A medical provider has to give you a good faith estimate of your costs before you receive services, and you can dispute a bill if it is significantly higher than that estimate. I recently had a case where a dentist told my client the bill would be $8,000, but they were actually charged $22,000. By referencing […]
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Here are different reasons you can dispute a bill. You can dispute a bill if you received care and did not have or did not use your health insurance to pay for it. You can also dispute it if, before receiving care, you told the provider you would not be using insurance. Another situation is if you
Different Causes for Disputing a Medical Bill Read More »
The No Surprises Act has been helpful in overturning cases and reducing fees when a patient is responsible for part of a bill. It provides protection against surprise bills from out-of-network providers or facilities. I recently handled a case where a client went to the emergency room and, after being denied three times, I reduced the bill
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Charity care qualification could reduce or eliminate a hospital bill, even when you have health insurance and the insurance company denied your claim. A denial can make the hospital’s full balance feel immediate and unavoidable. You may be urged to begin payments, use a medical credit card, or accept responsibility before anyone explains your financial-assistance
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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
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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.
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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
Having Medicare Advantage Plan Issues Read More »
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
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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
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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. https://vimeo.com/1117099525?share=copy
Doctor Recommends an MRI? Read More »