As the CEO and founder of MedWise Insurance Advocacy, I have dedicated my career to assisting individuals in overcoming these challenges. Drawing from over 25 years of experience in the insurance industry, I understand the intricacies of medical billing and the frustration that comes with claim denials.
Understanding Insurance Denials
Insurance claim denials occur for various reasons, including coding errors, lack of pre-authorization, or services deemed not medically necessary. These denials can lead to unexpected medical bills and financial stress for patients. At MedWise Insurance Advocacy, we specialize in identifying the root causes of these denials and developing strategies to address them effectively.
Our Approach to Advocacy
Our process begins with a thorough review of your medical bills and insurance policies. We meticulously examine each claim to identify discrepancies or errors that may have led to a denial. By understanding the specific reasons for denial, we can craft a tailored appeal to challenge the decision.
For instance, if a claim is denied due to a coding error, we work with healthcare providers to correct the codes and resubmit the claim. If the denial is based on the insurer’s determination of medical necessity, we gather supporting documentation from your healthcare providers to substantiate the necessity of the services rendered.
Success Stories
Over the years, we have successfully overturned numerous denied claims, resulting in significant savings for our clients. One notable case involved a client who faced a substantial bill for a procedure that was initially denied by their insurance company. Through diligent review and persistent advocacy, we were able to have the claim approved, relieving the client of the financial burden. You can see many case studies on this website.
Empowering Patients
Beyond resolving individual cases, our mission is to empower patients with the knowledge and tools to navigate the healthcare system confidently. We provide education on understanding insurance policies, recognizing common billing errors, and advocating for oneself in the face of denials.
At MedWise Insurance Advocacy, we are committed to standing by your side, ensuring that you receive the benefits you are entitled to and that your medical bills are accurate and fair. If you are facing a denied claim or need assistance with medical billing issues, we are here to help you navigate these challenges with expertise and compassion.
