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 […]
Is Your Insurance Plan Fully Funded? Read More »
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
Why a Letter of Medical Necessity May Save You Thousands Read More »
State vs federal regulations can dramatically affect how denied medical claims, insurance appeals, billing protections, and patient rights are handled across the United States. Many patients assume all health insurance rules operate under one unified system, only to discover that state laws and federal laws sometimes overlap, conflict, or apply differently depending on the insurance
State vs Federal Regulations for Health Insurance Claims Read More »
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.
$26,500 Claim Paid for This Reason Read More »
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
Is AI Automatically Denying Your Medical Claims Read More »
HIPAA privacy rules explained in simple terms can help patients protect their medical information while navigating denied medical claims, health insurance disputes, and complex billing situations. Across the United States, many people feel confused about what healthcare providers, insurance companies, and third parties are legally allowed to access or share. That confusion often becomes even
HIPAA Privacy Rules Explained for Insurance Claims and Appeals Read More »
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. https://vimeo.com/1188114630?share=copy&fl=sv&fe=ci
Dispute Resolution for Self Paying Individuals Read More »
The peer-to-peer review process can become one of the most important turning points in a denied medical claim. Across the United States, patients are often shocked to discover that a health insurance company denied treatment, testing, or procedures recommended by their physician without ever speaking directly to the doctor first. That denial can delay care,
Peer-to-Peer Review Process for Denied Medical Claims Read More »
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 Claim Been Incorrectly Denied Read More »
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
Has Your Health Insurance Been Incorrectly Terminated? Read More »