Billing Disputes and Denials of Medical Coverage
I hope you’re having a great day. Think about people’s billing disputes and denials of coverage. What emerges is that many realize positive outcomes when they appeal decisions they perceive to be in error. Yet only half of those who believe that they were erroneously billed or denied care actually challenge the decision or have […]
Who’s Responsible for the Medical Appeal Process?
I hope you’re having a fantastic day. The responsibility of appealing may not be clear between the patients, the providers, or between the employers and the employees, and the documentation requirements to appeal can create additional barriers. As a beneficiary, you have a right to appeal your insurer’s decision. Due to artificial intelligence, all too […]
What is Hospital Upcoding
Hospital upcoding, which is claiming a higher level of patient severity in order to obtain a higher insurance payment, is a major issue. One study estimates that increased upcoding relative to a decade earlier was associated with $14.6 billion in hospital payments. I have people calling me about this, where they feel that they were […]
How Top CEOs in Medical Fields Make More Money
You know Americans are sick of the health insurance companies who steal our money and our lives. The more profits that the insurance companies make, the more extra cash is available to distribute to shareholders as dividends and buybacks, and generally the higher the stock price, the greater the potential for higher top executive pay. […]
Don’t Let Medical Bills Bankrupt Your Family
An illness can destroy an entire family, leaving them bankrupt and homeless, with the repercussions of that sudden fall into poverty echoing down through generations. Most Americans have no idea that the US is quite literally the only country in the developed world that doesn’t define healthcare as an absolute right for all of its […]
How to Challenge Your Medical Bill
One of the issues I hear so much is people have no idea how to challenge a bill. I worked for two insurance companies that not only taught me all the steps on how to deny a claim, but I learned how to challenge a bill, handle appeals, and either overturn the cases or minimize […]
Was Your Medical Bill Much Higher Than it Should Have?
When you know you have been billed much more than you should have, please call midwives. All too often people are taken advantage of on their medical bills. We recently decreased a bill from $1,200 down to $55. Remember, I’m here to help you. Thank you. https://vimeo.com/1117099552?share=copy
How to Shop and Compare Hospital Costs
Hospital price transparency helps Americans know the cost of a hospital item or service before receiving it. Starting January 1st, 2021, each hospital operating in the United States was required to provide clear, accessible pricing information online about the items and services they promote in two ways. The first was as a comprehensive machine-readable file […]
Was Your Medical Claim Denied Even After pre-Authorization?
You know, insurers are becoming increasingly adept in using technology to deny payment of medical claims and pressure their company physicians to deny care during prior authorization reviews. Doctors are reporting spending increasing amounts of time on the phone with insurance company physicians over denials of care for their patients, even when a pre-authorization is […]
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 […]