Your Medical Insurance Advocate
Media/Videos
These medical bills advocacy videos and case studies will help you save money on your health insurance and denied medical claims.
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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
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
$26,500 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
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
Reduced Bill from $8,500 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
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.
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,
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
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
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
How I Saved Her $16,000
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
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
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
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
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
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,
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,
The Best Chance You’ll 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
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,
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
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,
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
Why America’s 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.
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
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
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.
A $32,000 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,
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
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
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