months. So this client was directed and was billed over $75,000. When we discussed this
- [How to Avoid Paying the Same Medical Bill Twice](https://www.medicalinsuranceadvocacy.com/how-to-avoid-paying-the-same-medical-bill-twice/) - If it’s possible, I highly recommend that you keep track of claims that you have received and paid. It’s always best not to pay your medical provider until you receive the explanation of benefits. Sometimes providers duplicate the bills and occasionally they’re paid twice. I had a case recently where they were paid by the
- [$25,000 Medical Claim Reduced to Zero With This](https://www.medicalinsuranceadvocacy.com/25000-medical-claim-reduced-to-zero-with-this/) - I recently had a case where the provider did not have medical records for which they were billing the patient for. It was very difficult for them to not be able to find any medical records, even though they kept on billing my client over $25,000. So there was a lot of fighting back and
- [Medicare Advantage Plan May be an Issue for Nursing Homes](https://www.medicalinsuranceadvocacy.com/medicare-advantage-plan-may-be-an-issue-for-nursing-homes/) - I have to tell you, you know, this is crazy out there. People do not realize when they’re, when they turn 65 and they think, oh, this is gonna be great. If I go on a Medicare Advantage plan, let me tell you, if you wind up in a rehab, it’s not great because they
- [Billed for Services Never Rendered? We Can Help.](https://www.medicalinsuranceadvocacy.com/billed-for-services-never-rendered-we-can-help/) - I recently had insured reach out to me since they were built for services, never rendered. It was difficult to prove, but luckily, by examining the medical records, we were able to reduce the bill from $11,000 to only $2,000. If you’re ever having problems with your medical bills, please call me, Adria, Medwise Insurance
- [What to Do if Medical Claim Not Paid Due to Missed Insurance Payment](https://www.medicalinsuranceadvocacy.com/what-to-do-if-medical-claim-not-paid-due-to-missed-insurance-payment/) - I recently overturned the case where the patient forgot to submit premium due to cancer treatment. You know what happens is when you’re going through the treatment, your brain really becomes clouded and you can’t think straight. So thank God after speaking with the insurance company, we were able to pay the missed premiums and
- [Complications Due to Overseas Medical Bills?](https://www.medicalinsuranceadvocacy.com/complications-due-to-overseas-medical-bills/) - I’ve had people call me up and request assistance since they had medical service rendered out of the country and when we return to the United States, they still needed medical services. Due to complications of the surgeries performed overseas, I was able to reduce a, a bill recently down to 25%. The original USA
- [$17,000 Emergency Room Bill Reduced to CoPay](https://www.medicalinsuranceadvocacy.com/17000-emergency-room-bill-reduced-to-copay/) - All too often you could be receiving a bill from the emergency room. Since the providers were out of network, you know, a lot of times the hospitals will cover you, but the pro provide the providers in the emergency room, were totally out of network. So I was recently able to reduce a bill
- [Bills Went to Collections, but Never Received from Hospital?](https://www.medicalinsuranceadvocacy.com/bills-went-to-collections-but-never-received-from-hospital/) - Have you ever been in a situation where you receive a bill from a collection agency and never from the medical provider? I have a case where my client is being charged only $280,000. I went back to the medical provider and explained what occurred. Guess what? The bills are being paid by the insurance
- [If Your Medication is Not Covered by Insurance, Do This](https://www.medicalinsuranceadvocacy.com/if-your-medication-is-not-covered-by-insurance-do-this/) - Medication’s not covered on your plan. You can go online and try to order the medication in Canada. Take a look at, certified International Canadian Pharmacy and pharmacychecker.com. What’s happening now here in the us? You can also reach out to GoodRx. When I am at my pharmacy and I feel that they’re overcharging me,
- [$27,000 in Medication Expenses Reduced to $0](https://www.medicalinsuranceadvocacy.com/27000-in-medication-expenses-reduced-to-0/) - I had a recent case where the medication was not covered on the patient’s health insurance policy. After reaching out to the pharmaceutical company that manufactures that medication, I was so thrilled. I was able to obtain free medication for my client for at least one year. That was a major savings of over $27,000.
- [Multiple Medical Procedures at No Cost Due to This](https://www.medicalinsuranceadvocacy.com/multiple-medical-procedures-at-no-cost-due-to-this/) - I recently had a bill that included multiple procedures on the same day of service with the same provider. When I reviewed the bill from the billing company, they would not look into that making changes on the medical bill. They, they keep on thinking to themselves, they wanna get their money, and they’re usually
- [Federal No Surprise Act Does Not Include Land Ambulances](https://www.medicalinsuranceadvocacy.com/federal-no-surprise-act-does-not-include-land-ambulances/) - When the federal No Surprise Act was effective on January 1st, 2022, land ambulances were not included. So that means that the air, the l uh, the land ambulances are still allowed to charge you whatever their heart desires. I recently worked on a bill where the ambulance company had gouged the patient, and believe
- [Air Ambulance Has Legal Limitations for Charges](https://www.medicalinsuranceadvocacy.com/air-ambulance-has-legal-limitations-for-charges/) - Air ambulance became part of the federal no surprise Act, January 1st, 2022. An air ambulance is always considered to be an emergency, and now they have legal limitations on how much they’re allowed to charge an individual. I had a recent phone call involving this exact matter. If you ever are in a situation
- [Didn't Use an In-Network Insurance Provider?](https://www.medicalinsuranceadvocacy.com/didnt-use-an-in-network-insurance-provider/) - If possible, before your services are rendered, request whether a medical provider is out of network or in-network, you want this in writing. Otherwise, you might be paying the medical provider bill rather than your insurance company. It’s always best to see an in-network provider. Contact Adria Adria Gross See Full Bio
- [Saved Over $20,000 in Medical Bills for Doctor Outside of Network](https://www.medicalinsuranceadvocacy.com/saved-over-20000-in-medical-bills-for-doctor-outside-of-network/) - I was handling Insurance on an older billing for a family of five one of the children wound up in a New York City Hospital. And they were being billed a lot of money by the surgeon and just so happened that the surgeon did not take any insurance. They knew this in advance, but
- [Having Problems Getting Medical Bills Covered After Age 65?](https://www.medicalinsuranceadvocacy.com/having-problems-getting-medical-bills-covered-after-age-65/) - I worked on a case where the wife was the primary insurer through her employer. This was crazy when the wife died the husband was sitting with outstanding bills of over $300,000. It took a lot of time and effort to prove that the family was entitled to the insurance from her employer and the
- [Nanny Wasn't Covered for $10,000 in Medical Bills Until Adria Came Along](https://www.medicalinsuranceadvocacy.com/nanny-wasnt-covered-for-10000-in-medical-bills-until-adria-came-along/) - I worked with a family where their Nanny was from a foreign country and the hospital they overbuilt her so high $10,000, but when I was able to explain to the hospital that she didn’t have any insurance and her income was really low. They finally agreed to write off the bill of 10,000 hours. So
- [Does Hospital Volunteering Help With Medical Bills?](https://www.medicalinsuranceadvocacy.com/does-hospital-volunteering-help-with-medical-bills/) - Have you ever done volunteer work at a hospital? Sometimes the hospital will take that into consideration. And not bill you especially let’s say you don’t have any health insurance. So this was a case where the patient was being balanced bill of $34,000. The fact that they volunteered their time to the hospital the
- [$75,000 of Medical Bills Not Medically Necessary?](https://www.medicalinsuranceadvocacy.com/75000-of-medical-bills-not-medically-necessary/) - I don’t know if any of you have ever had an outstanding medical bill like for $75,000 did the insurance company tell you that the procedure was not medically necessary. Please I beg you fight and do not allow the insurance company to try and improve you wrong fight for your rights. Medwise is here
- [$60,000 Medical Bills in California Gets Written Off](https://www.medicalinsuranceadvocacy.com/60000-medical-bills-in-california-gets-written-off/) - I worked with a client in California where their medical bills were over sixty thousand dollars and it was involving their son where the hospital believe it or not. They were billing him an additional 60,000 the boy had a rare disease, but finally I was able to get the insurance company to pay the
- [Organizing Life's Daily Demands with Peter Gordon and Adria Gross](https://www.medicalinsuranceadvocacy.com/organizing-lifes-daily-demands-with-peter-gordon-and-adria-gross/) - In this episode of “Organizing Life’s Daily Demands” Peter Gordon interviews Adria Gross, Medical Bill Advocate, President/CEO at MedWise Ins Advocacy, and Co-Author of “Solved! Curing Your Medical Insurance Problems”. Adria helps clients reduce medical bills, avoid overcharges and negotiates bills down to a reasonable amount. Peter Gordon, Founder and President of New York Financial
- [Tennessee Family Saves $23,000 in Doctor Bills](https://www.medicalinsuranceadvocacy.com/tennessee-family-saves-23000-in-doctor-bills/) - Well, I worked with a family in Tennessee and the family involved a family of six. We had the husband his wife and his four kids, but he was the only family member who was making income. So the husband lines up in a major Hospital most of his medical bills are covered except for
- [$2,500 Emergency Room Bill Reduced to $230](https://www.medicalinsuranceadvocacy.com/2500-emergency-room-bill-reduced-to-230/) - So some of the health insurance policies are very limited. One of my clients. He was living in New York City and he had an emergency in New Jersey. And he received the bill for almost $2,500. By fighting with this insurance company and explaining that this was an emergency. Since that was the reason
- [Medical Bills from 24 Hour Psych Facilities?](https://www.medicalinsuranceadvocacy.com/medical-bills-from-24-hour-psych-facilities/) - So all too often people are having problems with 24 hours psych facilities, and they call me up for assistance involving medical bills. The one thing you have to try and remember is before you ever go into one of these 24-hour facilities. You must get authorization from your health insurance carrier. You have to
- [$15,408 Medical Bill Overcharge is Overturned](https://www.medicalinsuranceadvocacy.com/15408-medical-bill-overcharge-is-overturned/) - So, you know when a provider’s telling you that they’re definitely a network and all you’re going to have is this small copay, make sure you get all that information writing before you allow that surgeon to perform the services. I recently overturned a case where my client was being gouged. The doctor received $5,000
- [How Adria Saved Client $18,000 on Frequent Doctor Visit Invoices](https://www.medicalinsuranceadvocacy.com/how-adria-saved-client-18000-on-frequent-doctor-visit-invoices/) - Hey everyone, this is Edison Guzman with Adria Gross. How are you today? Adria? Nice and sunny and beautiful. Excellent. What do you have for us today? So a recent client was having issues with the balance that he was being charged. He had to see a doctor three times a week and his bills were
- [Overcharged by Psychiatrists and Psychologists?](https://www.medicalinsuranceadvocacy.com/overcharged-by-psychiatrists-and-psychologists/) - One of my clients was seeing a psychiatrist and also psychologist and I just want to give you some information. You don’t know it yet. Psychology bills normally range between $600 to $250 a visit and psychiatric bills are usually for psychiatrists. They’re usually between per visit between $200 to $500. So this client was being charged a thousand dollars per visit. She never
- [Liable for $27,000 Gets Reduced to $0 and Surgeon is Paid in Full](https://www.medicalinsuranceadvocacy.com/liable-for-27000-gets-reduced-to-0-and-surgeon-is-paid-in-full/) - one of my clients had to have a major surgery performed and they were not informed in advance that she was going to be liable for $27,000. I contacted her doctor and the insurance company. It was a tremendous amount of work, but I was able to finally save her the $27,000. And I was able to have the surgeon paid in full by the
- [A Surprise with The Surprise Bill Law](https://www.medicalinsuranceadvocacy.com/a-surprise-with-the-surprise-bill-law/) - If a procedure is an emergency, there’s been laws in States and all began when New York states started the surprise Bill law April 1st 2015, April Fool’s Day. One of my clients had excellent coverage and need emergency surgery. She even had multiple types of coverage. She did not just one policy. So the insurers paid
- [Medical Insurance Advocate and Attorney Work Together to Reduce a $370,000 Claim to $12,000](https://www.medicalinsuranceadvocacy.com/medical-insurance-advocate-and-attorney-work-together-to-reduce-a-370000-claim-to-12000/) - See now, I do a lot of work for law firms. They often. Call me in. I am considered to be an expert witness in cases. So this Law Firm came to me asking me to consult a case involving a surgeon’s bill for $373,000. When I was able to prove how much the provider
- [$500,000 Out of State Medical Bill Gets Covered in Full](https://www.medicalinsuranceadvocacy.com/500000-out-of-state-medical-bill-gets-covered-in-full/) - I worked on a case involving in New York City hospital where this person had brain surgery. Even though the hospital was paid money from her insurance company, which was out of state. She came from the Midwest to New York and her out of state insurance company paid for at the hospital was still
- [Out of Network Gynecologist Gets Paid Even with an HMO Policy](https://www.medicalinsuranceadvocacy.com/out-of-network-gynecologist-gets-paid-even-with-an-hmo-policy/) - So this is a crazy case where my client had difficulty with pregnancy. She needed surgery and she found the gynecologist that was out of network. The gynecologist told my client that even though he was out of network, he would come in to do the surgery after the first surgeon made the incision. The
- [Is Cyberknife Radiosurgery Covered?](https://www.medicalinsuranceadvocacy.com/is-cyberknife-radiosurgery-covered/) - I don’t know if he ever heard of this one, but cyber knife radio surgery I handle the case recently and was able to get my client covered for a hundred thousand dollars. You have to be careful as for what your insurance policy will cover. Every insurance policy differs on what they’ll cover. You
- [How to Get a $25,000 Medical Bill Paid if Denied by Health Insurance](https://www.medicalinsuranceadvocacy.com/how-to-get-a-25000-medical-bill-paid-if-denied-by-health-insurance/) - Hi, everyone, one of my clients had surgery and her major insurance company would not pay it. When I was able to prove that this surgery was medically necessary. That’s how they often deny saying it wasn’t medically necessary. So when I was able to prove that this surgery was medically necessary the insurance company
- [How to Reduce a $240,000 Medical Bill to $15,000 When You Have Travel Insurance](https://www.medicalinsuranceadvocacy.com/how-to-reduce-a-240000-medical-bill-to-15000-when-you-have-travel-insurance/) - I handled a case for a client who had bills from over 15 medical providers. It has to be like maybe 17 or 18 and this is really I need to it’s good to listen to this because I’m sure you have relatives who come here to the United States and they have travel insurance.
- [Will Your Insurance Cover Hearing Aids for Your Child?](https://www.medicalinsuranceadvocacy.com/will-your-insurance-cover-hearing-aids-for-your-child/) - I recently had a case where this four year old boy could not get a cochlear implant. The crazy part about the insurance policy was If the child was deaf in one ear but not the other the insurance company would not cover the procedure. So I asked you if you have the time and
- [The Easiest Way to Get Your Insurance Company Paying Your Claims](https://www.medicalinsuranceadvocacy.com/the-easiest-way-to-get-your-insurance-company-paying-your-claims/) - An attorney recently brought me into a case, which was almost twelve thousand dollars. The claim was definitely payable, but the issue was the insurance company kept on denying it. Just remember, this is when you are able to prove that according to your health insurance policy this procedure is covered. You can get that
- [Surgeon Bill of $273,000 Reduced to $27,000](https://www.medicalinsuranceadvocacy.com/surgeon-bill-of-273000-reduced-to-27000/) - I’m very often hired by an attorney to help their clients with their bills. And I was called into a case where the doctor performed back surgery, and this doctor was requesting over $273,000. After reviewing all the bills, I was able to make a reduction, of, you started out at $273,000, I reduced it
- [What to do if You Can't Use a Specific Doctor Outside of Your Network](https://www.medicalinsuranceadvocacy.com/what-to-do-if-you-cant-use-a-specific-doctor-outside-of-your-network/) - There are times when a patient is unable to see a doctor who’s on their plan. So when this happens, it’s best to contact your insurance company and see if you can request an exception. And if you’re able to prove that there’s no other doctor who can provide these Services who’s on your plan.
- [What to do When Medical Insurance Doesn't Pay What Doctors Charge](https://www.medicalinsuranceadvocacy.com/what-to-do-when-medical-insurance-doesnt-pay-what-doctors-charge/) - So, I recently had a case where a gentleman started out with bills of over $33,000. All the medical providers were gouging on this gentleman’s charges. I mean, you’ll see this all the time where they gouge. So I was able to reduce the bills from over $33,000 down to $11,000. The problem was that
- [This Medical Bill Advocate Was able to Get a $26,000 Bill Paid After Insurance Denial](https://www.medicalinsuranceadvocacy.com/this-medical-bill-advocate-was-able-to-get-a-26000-bill-paid-after-insurance-denial/) - So, a recent case involved a bill for $26,000. The issue was a problem with the medical billing company for the medical provider. Believe it or not, they had incorrect information about who the insurance carrier was for the patient. So the client never informed the medical provider of this new coverage, and finally I
- [Why You Should Never Allow Medical Bills to Go to Collections](https://www.medicalinsuranceadvocacy.com/why-you-should-never-allow-medical-bills-to-go-to-collections/) - This was a recent case where these two gentlemen were skydiving. One of the gentleman’s claims was totally paid for but the other one was not. I just want to tell you it involved two different insurance companies. So, you know, everybody always says to me which one’s better. I can’t tell you, but this
- [Need Reimbursements for Medical Charges?](https://www.medicalinsuranceadvocacy.com/need-reimbursements-for-medical-charges/) - Too many times people are incapable of submitting their medical bills, and you know when you think about it, you know, someone has dementia there are unable to find time. They might be too sick or there’s like multiple reasons. I have a case right now where this woman lost her husband and she’s so
- [How to Reduce Medical Bills Even if the Doctor is Out of Network](https://www.medicalinsuranceadvocacy.com/how-to-reduce-medical-bills-even-if-the-doctor-is-out-of-network/) - So I’m going to tell you a really crazy story. I handled a case where this woman had a blockage in her fallopian tubes. She was having a rough time getting pregnant. So she had an HMO policy and the doctor she hired was not on her plan. The doctor who is performing the surgery
- [Watch This if You've Ever Had Major Dental Work](https://www.medicalinsuranceadvocacy.com/watch-this-if-youve-ever-had-major-dental-work/) - If you’ve had major dental work, you might want to think about what I’m about to say. You send your claims in and there are issues on how the bills are submitted very often. You might be covered through your medical policy for dental services due to an injury. Now, you might have dental insurance. That’s
- [Bloodwork Lab Fees too High? See How to Reduce Them](https://www.medicalinsuranceadvocacy.com/bloodwork-lab-fees-too-high-see-how-to-reduce-them/) - Have you ever seen blood work lab fees where you might be charged thousands of dollars? Very often lab charges might not be covered under your insurance or it might be part of your deductible which some of them are so high. So I recently had a case where I saved a client $4,000 just
- [Why You Shouldn't Pay Your Medical Bill Right Away](https://www.medicalinsuranceadvocacy.com/why-you-shouldnt-pay-your-medical-bill-right-away/) - I tell people all the time don’t ever go ahead and pay your medical bill. Very frequently they’re just overcharging you. So, I was recently hired by an attorney for a case in which the client was being charged $61,922. After reviewing the reasonable customer charges, I was able to reduce the bill where the
- [$176,000 Bill Reduced to $0 After Speaking with a Medical Bill Advocate](https://www.medicalinsuranceadvocacy.com/176000-bill-reduced-to-0-after-speaking-with-a-medical-bill-advocate/) - This is the case which involved Believe It or Not $176,000, and after receiving the medical records from the hospital and determining what the provider had a right to bill for the bill believe it or not. It was reduced from $176,000 to zero. So, when you see these astronomical bills do not hesitate to
- [Will Your Medical Bills be Fully Covered After A Legal Settlement?](https://www.medicalinsuranceadvocacy.com/will-your-medical-bills-be-paid-after-settlement/) - Will your settlement be enough to cover all your medical bills? Watch Adria explain what you can do if this happens to you. Contact Adria If you have a trial coming up or you know someone who’s in this position due to an injury, and you’re going to be responsible for a lot of money
- [How Long Do You Have to Submit Your Medical Claims for Payment](https://www.medicalinsuranceadvocacy.com/how-long-do-you-have-to-submit-your-medical-claims-for-payment/) - What happens if you let your claims pile on over time, and don’t submit them to be paid by the insurance company in a timely manner. This is what happened to one of Adria’s clients. See how you can avoid this situation by watching this video now. Contact Adria So a case was referred to
- [What You Can do if Medicaid Doesn't Pay the Medical Bill](https://www.medicalinsuranceadvocacy.com/what-you-can-do-if-medicaid-doesnt-pay-the-medical-bill/) - Medicaid bills are rare, but when it does happen, Adria explains what you can do if you ever get a medical bill that was supposed to be covered. Contact Adria I recently had a gentleman in New York City who was a freelancer. He was on Medicaid since he was not making enough money to
- [How to Legally Bring a Medical Bill Down from $5,300 to $2,000](https://www.medicalinsuranceadvocacy.com/how-to-legally-bring-a-medical-bill-down-from-5300-to-2000/) - The size of the bill doesn’t matter to the person who can’t afford it. See how Adria was able to help her client decrease the medical bill for a hospital employee. You’ll be surprised about the added benefit she was able to deliver for this client. Contact Adria So I worked with the gentleman who
- [How to Get Your Medical Bills out of Collections and Fully Paid](https://www.medicalinsuranceadvocacy.com/how-to-get-your-medical-bills-out-of-collections-and-fully-paid/) - Here’s a “funny” story about a gentleman in the West Coast who had a extremely limited medical insurance and worked for a hospital. The large bill was sent to collections and Adria was able to help him with most of the balance. See how she was able to help in this video. Contact Adria Edison:Hi,
- [Can Medicare Bills be Paid Off By the Hospital](https://www.medicalinsuranceadvocacy.com/can-medicare-bills-be-paid-off-by-the-hospital/) - Adria has helped hundreds of people reduce or eliminate their medical bills, but is it possible to get a Medicare bill marked as “Paid” by the hospital? Watch the video and find out. Contact Adria So recently I worked on a case involving a senior who was on Medicare and sometimes they have these issues
- [Proving That You Really Have a Disability](https://www.medicalinsuranceadvocacy.com/proving-that-you-really-have-a-disability/) - How can you prove you have a disability? Watch this video where Adria explains how she helped a client with a disability and help them claim a monthly income. Contact Adria So, one of the most difficult even though I’m relaxed today one, of the most difficult cases to deal with a disability. It’s very
- [A $7,000 Medical Bill Written Off Because of This](https://www.medicalinsuranceadvocacy.com/a-7000-medical-bill-written-off-because-of-this/) - Adria explains how she helped a client get a hospital to write off $7,000 in medical bills. Contact Adria So I had a case where this gentleman went to an emergency room in a hospital at Long Island and after continuous months of going back and forth in the hospital not able to receive any
- [What's an Ambulatory Surgery Center, and How Does it Affect Your Medical Bills](https://www.medicalinsuranceadvocacy.com/will-your-medical-bills-be-fully-covered-after-a-legal-settlement/) - Adria explains what an ASC is on your medical bills. If the provider or billing company wants you to pay these bills, this is what you can do about it. Contact Adria I often see cases where doctor needs to perform services, but they don’t have access to a hospital. So they use an outside
- [What Happens When Your Term Care Policy Company Goes Out of Business](https://www.medicalinsuranceadvocacy.com/what-happens-when-your-term-care-policy-company-goes-out-of-business/) - There’s hope, even if your long term care policy company goes out of business. Watch this video and learn what Adria did to help with claims, even when there was no company to pay benefits. Adria Gross See Full Bio
- [Coordination of Benefits in an Auto Accident](https://www.medicalinsuranceadvocacy.com/coordination-of-benefits-in-an-auto-accident/) - Ever wonder who’s responsible for benefits in an auto accident? If you have medical bills due to a car accident, there a few things you should know in order to get the claims paid. Adria reveals the simple method to ensure your medical claims are paid so that you minimize out of pocket expenses. Adria
- [Help for Children With Autism as a Disability](https://www.medicalinsuranceadvocacy.com/help-for-children-with-autism-as-a-disability/) - There are many resources for parents that have children with mental health issues, including Autism. Here’s a quick tip and resource if you’re a person in need. Adria Gross See Full Bio
- [How to Overturn a $30k Denied Medical Claim](https://www.medicalinsuranceadvocacy.com/how-to-overturn-a-30k-denied-medical-claim/) - What do you do when you have a $30,000 medical insurance bill, which was denied and can’t get it paid by the insurance company? Watch this video and see what it takes to get it paid. Adria Gross See Full Bio
- [What to Do for Health Insurance When Traveling From Another Country](https://www.medicalinsuranceadvocacy.com/what-to-do-for-health-insurance-when-traveling-from-another-country/) - Do you have parents, or elderly relatives traveling from another country into the U.S.A.? What do you for health insurance? This video warns you about what not to do, and reveals the best way to protect yourself against medical expenses that can ruin your visit. Adria Gross See Full Bio
- [Is Your Pre-Existing Condition Getting Your Claims Denied?](https://www.medicalinsuranceadvocacy.com/is-your-pre-existing-condition-getting-your-claims-denied/) - Pre-existing conditions are supposed to be a thing of the past due to the ACA, but there are still many companies selling these types of policies. Listen in as Adria reveals a special agency that will help you decide the best type of health insurance policy for you and your family. Adria Gross See Full
- [How Multi-Plan Health Plans Work and Are They Worth It?](https://www.medicalinsuranceadvocacy.com/how-multi-plan-health-plans-work-and-are-they-worth-it/) - Part of a Preferred Health Care System, Multi-Plan Health Plan? You need to watch this video to protect yourself. There are things you need to know before purchasing this type of policy, and what you should do if you already have it. Adria Gross See Full Bio
- [How to Reduce Million Dollar Medical Fees to a Few Thousand](https://www.medicalinsuranceadvocacy.com/how-to-reduce-million-dollar-medical-fees-to-a-few-thousand/) - Adria explains how Neonatal bills procedural codes were used to reduce million dollar medical fees to a few thousand. Watch and see exactly how you too can reduce your medical insurance costs by simply using the right codes. Adria Gross See Full Bio
- [How to Get Out of State Medical Claims Paid](https://www.medicalinsuranceadvocacy.com/how-to-get-out-of-state-medical-claims-paid/) - In this interview, Adria discusses how she was able to get out of state medical claims paid. If you’ve ever had issues with your bills not being covered because you were out of state, this is a must see interview. Adria Gross See Full Bio
- [What is Balance Billing?](https://www.medicalinsuranceadvocacy.com/what-is-balance-billing/) - Have you ever received a large bill from the hospital, and have your insurance pay a portion, and leave you with the bulk of the balance? That is balance billing, and watch this episode to discover how Adria is helping a client with a $102,000 medical insurance debt. Adria Gross See Full Bio
- [What Are Reasonable and Customary Charges for Specific Procedure Codes?](https://www.medicalinsuranceadvocacy.com/what-are-reasonable-and-customer-charges-for-specific-procedure-codes/) - This is a very interesting story where you’ll discover how procedure Codes affect reasonable and customary charges when you go to the hospital. See how Adria reduced a massive hospital bill by applying her knowledge and experience as a medical insurance advocate. Adria Gross See Full Bio
- [How Deductibles and Copays Affect Medical Bills](https://www.medicalinsuranceadvocacy.com/how-deductibles-and-copays-affect-medical-bills/) - How do deductibles and copays affect your out of pocket medical expenses? This video reveals a case study where a high deductible was interfering with getting medical claims paid, and what Adria did to reduce the out of pocket expense for her client. Adria Gross See Full Bio
- [How to Get Your Denied Bill Claims Paid](https://www.medicalinsuranceadvocacy.com/medical-insurance-advocacy-adria-gross-interview/) - Why Hire Medical Insurance Advocate Adria Gross? If you’ve ever had medical bills denied by your insurance company, this video interview reveals why it’s important to hire a medical insurance advocate. Insurance advocacy is a necessary service many people are not aware of, and certainly need. This short interview will tell you how to utilize
- [Have a Health Sharing Plan? Here's How to Get Your Denied Claim, Paid.](https://www.medicalinsuranceadvocacy.com/have-a-health-sharing-plan-heres-how-to-get-your-denied-claim-paid/) - This video covers a case study about a person who is a member of a share health plan. See how Adria was able to get them to cover the maximum benefit amount for her client. If you have similar issues, contact Adria right away by clicking here. Adria Gross See Full Bio
- [Adria Gross Case Study as a Medical Insurance Advocate](https://www.medicalinsuranceadvocacy.com/adria-gross-case-study-as-a-medical-insurance-advocate/) - Another Reason to Hire a Medical Insurance Advocate Adria Gross reveals a case study that you need to hear about if you’ve ever had denied medical bill claims. As a medical insurance advocate, Adria breaks down exactly what she’s doing to get a large claim paid for one of her medical billing clients. Adria Gross
- [What to Do if Rehab or Nursing Homes Deny Long Term Care Policies](https://www.medicalinsuranceadvocacy.com/what-to-do-if-rehab-or-nursing-homes-deny-long-term-care-policies/) - Adria Gross discusses what to do if rehab or nursing homes deny long term care policies on the Greenburgh Report with Supervisor Paul Feiner. Adria Gross See Full Bio
- [A Two Million Dollar Denied Medical Claim Gets Paid After Getting Adria Involved](https://www.medicalinsuranceadvocacy.com/a-two-million-dollar-denied-medical-claim-gets-paid-after-getting-adria-involved/) - The fear of not knowing how to get through with paying your medical bills, regardless of the amount you owe, can be debilitating. This video shows how Adria was able to help one of her clients with medical debts totaling over 2 million dollars. Contact Adria Adria Gross See Full Bio
- [Can Electronic Convulsive Therapy Help With Depression and be Covered by Medical Insurance?](https://www.medicalinsuranceadvocacy.com/can-electronic-convulsive-therapy-help-with-depression-and-be-covered-by-medical-insurance/) - There are times when people are so depressed, and they’ve tried all types of medication. Sometimes they have no other options and try ECT. These are frequently performed in a hospital. It’s mostly an outpatient treatment, but due to COVID, it may have been in-patient. See how Adria can help if you have this type
- [Canadian Woman with Deformity Gets Surgery in U.S. Reduces Bill from $125K down to 7K](https://www.medicalinsuranceadvocacy.com/canadian-woman-with-deformity-gets-surgery-in-u-s-reduces-bill-from-125-down-to-7k/) - What happens when residents from Canada visit the U.S. for surgery and the bill is astronomical? Adria explains a case study for one of her clients, and shows you what you can do in the same situation. Contact Adria Adria Gross See Full Bio
- [This is Adria's Story As Presented to Master Networks](https://www.medicalinsuranceadvocacy.com/this-is-adrias-story-as-presented-to-master-networks/) - Adria Gross has been helping individuals with their unpaid medical bills for a long time now, but have you heard how she started this business? This video presentation tells the full story behind her beginnings and why she wants to help as many people as possible, as a medical insurance advocate. Contact Adria Adria Gross
- [What to Do When Medicare Doesn't Pay Because They Say It's Pre-Existing from 20 Years Ago](https://www.medicalinsuranceadvocacy.com/what-to-do-when-medicare-doesnt-pay-because-they-say-its-pre-existing-from-20-years-ago/) - Have you ever received a medical bill that wasn’t covered because Medicare says it was from a pre-existing condition? This video shows what you can do to get that bill paid so that you can have peace of mind. Contact Adria Adria Gross See Full Bio
- [Medical Bill Advocate Helps Client in California with $700,000 Bill](https://www.medicalinsuranceadvocacy.com/medical-bill-advocate-helps-client-in-california-with-700000-bill/) - It doesn’t matter if you’re in New York, or California, Adria Gross can help you with medical bills. This video shows how Adria helped a client with a $700,000 medical bill. You’ll be surprised how she was able to help. Contact Adria Adria Gross See Full Bio
- [Have Questions About Long Term Care Policies?](https://www.medicalinsuranceadvocacy.com/have-questions-about-long-term-care-policies/) - What questions would you like answered about Long Term Care policies? Adria Gross has helped individuals from New York to Texas answer their Long Term Care policy questions. This video explains how you can get help. Contact Adria Adria Gross See Full Bio
- [Adria Helps Texas Client Reduce Bill from $35,000 to $3,000](https://www.medicalinsuranceadvocacy.com/adria-helps-texas-client-reduces-bill-from-35000-to-3000/) - As a medical bill advocate, Adria Gross helped a Texas client reduce their medical bill from $35,000 to only $3,000. Watch this short video and see how she did it. Contact Adria Adria Gross See Full Bio
- [The Business Power Hour with Adria Gross](https://www.medicalinsuranceadvocacy.com/the-business-power-hour-with-adria-gross/) - Adria Gross See Full Bio
- [A Dose of Advice How to Avoid Unexpected Medical Bills](https://www.medicalinsuranceadvocacy.com/a-dose-of-advice-how-to-avoid-unexpected-medical-bills/) - In an interview at Lasell University, Adria Gross explains how to avoid unexpected medical bills for you and your family. The presentation is followed by Q&A where more answers follow great medical insurance advocacy questions. Adria Gross See Full Bio
- [Out-of-Pocket Costs Put Health Care Out of Reach](https://www.medicalinsuranceadvocacy.com/out-of-pocket-costs-put-health-care-out-of-reach/) - Medical Bill Advocate, Adria Goldman Gross, was published in the following Boston Globe article: Out-of-pocket costs put health care out of reach THE BOSTON GLOBE | OPINION By Mark Pothier GLOBE STAFF JUNE 25, 2015 SOON AFTER A RECENT minor surgery, I began suffering from a painful complication — it hurt to open the mail. Within weeks, I had
- [Being Overcharged For Medical Bills? Read About Adria Gross & MedWise on Fox News](https://www.medicalinsuranceadvocacy.com/being-overcharged-for-medical-bills-read-about-adria-gross-medwise-on-fox-news/) - Balance billing: How to avoid this common medical expense trap By Lacie Glover Published September 23, 2015 Imagine receiving a hospital bill for tens of thousands of dollars despite having the best health insurance you can afford. This scenario happens to even the most diligent health care consumers more than you’d think. Often, the culprit is
- [Pitfalls of Multi-Payer Health Insurance|Medical Insurance Advocate, Adria Gross, Authors Book](https://www.medicalinsuranceadvocacy.com/pitfalls-of-multi-payer-health-insurancemedical-insurance-advocate-adria-gross-authors-book/) - Medical Insurance Advocate, Adria Gross, Authors Book on Pitfalls of Multi-Payer Health Insurance President of MedWise Insurance Advocacy Details the Woes of American Medical Insurance and Ways to Counter These Issues; Book Available on Amazon.com for US and Canada Markets MONROE, N.Y., November 9, 2015 – Consumers concerned about the rising cost of health care
- [Billing Battles Begone! Solved! Curing Your Medical Insurance Problems](https://www.medicalinsuranceadvocacy.com/billing-battles-begone-solved-curing-your-medical-insurance-problems/) - Billing Battles Begone! Acclaimed Medical Insurance Advocate Adria Goldman Gross Writes New Book: “Solved … Should you find yourself doing battle with a health insurance company or hospital, I have three words of advice: get this book! (PRWEB) March 08, 2016 Acclaimed medical insurance advocate Adria Goldman Gross, FIPC, has written a new book entitled
- [Best Seller Adria Gross Multi Payer Medicine Nightmare Made in the USA](https://www.medicalinsuranceadvocacy.com/best-seller-adria-gross-multi-payer-medicine-nightmare-made-in-the-usa/) - Co- Author Adria Gross, MedWise Insurance Advocacy, Best Selling Book Outskirts Press Reveals Top 10 Best Selling Books in Self-Publishing from April 2016 Outskirts Press, the fastest-growing full service self-publishing and book marketing company today announced their top 10 best-selling, self-published books from April 2016. www.outskirtspress.com Outskirts Press, the fastest-growing full service self-publishing and book
- [ACA... "Obamacare"... New Health Care... 10 Tips to Reduce Medical Bills On Any Health Plan](https://www.medicalinsuranceadvocacy.com/10-tips-to-reduce-medical-bills-on-any-health-plan/) - The United States is in a time of transition. Anxiety over changes in health insurance and paying medical bills is rising as the Senate took steps to repeal “Obamacare” and the administration made an executive order about health care on January 20th, 2017. Advice from a medical bill advocate on how to lower health costs
- [6 Steps to Lower Medical Bills before Service is Rendered and You Pay for it](https://www.medicalinsuranceadvocacy.com/6stepslowermedicalbills/) - Health insurance coverage requires contracts between insurance companies, employers, employees, private individuals, as well as state and federal governments. The Affordable Care Act, which covers 20 million people, limits the wiggle room companies have when crafting these contractual agreements. The contractual limitations trigger protections for long-term care, coverage for preexisting conditions, dependent coverage until age
- [Rest Easy as Medical Bills Get Paid](https://www.medicalinsuranceadvocacy.com/rest-easy-as-medical-bills-get-paid/) - Her body was tired, she couldn't switch hospitals her bills accumulated. Insurance had forsaken her, an estate in shambles. Find out what we did... A woman was suffering from Stage 4 Cancer for over 4 years. She went to the same hospital and saw the same doctors throughout her illness. In 2016, state insurance coverage
- [2 Clients with Over 1.5 Million in Denied Medical Bills are Paid](https://www.medicalinsuranceadvocacy.com/2-clients-with-over-1-5-million-in-denied-medical-bills-are-paid/) - Last month, I shared a story about a woman, who had medical bills that had to be negotiated, totaling close to a million dollars and the bills were paid in full to the hospital from her insurance company. Now, I will tell a story of a woman, who had medical bills over $500,000, from out-of-state
- [Medical Bills Affect Credit and Cause Bankruptcy: There are Solutions](https://www.medicalinsuranceadvocacy.com/medical-bills-affect-credit-and-cause-bankruptcy-there-are-solutions/) - The debt from medical bills are like a black hole on a credit report. Tracking the origin of the medical bills is the first step to navigating the debt and determining if and how the bills can be reduced. Medical providers are less likely to report the debt to a credit reporting agency and are
- [Federal and State Programs that Help Pay Medical Bills](https://www.medicalinsuranceadvocacy.com/state-and-federal-programs-that-help-pay-medical-bills/) - Medical care and prescription drugs are expensive. If someone is struggling paying for medical care or prescription drugs, these state and federal programs may be able to help: HealthCare.gov this site helps find insurance options, compare care, learn about prevention, and understand the Affordable Care Act. State human/social service agencies offer direct aid and referrals
- [National Organizations that Pay for Medical Care](https://www.medicalinsuranceadvocacy.com/nationalorganizationspaymedicalcare/) - National Organizations that Provide Assistance Paying for Medical Care and Procedures Department of Health and Human Services (DHHS) [hhs.gov] The Department of Health and Human Services (DHHS) has information on assistance in paying for medical care for low-income families. Go to "Families & Children." Government Benefits [benefits.gov] The official government benefits website. This is a
- [Is Your Medical Benefits Advocate Conflicted?](https://www.medicalinsuranceadvocacy.com/medicaladvocateconflict/) - Companies are relying on advocates from their insurance company to get employee medical bills approved and paid. This is bad news for employees, as in-house human resource positions are removed and the people who are fighting for bills to be approved are conflicted by their true employer... the insurance company. Read more about this conflict
- [Appealing Self-Insured Benefits Denials](https://www.medicalinsuranceadvocacy.com/appealing-self-insured-benefits-denials/) - Big corporations are no stranger to self-insuring their employees. When an employer only contracts with an insurance carrier for insurance services such as enrollment, claims processing and provider networks with a third party administrator, the employer is agreeing to be the party to payout any medical bills incurred by their employees. Keep in mind, that
- [Affordable Care Act Open Enrollment and NYC Workshop](https://www.medicalinsuranceadvocacy.com/openenrollment/) - Don’t Miss My Upcoming Workshop or Health Insurance Open Enrollment Although there are ways to lower health care costs when someone doesn’t have coverage, check out the multiple resources I have gathered to help people when they are sick; it is ideal for people to have some form of coverage. For more information on how
- [Save on Prescription Medications](https://www.medicalinsuranceadvocacy.com/save-on-prescription-medications/) - Venturing out to cut costs for prescriptions can be like wandering down a dark ally while haggling for the best price at the busiest market. The price of a medication can vary greatly, even within the same zip code depending on the available retailers. Pharmaceutical companies price medications at a high rate because they do
- [Is a Settlement or Court Ordered Judgment Protected from Subrogation?](https://www.medicalinsuranceadvocacy.com/subrogation/) - Can Medical or Insurance Providers Claim Rights over Settlement or Judgment Money? Medical providers ask a lot of questions about how and why you are seeing them. During this inquisition it gives them information needed to care for you, as well as, an insight into the likelihood that someone else is responsible for the injury.
- [How Medical Billing Advocates Negotiate to Help Pay Medical Bills](https://www.medicalinsuranceadvocacy.com/how-medical-billing-advocates-negotiate-to-help-pay-medical-bills/) - Medical bills become a problem after claims have been denied from insurance carriers and paying off the bills becomes a game of negotiation. This is where a medical billing and insurance advocate can help negotiate and appeal medical claim denials. Why Medical Claims are Denied Claims may be denied because the insurance carrier decides
- [Are Low Cost Associated Health Plans Worth It?](https://www.medicalinsuranceadvocacy.com/are-low-cost-associated-health-plans-worth-it/) - Your health is great, until it isn't. Health care plans that are pitched to someone who is healthy may not necessarily cover them when sick, especially if a low cost Associated Health Plan (AHP) is purchased. The latest news in healthcare is the introduction of AHPs that offer alternative coverage that is not governed by
- [Use Due Diligence to Negotiate Medical Bills](https://www.medicalinsuranceadvocacy.com/use-due-diligence-to-negotiate-medical-bills/) - Associated health plans and self-insurance programs are increasingly part of the healthcare marketplace and they are leading a movement of comparative shopping for medical care and prescriptions . Over 90% of patients want to know what their costs will be for care prior to service. In January 2019 a federal requirement insists hospitals list their
- [Negotiating International Medical Care: 10 Key Questions to Lower Medical Costs When Traveling Abroad](https://www.medicalinsuranceadvocacy.com/negotiating-international-medical-care-10-key-questions-to-lower-medical-costs-when-traveling-abroad/) - Senators like Rand Paul are going to Canada to competitively shop and save on care. Patients seeking tips on how to lower costs on past bills can save and receive specialized care when they travel beyond borders for health services. The growth in international medical travel is due to improved availability of health technology, decreasing costs for
- [The Courts in Texas and the Affordable Care Act](https://www.medicalinsuranceadvocacy.com/the-courts-in-texas-and-the-affordable-care-act/) - The Affordable Care Act created a private insurance market that 15 million Americans use for coverage. The act also encouraged state Medicaid expansion that covers another 15 million, as well as, provides protections for people with preexisting conditions and other regulations. The contractual dynamic between insurance companies, physicians and the insured gradually became standardized. There was a time, I
- [Faith-Based Health Cost Sharing Vs. Associated Health Plans](https://www.medicalinsuranceadvocacy.com/faith-based-health-cost-sharing-vs-associated-health-plans/) - Taking care of our health can be a costly endeavor. The ability to pay can become a matter of life and death if bills rack up over long term care that falls into collections. That is why having insurance is so important during unexpected emergencies or when someone has a chronic illness. Medwise Insurance Advocacy,
- [Surprise Medical Bills and Balance Billing or Just Billed](https://www.medicalinsuranceadvocacy.com/surprise-medical-bills-and-balance-billing-or-just-billed/) - Balance billing and surprise medical bills can be difficult to negotiate when you don't know how to apply laws against the practice. Ask a medical bill advocate how the laws are applied to different plans.
- [Healthcare Enrollment Dates, Fees and a Delicate Dance for Coverage](https://www.medicalinsuranceadvocacy.com/healthcare-enrollment-dates-fees-and-a-delicate-dance-for-coverage/) - There are so many costs associated with healthcare. To meet contractual requirements, each fee has a different name with specific stipulations. As insurance holders, members pay premiums for coverage to insurance companies and then pay providers directly until they meet their deduction before insurance starts to pay the bill, as well as, other out-of-pocket expenses
- [Medical Bills and Arbitration:  Surprise Billing is Coming to an End, What is the Solution?](https://www.medicalinsuranceadvocacy.com/medical-bills-and-arbitration-surprise-billing-is-coming-to-an-end-what-is-the-solution/) - Individuals have the power to make contracts with people over almost anything, so long as all parties mutually agree and are aware of the stipulations within the agreement. The issue with medical billing in an emergency is that people are agreeing to receive care from professionals when they are not in an equal bargaining position,
- [Mental Health Care is Medically Necessary- 10 Tips to Lower Mental Health Costs](https://www.medicalinsuranceadvocacy.com/mental-health-care-is-medically-necessary-10-tips-to-lower-mental-health-costs/) - Mental Health Care is medically necessary and covered by health insurance in specific instances. Here are 10 ways to lower the cost of mental health care.
- [Covid-19 Medical Costs and How they are Covered](https://www.medicalinsuranceadvocacy.com/covid-19-medical-costs-and-how-they-are-covered/) - PPE is hard to come by and medical costs for care are on the rise with Covid-19. Even before a patient sees a doctor, many are left to wonder if they are covered. Every aspect of this viral disease is a costly endeavor for the provider as it infects their offices, requires expensive tests, procedures
- [Where to Find Help Paying Medical Bills](https://www.medicalinsuranceadvocacy.com/wheretofindhelppayingmedicalbills/) - I have spoken with people who have lost everything because of an illness. Having to choose between paying rent, buying food or paying for medical care is stressful. The Kaiser Family Foundation reports that in 2016, half of all insurance policy-holders face a deductible of at least $1,000. This is the amount someone has to
- [10 Tips to Lower Mental Health Costs](https://www.medicalinsuranceadvocacy.com/10-tips-to-lower-mental-health-costs/) - Is Mental Health Care Covered? Mental Health Care has a huge range of care possibilities and little coverage options. Insurance often pays for services that are medically necessary in an emergency or when referred to specialists as medically necessary from a primary care physician. Patients have to ensure that the doctors that treat them are
- [Faith-Based Health Cost Sharing Vs. Associated Health Plans](https://www.medicalinsuranceadvocacy.com/faith-based-health-cost-sharing-vs-associated-health-plans-2/) - Taking care of our health can be a costly endeavor. The ability to pay can become a matter of life and death if bills rack up over long term care that falls into collections. That is why having insurance is so important during unexpected emergencies or when someone has a chronic illness. Medwise Insurance Advocacy,
- [Surprise Medical Bills and Balance Billing or Just Billed](https://www.medicalinsuranceadvocacy.com/surprise-medical-bills-and-balance-billing-or-just-billed-2/) - When you go to a hospital that is In-Network it only seems natural to think that everyone you work with at the hospital is covered within the facility. However, that is not the case. Clients have even come to me where they received medically necessary care at an in-network facility only to be taken to
- [Medical Bills and Arbitration: Surprise Billing is Coming to an End, What is the Solution?](https://www.medicalinsuranceadvocacy.com/medical-bills-and-arbitration-surprise-billing-is-coming-to-an-end-what-is-the-solution-2/) - Individuals have the power to make contracts with people over almost anything, so long as all parties mutually agree and are aware of the stipulations within the agreement. The issue with medical billing in an emergency is that people are agreeing to receive care from professionals when they are not in an equal bargaining position,
- [Obamacare | More Americans buy short-term plans](https://www.medicalinsuranceadvocacy.com/obamacare-more-americans-buy-short-term-plans/) - Joan and Dr. John Mendola were my clients involving Joan's medical bills due to her stroke. We were being denied by the insurer saying it was pre-existing. Joan never had this condition prior to purchasing the insurance. We persevered and was able to ensure the hospital bills were covered. We were also able to subrogate
- [MedWise Insurance Advocacy  - Adria Gross Filmed on CBS](https://www.medicalinsuranceadvocacy.com/medwise-insurance-advocacy-adria-gross-filmed-on-cbs/) - Take a look at the below video - Adria Gross from MedWise Insurance Advocacy was filmed on CBS6 and shown in Albany, NY. Watch and learn about another reason why your medical bill will not be reimbursed by your health insurance company. https://www.youtube.com/watch?v=AF9-8xBtHkg
- [Law helps cut down on surprise medical bills](https://www.medicalinsuranceadvocacy.com/law-helps-cut-down-on-surprise-medical-bills/) - Column: Law helps cut down on surprise medical bills by Westfair Online | April 28, 2015 10:11 am BY ADRIA GROSS A new consumer protection law went into effect April 1 in New York — the Emergency Medical Services and Surprise Bills law — which protects patients from unexpected expenses related to out-of-network and emergency
- [Diagnosing and Deciphering Medical Bills for Your Clients  FPA GHV Dinner](https://www.medicalinsuranceadvocacy.com/diagnosing-and-deciphering-medical-bills-for-your-clients-fpa-ghv-dinner/) - Financial Planning Association Greater Hudson Valley Dinner Program Tuesday, March 10, 2015 4:30pm - 8:00pm Sam's of Gedney Way, White Plains, NY PROGRAM DESCRIPTION & SPEAKER BIO Diagnosing and Deciphering Medical Bills for Your Clients This one hour presentation will educate advisors on how to help their clients plan for and understand their health
- [Medicare Coverage: It Begins to Change ’Round Midnight](https://www.medicalinsuranceadvocacy.com/medicare-coverage-it-begins-to-change-round-midnight/) - Medicare Coverage: It Begins to Change ’Round Midnight by Advisor Voices on January 21, 2015 | posted in Advisor Voices By Adria Gross Learn more about Adria on NerdWallet’s Ask an Advisor Imagine you go to the emergency room with chest pains, and the doctor on duty sends you to the ICU for overnight observation.
- [If Your Health Claim Is Rejected - MedWise Insurance Advocacy](https://www.medicalinsuranceadvocacy.com/if-your-health-claim-is-rejected-medwise-insurance-advocacy/) - If Your Health Claim Is Rejected By Adria Gross Every time you make a claim under your health insurance policy, there is a substantial possibility that your insurer will decide to reject it. When claims are rejected, policyholders must either pay out of pocket for medical bills or spend an inordinate amount of time battling
- [Chain reaction: Hospital affiliations could drive up costs](https://www.medicalinsuranceadvocacy.com/chain-reaction-hospital-affiliations-could-drive-up-costs/) - Chain reaction: Hospital affiliations could drive up costs By Jane Lerner, Journal News Over the past year, community hospitals in the Lower Hudson Valley have been courted by large, out-of-town health care networks, with many marching down the aisle to cast their future with giant health systems. But these mergers may not lead to relationships
- [Nexus Health Academy Presents  -- UNDERSTANDING MEDICAL BILLS](https://www.medicalinsuranceadvocacy.com/nexus-health-academy-presents-understanding-medical-bills/) - Wednesday November 12, 2014 from 2:00 PM to 3:00 PM EST Nexus Health Academy Presents UNDERSTANDING MEDICAL BILLS at Orange Regional Medical Center 707 East Main Street Ground Floor Conference Room 1 Middletown, NY 10940 Join us to learn how to decrypt medical bill codes and understand YOUR medical bills. Medical bills can be complex,
- [Adria Goldman Gross will be speaking “Your Prescription for Financial Well-Being” in White Plains, NY](https://www.medicalinsuranceadvocacy.com/adria-goldman-gross-will-be-speaking-your-prescription-for-financial-well-being-in-white-plains-ny/) - Adria Goldman Gross will be speaking at Digital Arts Experience in White Plains, NY , October 23, 2014, 10am-12pm @ Digital Arts Experience Mid-Central Region Livable Communities Presents “Your Prescription for Financial Well-Being” Join us for a panel discussion by leading professionals on how to become prepared and financially savvy for the future! “How to Choose
- [6 Questions You Should Ask Before Paying Any Medical Bill](https://www.medicalinsuranceadvocacy.com/6-questions-you-should-ask-before-paying-any-medical-bill/) - Medical billing is wrought with errors and overcharges. Here's how to avoid overpaying. As written by US NEWS and World Report The next time you receive a medical bill, read it carefully. It's not uncommon to be charged for services you didn't receive. Because they’re usually unexpected, medical bills can force otherwise financially savvy consumers
- [Learn How to Get Your Medical Insurance Claim Paid](https://www.medicalinsuranceadvocacy.com/learn-how-to-get-your-medical-insurance-claim-paid/) - I was published in Bottom Line Publications on August 15th, 2014. The article teaches people how to handle their own medical insurance claims. If you'd like to know the best way to get your claim paid, click on the link below to read the full article. Bottom Line Article
- [Medicare 101 and How It Affects You | Adria Gross | July 9, 2014](https://www.medicalinsuranceadvocacy.com/medicare-101-and-how-it-affects-you-adria-gross-july-9-2014/) - Medicare 101 and How It Affects You Wednesday July 9, 2014 at 11:00 AM Presented by Adria Goldman Gross, Medical Claim Advocate Expert CEO of MedWise Insurance Advocacy Join us for Lunch & Learn How Health Care Changes Could Impact Your Future The recent changes to health insurance and the health care industry
- [Avoid High Cost Medical Bills - Medical Bill Advocate](https://www.medicalinsuranceadvocacy.com/avoid-high-cost-medical-bills-medical-bill-advocate/) - Take a look at ABC NEWS - outrageous medical bills. Medical bills are the number one cause of personal bankruptcy in this country: http://abcnews.go.com/WNT/video/avoiding-high-cost-medical-care-24272962 Are you facing exorbitant medical bills? Call MedWise Insurance Advocacy to save you time and money. We Give A Hoot About Your Claims!!
- [MEDWISE INSURANCE ADVOCACY FOUNDER ADRIA GROSS: FEATURED  SPEAKER AT 92ND ST Y IN NEW YORK CITY](https://www.medicalinsuranceadvocacy.com/medwise-insurance-advocacy-founder-adria-gross-featured-speaker-at-92nd-st-y-in-new-york-city/) - MEDWISE INSURANCE ADVOCACY FOUNDER ADRIA GROSS: FEATURED SPEAKER AT 92ND ST Y IN NEW YORK CITY IN MARCH Among Adria Gross’ many speaking engagements to better inform the public about the confusing subject of medical billing, she was distinguished as the featured speaker on the March 25 “To Your Health” series of the 92nd St. Y.
- [Decompress Stress with Medical Bills & Pinpoint Why You Might Be Denied!](https://www.medicalinsuranceadvocacy.com/decompress-stress-with-medical-bills-pinpoint-why-you-might-be-denied/) - FREE: Decompress Stress with Medical Bills & Pinpoint Why You Might Be Denied! Hear A Professional Medical Bill Advocate Presenter: Adria Goldman Gross, Medwise Insurance Advocacy, Medical Bill Advocate JCC Rockland 450 West Nyack Road West Nyack, NY 10994 845.362.4400 ext. 100 Thursday, April 3, 1pm Meet a Medical Bill Advocate and Gain a Better
- [Learn Seven Ways to Cut Medical Costs from Medical Bill Advocate](https://www.medicalinsuranceadvocacy.com/learn-seven-ways-to-cut-medical-costs-from-medical-bill-advocate/) - NEWS RELEASE Public is Invited to Learn Seven Ways to Cut Medical Costs from Medical Insurance Advocate at 92nd Street Y on March 25 Adria Gross of MedWise Insurance Advocacy Will Share Helpful Tips for Consumers on How to Decipher Medical Bills and Charges, Who to Contact to Dispute a Charge, and How to Reduce
- [Don’t Pay that Total |How to Negotiate Your Medical Bills | Medical Bill Advocate](https://www.medicalinsuranceadvocacy.com/dont-pay-that-total-how-to-negotiate-your-medical-bills-medical-bill-advocate/) - I read this article and thought it is very informational involving the need and assistance of a medical bill advocate. Don’t Pay that Total. How to Negotiate Your Medical Bills By Donna Fuscaldo Published February 11, 2014 FOXBusiness We have no problem haggling over the price of a car or home, so why not our
- [What Makes Older People Happy | Medical Bill Advocate](https://www.medicalinsuranceadvocacy.com/what-makes-older-people-happy-medical-bill-advocate/) - As a medical bill advocate, at least one third of my business involves seniors. I thought this is a beautiful article many would like to read: February 11, 2014 What Makes Older People Happy By JUDITH GRAHAM Every year, my husband and I wonder what kind of birthday gift to give his dad, now 86
- [Fighting ‘Observation’ Status | Medical Bill Advocate](https://www.medicalinsuranceadvocacy.com/fighting-observation-status-medical-bill-advocate/) - January 10, 2014 Fighting ‘Observation’ Status | Medical Bill Advocate By SUSAN JAFFE Every year, thousands of Medicare patients who spend time in the hospital for observation but are not officially admitted find they are not eligible for nursing home coverage after discharge. A Medicare beneficiary must spend three consecutive midnights in the hospital — not
- [Roughed Up by an Orca? There’s a Code for That | Medical Bill Advocate](https://www.medicalinsuranceadvocacy.com/roughed-up-by-an-orca-theres-a-code-for-that-medical-bill-advocate/) - December 29, 2013 Roughed Up by an Orca? There’s a Code for That The New York Times By ANDREW POLLACK Know someone who drowned from jumping off burning water skis? Well, there’s a new medical billing code for that. Been injured in a spacecraft? There’s a new code for that, too. Roughed up by
- [Adria Gross of Medwise Insurance Advocacy Honored as “Woman of Achievement”  by WCBS Newsradio 880 at Annual Awards Event](https://www.medicalinsuranceadvocacy.com/adria-gross-of-medwise-insurance-advocacy-honored-as-woman-of-achievement/) - Adria Gross, MedWise Billing and MedWise Insurance Advocacy 24 Pawtuxet Avenue Monroe, N.Y. 10950 Media contact: Adria Gross/adria@medwisebilling.com or (845) 238-2532 Adria Gross of Medwise Insurance Advocacy Honored as “Woman of Achievement” by WCBS Newsradio 880 at Annual Awards Event New York Area Business Woman Selected for Leadership, Business Contributions, Commitment to Community by Regional
- [Medicare Planning: 6 Things All Seniors Should Do Today](https://www.medicalinsuranceadvocacy.com/medicare-planning-6-things-all-seniors-should-do-today/) - Medicare Planning: 6 Things All Seniors Should Do Today November 25, 2013 By Amy De Vore+ Many Seniors 65 and over are very independent and are living their lives with little to no assistance. As November is National Medicare Family Caregiver’s Month, we decided to write an article about what you, your medical bill advocate and
- [Adria Gross Frankly Speaking At Northern NJ Gilda's Club December 11, 2013](https://www.medicalinsuranceadvocacy.com/adria-gross-frankly-speaking-at-northern-nj-gildas-club-december-11-2013/) - Adria Goldman Gross, medical bill advocate, is Frankly Speaking About Cancer at Northern NJ Gilda's Club December 11, 2013, from 6:00 - 7:30 pm. The topic is Coping With the Cost of Care. The Cancer Support Community and Gilda's Club Northern NJ at 575 Main Street in Hackensack, NJ, invites people living with cancer and their loved ones for a
- [Cuomo: State will not reoffer canceled health plans](https://www.medicalinsuranceadvocacy.com/cuomo-state-will-not-reoffer-canceled-health-plans/) - Cuomo: State will not reoffer canceled health plans Gov. Andrew M. Cuomo said Monday it is unlikely that New York will reoffer canceled health insurance policies that don't meet the Affordable Care Act's requirements. On Thursday, President Barack Obama, reeling from criticism that he didn't keep his promise to let people keep their health plans
- [Laying the Foundation for 2014 - Medical Bill Advocate](https://www.medicalinsuranceadvocacy.com/laying-the-foundation-for-2014-medical-bill-advocate/) - Laying the Foundation for 2014 - Medical Bill Advocate Starting in 2014, the Health Insurance Marketplace will make it easy for you to compare qualified health plans, get answers to questions, find out if you are eligible for tax credits for private insurance or health programs like Medicaid and the Children’s Health Insurance Program (CHIP),
- [Companies, patients shop for better health care deals](https://www.medicalinsuranceadvocacy.com/companies-patients-shop-for-better-health-care-deals/) - Companies, patients shop for better health care deals TOM MURPHY AP Business Writer Published: October 25, 2013 12:26PM Paul Freeman drove 600 miles last year to save himself -- and his employer -- thousands of dollars on his surgery. Freeman's insurer covered his travel costs and the entire bill because a medical center in Oklahoma
- [Healthcare Environment & Obamacare | Adria Gross | Tuesday, October 29, 2013](https://www.medicalinsuranceadvocacy.com/healthcare-environment-obamacare-adria-gross-tuesday-october-29-2013/) - Tuesday 12:15-1:30 PM La Fontana Restaurant 95 S Broadway Nyack, NY 10960 Rotary Club of Nyack 1923-2013 – 90 Years of Service Above Self Luncheon Meeting – Healthcare Environment & Obamacare by Adria Gross, Medical Bill Advocate Event Details Start: Tuesday, October 29, 2013 12:15 pm Location: La Fontana Restaurant Program: Adria Goldman Gross, medical
- [Medical Billing 101 : MedWise Insurance Advocacy](https://www.medicalinsuranceadvocacy.com/medical-billing-101-medwise-insurance-advocacy/) - Medical Billing 101 Presented by medical bill advocate Adria Gross of MedWise Billing, Inc Learn how to better navigate the complicated world of medical insurance claims. Adria is an expert in her field, medical bill advocate, award winner and on top of industry regulations. Call the Library to register Thursday; October 17, 2013, 7:00 pm
- [How to Charge $546 for Six Liters of Saltwater](https://www.medicalinsuranceadvocacy.com/how-to-charge-546-for-six-liters-of-saltwater/) - August 25, 2013 How to Charge $546 for Six Liters of Saltwater By NINA BERNSTEIN It is one of the most common components of emergency medicine: an intravenous bag of sterile saltwater. Luckily for anyone who has ever needed an IV bag to replenish lost fluids or to receive medication, it is also one of
- [SAVE THE DATE - Diagnosing & Decoding Your Medical Bills - A Healthy Way to Cut Costs](https://www.medicalinsuranceadvocacy.com/save-the-date-diagnosing-decoding-your-medical-bills-a-healthy-way-to-cut-costs/) - SAVE THE DATE | Tue, Mar 25, 2014, 6:30 pm Diagnosing & Decoding Your Medical Bills - A Healthy Way to Cut Costs Get tips for analyzing medical bills and identifying costly errors by a medical bill advocate. Learn the right questions to ask when determining what medical tests are really requried (and reimbursable) and
- [Medical Bill Advocate - Adria Gross - New Paltz, NY Rotary](https://www.medicalinsuranceadvocacy.com/medical-bill-advocate-adria-gross-new-paltz-ny-rotary/) - Adria Gross will be speaking about Medical Bill Advocacy on September 12, 2013 at the New Paltz Rotary. She will include the 10 Techniques to Prevent Staggering Hospital Overcharges. Come hear Adria Gross speak, a medical claims advocate who has been in the insurance arena for over twenty three years. http://www.newpaltzrotary.org/
- [Medical Bill Advocate | RBA | Women’s Forum](https://www.medicalinsuranceadvocacy.com/medical-bill-advocate-rba-womens-forum/) - Wednesday, July 31st Rockland Business Association / Women’s Forum 3:00 - 5:00 pm Comfort Inn & Suites 425 East Route 59, Nanuet, NY Topic: Managing Your Health Care In An Ever-Changing Environment - 10 Essential Health Benefits - Impact on Individual Health Insurance - New Medicare Laws Under Oberservation / Outpatient Rules / Medical Bill
- [Medical Bill Advocate | Medical Bills - You CAN fight them](https://www.medicalinsuranceadvocacy.com/medical-bills-you-can-fight-them/) - http://www.usatoday.com/story/money/personalfinance/2013/07/21/consumers-fighting-medical-bills/2573355/ http://www.lohud.com/article/20130720/NEWS02/307200073/Medical-bills-Baffled-consumers-seek-help-rising-costs-vary-widely-among-hospitals-video- Medical Bills - You CAN fight them Baffled consumers seek help with rising medical bills by Jane Lerner A new industry helps people decipher and challenge medical bills they don't understand. The cost of health care nationwide is rising at breakneck speed while people are being asked to pay higher premiums and co-insurance. That
- [HealthCare 2014: Adria Gross, Medical Bill Advocate, Founder & CEO Speaking at Bear Mountain Inn](https://www.medicalinsuranceadvocacy.com/healthcare-2014-adria-gross-founder-ceo-speaking-at-bear-mountain-inn/) - Friday July 27, 2013, at Bear Mountain Inn, NY, Adria Goldman Gross , CEO and Founder of MedWise Insurance Advocacy, Division of MedWise Billing, Inc., will be speaking on behalf of Ameriprise Financial. Her topic will be: 2014 Healthcare and Medicare Rules Medical Bill Advocate
- [Everything You Want to Know About the Obamacare Delay but Were Afraid to Ask | Medical Bill Advocate](https://www.medicalinsuranceadvocacy.com/everything-you-want-to-know-about-the-obamacare-delay-but-were-afraid-to-ask/) - Everything You Want to Know About the Obamacare Delay but Were Afraid to Ask Elspeth Reeve July 3, 2013 Obamacare was designed to take effect in little pieces — people under 26 could stay on their parents' insurance immediately, for example, but the expansion of Medicaid takes effect next year. One of those pieces was
- [Medwise Insurance Advocacy, Medical Bill Advocate, Wins Cases Previously Denied](https://www.medicalinsuranceadvocacy.com/medwise-insurance-advocacy-wins-cases-previously-denied/) - Medwise Insurance Advocacy Wins Cases Previously Denied Multiple Times, Recoups Half a Million Dollars in Unwarranted Medical Expenses Published: July 1, 2013 9:38 AM Founder Adria Gross helps beleaguered patients fight Insurance companies and medical providers on contested charges, confusing bills Monroe, NY (PRWEB) July 01, 2013 At a time when the health insurance industry
- [Laying the Foundation for 2014 | Medical Bill Advocate](https://www.medicalinsuranceadvocacy.com/laying-the-foundation-for-2014/) - Laying the Foundation for 2014 Starting in 2014, the Health Insurance Marketplace will make it easy for you to compare qualified health plans, get answers to questions, find out if you are eligible for tax credits for private insurance or health programs like Medicaid and the Children’s Health Insurance Program (CHIP), and enroll in a
- [ADRIA GROSS ON WALL RADIO  | MEDICAL BILL ADVOCATE](https://www.medicalinsuranceadvocacy.com/adria-gross-on-wall-radio/) - Adria Gross, owner of MedWise Insurance Advocacy, a medical bill advocate, was on WALL Radio, Mark West Show, in Orange County New York, from 9 AM until 10 AM on Wednesday, June 19, 2013 discussing the Current and Upcoming Health Care Laws and how it can affect everyone. Take a look at http://www.wallhasitall.com/listen.html
- [Holding Insurance Companies Accountable | Medical Bill Advocate](https://www.medicalinsuranceadvocacy.com/holding-insurance-companies-accountable/) - Holding Insurance Companies Accountable Under the law, patients have more rights and protections – and more security that their coverage will be there for them when they need it. For example: No more pre-existing condition denials for children: The parents of over 17.6 million children with pre-existing conditions no longer have to worry that their children
- [Wide differences found in what hospitals charge patients for same procedures](https://www.medicalinsuranceadvocacy.com/wide-differences-found-in-what-hospitals-charge-patients-for-same-procedures/) - Wide differences found in what hospitals charge patients for same procedures By Elise Viebeck - 05/08/13 09:30 AM ET The federal government released stunning figures Wednesday showing dramatic variations in what hospitals charge Medicare for routine procedures. The Medicare agency reported that medical claims for the same procedure can differ by tens of thousands of
- [Strengthening Medicare](https://www.medicalinsuranceadvocacy.com/strengthening-medicare/) - Strengthening Medicare Nearly 50 million seniors and Americans with disabilities depend on Medicare every day. The health care law makes Medicare stronger and extends the life of the Medicare Trust Fund by eight years. Reducing prescription drug costs in Medicare: Over 6 million seniors and people with disabilities have saved more than $5.7 billion on
- [Making Care More Affordable](https://www.medicalinsuranceadvocacy.com/making-care-more-affordable/) - Making Care More Affordable The health care law is bringing down health care costs and making sure health care dollars are spent wisely. • 80/20 Rule: The health insurance companies of 76 million Americans now have to meet the 80/20 rule, or Medical Loss Ratio, where they must spend at least 80 cents of your
- [Increasing Access to Affordable Care](https://www.medicalinsuranceadvocacy.com/increasing-access-to-affordable-care/) - Increasing Access to Affordable Care Millions of Americans have gained new access to more affordable health coverage and care. • Coverage for young adults: 3.1 million young adults who were uninsured have gained coverage by being able to stay on their parent’s health plan, giving their families peace of mind. • Access to free preventive
- [Health Insurance Market Reforms: Pre-Existing Condition Exclusions](https://www.medicalinsuranceadvocacy.com/health-insurance-market-reforms-pre-existing-condition-exclusions/) - Health Insurance Market Reforms: Pre-Existing Condition Exclusions Insurers pursue multiple strategies to reduce the cost of covering enrollees with pre-existing conditions, or medical conditions and health problems that existed before the individual enrolled in a health plan. One strategy, the pre-existing condition exclusion, allows insurers to refuse to cover any costs associated with care for
- [CMS’ Proposed Rules on Observation Status Will Not Help Beneficiaries](https://www.medicalinsuranceadvocacy.com/cms-proposed-rules-on-observation-status-will-not-help-beneficiaries/) - medicareadvocacy.org http://www.medicareadvocacy.org/2013/03/28/cms-proposed-rules-on-observation-status-would-not-help-beneficiaries/ CMS’ Proposed Rules on Observation Status Would Not Help Beneficiaries The Center for Medicare & Medicaid Services (CMS) recently issued proposed rules and an interim CMS Ruling to allow hospitals to bill Medicare Part B after a Part A claim is denied. 78 Fed. Reg. 16,632 (March 18, 2013).[1] These actions address some
- [More people filing medical claims, less money for state health insurers](https://www.medicalinsuranceadvocacy.com/more-people-filing-medical-claims-less-money-for-state-health-insurers/) - More people are filing medical claims, and that means less money for state health insurers By Robert Weisman, Globe Staff The state’s largest commercial health insurers posted lower third-quarter financial results Thursday, with most blaming an increase in claims for medical care after a two-year period during which many people went to the doctor less
- [InSightec® / Focused Ultrasound Surgery (MRgFUS)](https://www.medicalinsuranceadvocacy.com/insightec-focused-ultrasound-surgery-mrgfus/) - InSightec, which is headquartered in Tirat Carmel near Haifa and draws 80 percent of its staff from Technion graduates, has developed a surgical system to treat tumors inside the body that perhaps can cure many different illnesses electronically without having to cut open the human body. This Israeli innovation has the potential to transform how
- [Adria Gross from MedWise Insurance Advocacy - Speaking on Current & Upcoming Health Care Laws](https://www.medicalinsuranceadvocacy.com/adria-gross-from-medwise-insurance-advocacy-speaking-on-current-upcoming-health-care-laws/) - February 21, 2013 at 11:00 AM, Adria Gross from MedWise Insurance Advocacy will be speaking about the Current & Upcoming Health Care Laws. Refreshments; Free; Held at the Esplanade, 168 Red Schoolhouse Road, Chestnut Ridge; For details, contact Carolyn Geiger, Tel. 574-4950; avi@avi-eyes.org; www.avi-eyes.org. Established in 1973, the Association for the Visually Impaired (AVI) assists
- [Mental Care Is Covered](https://www.medicalinsuranceadvocacy.com/mental-care-is-covered/) - Mental Care Is Covered September 22, 2012 By AVERY FORMAN Coping with a mental-health condition can be daunting and costly, but a recent law is aiming to ease the burden. As of last year, some health plans that offer mental-health and addiction coverage are required to offer it at an equal level to the medical
- [CBS New York City MedWise Insurance Advocacy](https://www.medicalinsuranceadvocacy.com/cbs-new-york-city-medwise-insurance-advocacy/) - Adria Gross has great news if you haven’t heard yet. Wednesday January 23, 2013 and Thursday January 24, 2013, Adria Gross was on CBS in New York City to talk about how many people are being overcharged on their hospital and medical bills. CBS filmed Adria on Wednesday morning and placed her on the CBS 11:00 PM and CBS 6:00
- [New Health Care Laws - Speaking Engagement](https://www.medicalinsuranceadvocacy.com/new-health-care-laws-speaking-engagement/) - Adria Gross will be speaking at the Heritage Point of Teaneck on February 11, 2013 at 11:30 AM. Adria enjoys educating people about the current and upcoming healthcare laws. What Everyone Should Know About The New Health Laws Adria Gross, CEO and founder of MedWise Insurance Advocacy and MedWise Billing, Inc., is a New York
- [Adria Gross, Owner of MedWise Insurance Advocacy](https://www.medicalinsuranceadvocacy.com/adria-gross-owner-of-medwise-insurance-advocacy/) - Adria Goldman Gross on MSNBC Your Business http://www.youtube.com/watch?feature=player_embedded&v=R9QDDjMUP14#!
- [Woman charged more on medical bill for asking "too many questions": Fair?](https://www.medicalinsuranceadvocacy.com/woman-charged-more-on-medical-bill-for-asking-too-many-questions-fair/) - Woman charged more on medical bill for asking "too many questions": Fair? A Minnesota woman is reportedly unhappy with her doctor after she was allegedly charged extra for asking too many questions. Susan Krantz of Minnatonka, Minn. visited her doctor recently for an annual physical, and when looking at her itemized bill, noticed an unusual
- [Governor Cuomo Announces that New York Will Request a Federal Waiver to...](https://www.medicalinsuranceadvocacy.com/governor-cuomo-announces-that-new-york-will-request-a-federal-waiver-to/) - Governor Cuomo Announces that New York Will Request a Federal Waiver to Invest $10 Billion in Medicaid Redesign Team Savings to Transform the State's Health Care System Federal Waiver Will Allow New York To Fully Implement the MRT Action Plan [1] Albany, NY (June 4, 2012) Governor Andrew M. Cuomo today announced that New York

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