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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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
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
Who’s 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
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
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
Don’t 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
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
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
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
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
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,
Bee Sting Leads to Emergency Room Bill Not Covered by Insurance
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
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 to1,200. That’s the savings of
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 outta network, so
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
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
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
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
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
Medical Bill Reduced from $150,000 to $5,000 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
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
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
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
$85,000 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
Rehab for Drugs and Alcohol $70,000 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
Coma Patient with a $300,000 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
Why Hospital Based Billing vs Professional Billing Matters
Understanding the differences between hospital-based billing and professional billing is crucial for patients navigating the complex healthcare system. These billing methods can significantly impact your medical expenses and how services
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
$6,000 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
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,