Have you ever heard of a facility fee? A facility fee is an extra charge that hospitals add to cover overhead costs such as equipment, maintenance, support staff, and security. Even if the visit is virtual or at a hospital-owned outpatient clinic, they might have these additional fees. So patients often unknowingly agree to these
What is a Facility Fee on Your Medical Bill? Read More »
In July 2025, a federal judge ruled medical debt can be included on people’s credit reports. That overruled a Consumer Finance Protection Bureau proclamation made in January of 2025. Had medical debt been left off of credit reports, it was expected to result in the approval of roughly 22,000 additional mortgages each year. Right before President Biden left
Can Medical Debt be Included in Your Credit Report? Read More »
Mental health billing challenges can interrupt treatment, create unexpected debt, and leave patients wondering whether their insurance company applied the same standards it uses for physical healthcare. A denial may arrive while therapy, psychiatric care, medication management, or substance-use treatment is still urgently needed. Paying immediately may feel like the easiest path, but the claim
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Too often when denials occur, we have to go through multiple appeals to resolve the issue. I often ask for help from the media because, many times, that is the only way the insurance company pays the claim. Last summer, I was published in NJ.com, and the article came out in September 2024 about a $25,000 denial
How I Used the Media to get a $225,000 Medical Bill Paid Read More »
The best way to protect yourself against a denial is to get pre-approval for medical services from your insurer in non-emergency situations. If it is an emergency, it is truly the responsibility of the medical provider to obtain the pre-authorization. Even if your provider is planning to perform surgery on you, it is their responsibility. I recently
The Best Way to Protect Yourself from a Medical Claim Denial Read More »
Surgical billing complexity can turn one medical procedure into several bills, conflicting insurance decisions, and a balance that is difficult to verify. A denial may make it appear that you owe every charge from the hospital, surgeon, anesthesiologist, laboratory, and imaging provider. But one coding problem, authorization dispute, network mistake, or missing document can ripple
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Some of the best advice I can provide is to shop carefully for the right insurance policy that offers comprehensive coverage from medical providers with a good reputation. With Medicare Advantage plans, this has been a major issue. Some of the best hospitals and doctors will not credential for a Medicare Advantage plan because they often
How to Shop for the Best Medicare Advantage Plan Read More »
If you’ve had a denied claim appeal, be prepared to provide documentation. It’s important to have a doctor write a letter explaining why the procedure was performed and why it was medically necessary for you. The letter should also explain what could have happened if you had not had the procedure. I recently overturned a case that
Why You Should Document Everything Read More »
Emergency room billing disputes can involve thousands of dollars, multiple providers, and an insurance denial that makes the entire balance appear to be your responsibility. The bill may feel impossible to challenge because the care already happened and there was no time to compare prices or networks. Yet emergency claims can be denied incorrectly, processed
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It’s so important to have health insurance. According to the No Surprises Act, you are generally protected from balance billing for emergency services and for non-emergency services received at an in-network facility from out-of-network providers. You are only responsible for your in-network cost-sharing. So please remember that. Because of the No Surprises Act, if it’s an
Why It’s So Important to Have the Right Medical Insurance Read More »