Have a PPO Plan and Had a Baby?
I recently worked with a case where the person gave birth and since the provider was outta network, they were billing her only $15,000. I was able to prove by sufficient medical records and a review of the health insurance policy that she should have been covered for this provider, even though they were out […]
15 Providers Out of Network Denying Your Medical Claims?
I recently worked with a client who had 15 different providers, and this case was like around 270 to 300 claims. They were denied as out-of-network. She also had limited visits on her physical therapy. It took a tremendous amount of work, but I was able to prove that it was her, that she was […]
Who Covers When Multiple Insurance Policies?
I had a case recently involving three insurance companies. The insured was working as a New York City police, and his wife was covered under his plan it the beginning. The insurance companies would not speak with the other, the other ones, but when we had to go to a higher level, which we did […]
Wheelchair Medical Expense Not Covered?
I was referred a client who was unable to get a wheelchair through his health insurance plan. It was interesting that the reason for that is the insurance company thought he had another insurance carrier when we were able to prove that he only had one health insurance policy. He was finally able to be […]
Hospital Bill Determined as Not Medically Necessary?
I hope you’re having a beautiful day today. I had a case recently where the gentleman was in the hospital due to severe leg pain. He spent two nights at the hospital and was stuck with over $45,000 in medical bills. The insurance company was stating that the two nights at the hospital were not […]
Overnight Medical Bill for $43,000 Fully Covered
Hi everyone. I gotta share this story with you. A gentleman was experiencing major pain, which involved kidney stones. He was kept in the hospital overnight and the pill was $43,000. It involved two different insurance companies. Neither of them would pay saying it wasn’t medically necessary. And they’re also saying like, who’s really responsible. […]
What If You’re Unable to use Generic Medication?
I hate to say this, but too often you are unable to be on a generic drug for your condition. If this happens to you, please ask your doctor to write a letter to fight for you to receive coverage for the correct medication. Sometimes your doctor will also need to reach out to your […]
Saved $600 Per Month for Compound Pharmacy Medication
If you go to a compound pharmacy for medication and they do not submit the bill to your prescription plan, please do not ignore the possibility of receiving reimbursement for that compound medication. I recently was able to save my client $600 a month. They get medication every week, $150, $600 a month, so that […]
Not Covered After Being Told That You’re Covered?
A recent client was informed by the surgeon’s office prior to the surgery that my client was covered for this upcoming surgery. Well, guess what? He was not covered, so now they’re billing my client for only $80,000. When I discussed the situation with the medical Provider’s billing office, it took months, but we were […]
Covid Client Billed $54,000 With No Insurance Reduced to $0
I recently had a Covid client. They were being billed $54,000, but the sad thing was they had no insurance, and at that point, even the government stopped covering the covid uh, patients. They, they stopped covering, I believe it was around February of 2022. But thank you, I was able to reduce the bill […]