$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 company did not want to pay it. Since the hospital at the time was out of network. The fact that there was pre-authorization, even though […]
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 weeks and believe it or not, they were demanding $70,000. That means the cost was $35, $35,000 per week. I could not believe that prior […]
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 that you will. They will definitely cover you, but after you leave the facility, you get a bill for over $300,000, which the provider claims […]
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 are charged. Unpacking Hospital-Based Billing Hospital-based billing, also known as institutional billing, pertains to charges incurred for services provided within a hospital setting. This includes […]
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 plans often deny necessary care and delay treatments, jeopardizing patient health. Ultimately, the United States healthcare system’s reliance on private insurers and their administrative complexities […]
$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 be no more than $2,000. You go home and what do you do? You get a bill in the mail for 6,500, not 2000. I […]
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, and after entering through the emergency room, the insurer felt it was not medically necessary for her to be at the hospital. The bills were […]
Thrown Out of Rehab While on Medicare
I had a recent case where this person went from a rehab to a hospital and back to another rehab. Again, this was a case where the commercial insurers are throwing people outta rehabs due to their limited time period of coverage. Everyone has. Everyone who has an advantage plan for Medicare is continuously thrown […]
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 to 1,200. That’s the savings of $6,000 since they were billed so many times for the same day of service with the same procedure codes. Please call […]
$15,000 Medical Bill for Severe Burns Reduced
Hello, my friends, one of my clients had a very severe burn when hot grease splashed on their wrist and they went to an urgent care, received a bill for over $15,000. When I looked at the procedure codes and was able to determine what the correct fees should have been according to those procedure […]