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# Adria Gross

The Best Medical Insurance Advocate

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## Posts

- [Working With Collections Agencies on Medical Debt](https://adriagross.com/working-with-collections-agencies-on-medical-debt/) - Working with collections agencies requires caution when the debt began with a denied medical claim. The collector’s demand does not prove that the bill is accurate, properly processed, or legally collectible.Collection calls can create pressure to pay immediately, reveal financial information, or accept a settlement before you understand the account. That urgency may cause you
- [When to Settle vs Fight a Denied Medical Bill](https://adriagross.com/when-to-settle-vs-fight-a-denied-medical-bill/) - When to settle vs fight a denied medical bill depends on one critical question: Is the balance legitimate, or are you being pressured to pay before the claim has been properly reviewed?A fast settlement may end collection calls, but it can also make you pay for an insurance error, illegal surprise charge, or inflated hospital
- [Medical Bill Negotiation Scripts for Insurance and Collections](https://adriagross.com/medical-bill-negotiation-scripts-for-insurance-and-collections/) - Scripts for negotiation conversations can help you stay calm, ask better questions, and avoid agreeing to pay a denied medical bill before you understand what happened.A billing representative or collector may sound certain that the balance is yours. Yet the claim could contain coding errors, missing records, uncredited insurance payments, or charges that qualify for
- [Hospital Billing Advocacy for Denied Medical Claims](https://adriagross.com/hospital-billing-advocacy-for-denied-medical-claims/) - Hospital billing advocacy can help you determine whether a denied medical claim should be corrected, appealed, reduced, or paid before the balance moves deeper into collections.A hospital statement can look final even when it contains coding problems, missing insurance adjustments, duplicate charges, or an unresolved coverage issue. Paying too quickly may close off opportunities that
- [Charity Care Qualification After a Denied Medical Claim](https://adriagross.com/charity-care-qualification-after-a-denied-medical-claim/) - 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 options.Do
- [Negotiating Out-of-Network Charges After a Claim Denial](https://adriagross.com/negotiating-out-of-network-charges-after-a-claim-denial/) - Negotiating out-of-network charges can prevent an unexpected medical bill from becoming a long-term financial burden, especially when your insurance company has denied all or part of the claim.The balance may look official, urgent, and nonnegotiable. Yet it could reflect an incorrect network classification, a processing error, an unlawful surprise bill, or a provider’s full charge
- [Discount Strategies for Uninsured Patients With Medical Bills](https://adriagross.com/discount-strategies-for-uninsured-patients-with-medical-bills/) - Discount strategies for uninsured patients can reduce a medical bill substantially, but the best time to ask is before paying, financing, or accepting the provider’s full charge.Being uninsured can make every medical statement feel final. The bill may arrive without the negotiated discounts insurers receive, leaving you uncertain whether the price is fair or even
- [Hospital Financial Assistance Programs](https://adriagross.com/hospital-financial-assistance-programs/) - Hospital financial assistance programs may reduce or eliminate a medical bill, even when you have insurance and your claim has been denied.A denial can leave you staring at a balance you never expected to pay. The hospital may suggest monthly payments or a medical credit card, but accepting either option too quickly could make the
- [Setting Up Payment Plans for Denied Medical Bills](https://adriagross.com/setting-up-payment-plans-for-denied-medical-bills/) - Setting up payment plans may protect your monthly budget, but agreeing too quickly can leave you paying a medical bill that should have been corrected, reduced, or covered by insurance.A denied claim can create immediate pressure. The provider wants payment, collection notices may be approaching, and a monthly arrangement can feel like the safest escape.Before
- [Cash Pay vs Insurance Pricing After a Claim Denial](https://adriagross.com/cash-pay-vs-insurance-pricing-after-a-claim-denial/) - Cash pay vs insurance pricing can create a startling result: the price for using health insurance may be higher than the amount offered to someone paying without insurance.That difference becomes especially painful when your claim is denied and the provider suddenly expects you to pay the full balance. Before paying, switching to cash pricing, or
- [Negotiating Medical Bills Effectively After a Denied Claim](https://adriagross.com/negotiating-medical-bills-effectively-after-a-denied-claim/) - Negotiating medical bills effectively can mean the difference between paying an inflated balance and resolving a denied claim for a fair, manageable amount.A denial can feel final, especially when collection notices arrive or the provider insists the full balance is your responsibility. But billing errors, coding problems, missing documentation, authorization disputes, and insurance processing mistakes
- [Confused by Insurance Jargon](https://adriagross.com/confused-by-insurance-jargon/) - Denial letters are full of insurance jargon, but don’t let that intimidate you. Look for the reason for the denial. It’s usually listed by a code. And check your explanation of benefits, your EOB, it’s called. You have to understand the exact reason, which will help you determine your next steps, whether it’s correcting an error, appealing a
- [A $54,000 Medical Bill Written Off After Denial](https://adriagross.com/a-54000-medical-bill-written-off-after-denial/) - When a provider considers your procedure to be necessary and the insurance company says, “Hey, it wasn’t medically necessary,” you have to fight to make sure that the insurer does not pass the cost to you. If you can prove that it was medically necessary, your denied claim should be paid. I recently had a case where
- [Out of Network Air Ambulance Services](https://adriagross.com/out-of-network-air-ambulance-services/) - The No Surprises Act prevents surprise bills for emergency services, even if received from an out-of-network provider or facility. It limits out-of-network cost-sharing for non-emergency services received at an in-network facility, such as hospitals or ambulatory surgical centers. It also prohibits balance billing for air ambulance services, even if they are out-of-network. Please call me. I’m here
- [The Most Common Reasons for Denied Medical Bill Claims](https://adriagross.com/the-most-common-reasons-for-denied-medical-bill-claims/) - 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
- [What is an Insurance Claim Denial?](https://adriagross.com/what-is-an-insurance-claim-denial/) - Have you ever gone to the doctor, submitted your claim, and got a letter saying your insurance won’t pay? That is a denial. It means your insurer has rejected the claim, either for a service they say isn’t covered or for some other reason. It doesn’t always mean you’re stuck with the bill, but it does mean
- [How I Had a $9,000 Medical Bill Written Off](https://adriagross.com/how-i-had-a-9000-medical-bill-written-off/) - I hope you’re having a fantastic afternoon. Eighty percent of medical claims are incorrect. There are often errors where procedures appear on your bill that never occurred, or you might find duplicate charges or incorrect charges. Please contact me if this happens to you. I recently had a case where a client was being billed $9,000, and
- [Saved Over $13,000 With This](https://adriagross.com/saved-over-13000-with-this/) - If your dispute was decided in your favor, but the provider is still billing you or has even sent your bill to collections, I highly recommend you reach out to MedWize, my company. We will review your situation and let you know what the next steps should be. A case like this happened recently, where I saved
- [Why Ask for an Itemized Bill When Denied Medical Claim](https://adriagross.com/why-ask-for-an-itemized-bill-when-denied-medical-claim/) - If you receive a balance bill or believe you are overcharged, request an itemized bill and dispute the charges. Ask the provider or hospital for an itemized bill with all billing codes listed. Your billing codes should be five-digit procedure codes. Make sure you’re not relying on a hospital bill that only shows three to five numbers or
- [How Your Insurance Works with the No Surprise Act](https://adriagross.com/how-your-insurance-works-with-the-no-surprise-act/) - Your insurer may have decided not to pay part or all of your claim. If you think this decision violates the No Surprises Act, appeal your bill. Follow the process described in your health insurance plan’s documents and the denial notices. Learn more about your rights under the No Surprises Act. If you receive a bill and have
- [If You're Appealing a Case-Do This](https://adriagross.com/if-youre-appealing-a-case-do-this/) - If you’re appealing a case and you, your healthcare provider, or the facility can settle the payment amount before the dispute ends, you can move forward if both parties agree to a reduced bill or to pay the agreed amount in full. If you and your provider or facility reach an agreement, be sure to notify
- [Is Your Case in Collections](https://adriagross.com/is-your-case-in-collections/) - I hope your day is as good as mine. If you have a case that is in collections while you are disputing a bill, your provider or facility cannot move your bill into collections. They also cannot collect any existing late fees on unpaid bills until the dispute process ends, and they cannot take action against you
- [Will Your Medical Bill Increase if You Dispute It](https://adriagross.com/will-your-medical-bill-increase-if-you-dispute-it/) - No matter what the outcome of your bill is, your cost will not increase if you dispute the bill. When you receive care, there may be items or services your doctor could not reasonably have anticipated. In those cases, whoever reviews your claim may determine that the cost of care was appropriate and leave your bill
- [Instances When Your Provider Must Reduce Your Medical Bill](https://adriagross.com/instances-when-your-provider-must-reduce-your-medical-bill/) - If a provider is unable to inform you about the cost of services in advance, or if the insurer claims the treatment was not medically necessary, you may have grounds to challenge the bill, and in some cases, your provider may need to reduce it. For example, if an ambulance takes you to the emergency room
- [Is The No Surprises Act Working](https://adriagross.com/is-the-no-surprises-act-working/) - 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
- [Different Causes for Disputing a Medical Bill](https://adriagross.com/different-causes-for-disputing-a-medical-bill/) - 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
- [How to Use a Good Faith Estimate to Reduce Your Bill](https://adriagross.com/how-to-use-a-good-faith-estimate-to-reduce-your-bill/) - 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
- [Why Hire Adria for Your Denied Medical Bills](https://adriagross.com/why-hire-adria-for-your-denied-medical-bills/) - I’m here to help you with all issues related to medical bills. Medical Insurance Advocacy, my company, helps you navigate the system, review medical records, and negotiate with providers and health insurance companies. I’ve been in the health insurance industry for 35 years and have been very successful in overturning cases. I was recently featured on Fox News
- [Important Questions About College Student Medical Insurance](https://adriagross.com/important-questions-about-college-student-medical-insurance/) - I hope I helped you with some information today. When it comes to college insurance, premiums may be included in tuition, but loan interest can still be high. Specialized care can be expensive, especially if it’s off-campus, and many plans may end during academic breaks or after graduation. It’s important to read the policy carefully to
- [Getting Denied Is Not the End](https://adriagross.com/getting-denied-is-not-the-end/) - 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.
- [Why You Always Want a Pre Approval Letter](https://adriagross.com/why-you-always-want-a-pre-approval-letter/) - Many services require pre-authorization from your insurance company. That means your doctor has to get approval before doing a test or procedure. If that doesn’t happen, your claim could be denied, even if you really needed that care. Always ask if your service needs pre-approval to avoid unexpected bills. I recommend you get the approval in writing from your
- [What is a Good Faith Estimate?](https://adriagross.com/what-is-a-good-faith-estimate/) - Good faith estimate requires providers to provide uninsured or self-pay patients with a good faith estimate of the total cost of care before services are rendered. I recommend always asking in advance how much your procedure will cost, and you should never be billed more than that amount. Please ask for it in writing, and I’m here
- [Always Ask for the SPD](https://adriagross.com/always-ask-for-the-spd/) - Hello, my friends. Have you ever heard of an SPD? Summary Plan Description. Ask for this information from your health insurance carrier. This description will help you to understand what you are covered and not covered for on your health insurance policy. When I am appealing your claims, this information will help me to better understand your
- [Top Reasons Claims Get Denied and How to Fight Back](https://adriagross.com/top-reasons-claims-get-denied-and-how-to-fight-back/) - The top reasons claims get denied often have little to do with the patient’s actual medical condition. Across the United States, thousands of people open medical bills expecting coverage, only to discover their health insurance company rejected the claim for technicalities, missing information, authorization issues, or coding errors.That denial can quickly spiral into collection notices,
- [Always Ask for the Response in Writing](https://adriagross.com/always-ask-for-the-response-in-writing/) - Good afternoon. Every time you call your insurance carrier, ask for their response in writing. If by any chance they will not provide you with that information, ask who you’re speaking to, their first name and last name, their ID number, location, and keep notes of the entire conversation, including the date and time you spoke
- [How I Saved Her $16,000](https://adriagross.com/how-i-saved-her-16000/) - An insurance carrier told my client that they can submit their claims online. Okay. My client submits the claims online, six months go by, and the insurance carrier is not paying the claim reimbursement. My client finally realizes this, and when I spoke with the insurance carrier, they stated the paperwork was never submitted on
- [State vs Federal Regulations for Health Insurance Claims](https://adriagross.com/state-vs-federal-regulations-for-health-insurance-claims/) - State vs federal regulations can dramatically affect how denied medical claims, insurance appeals, billing protections, and patient rights are handled across the United States. Many patients assume all health insurance rules operate under one unified system, only to discover that state laws and federal laws sometimes overlap, conflict, or apply differently depending on the insurance
- [Why a Letter of Medical Necessity May Save You Thousands](https://adriagross.com/why-a-letter-of-medical-necessity-may-save-you-thousands/) - Medical claims that require pre-approvals or claims involving newly developed drugs or treatment, and many types of behavioral health treatment may require a letter of medical necessity from the treating doctor before the claim is approved. Claimants should be aware that their physicians are ready and willing to back up their claims. You do not want to
- [Is Your Insurance Plan Fully Funded?](https://adriagross.com/is-your-insurance-plan-fully-funded/) - 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
- [Medical Debt Collection Laws and Your Patient Rights](https://adriagross.com/medical-debt-collection-laws-and-your-patient-rights/) - Medical debt collection laws can affect everything from collection calls to credit reporting after denied medical claims and unpaid healthcare bills. Across the United States, many patients feel trapped between health insurance denials, rising balances, and aggressive collection notices without fully understanding the legal protections that may still exist.That pressure can escalate quickly.A single denied
- [Why Patient Insurance Oversight is Necessary](https://adriagross.com/why-patient-insurance-oversight-is-necessary/) - 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
- [Having Medicare Advantage Plan Issues](https://adriagross.com/having-medicare-advantage-plan-issues/) - 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
- [Filing Complaints Against Providers/Insurers After Denied Claims](https://adriagross.com/filing-complaints-against-providers-insurers-after-denied-claims/) - Filing complaints against providers/insurers can become an important step when denied medical claims, billing disputes, or unfair insurance practices leave patients overwhelmed and financially vulnerable. Across the United States, many people feel powerless after repeated denials, unanswered calls, or confusing medical bills that never seem to get resolved.That frustration can quickly turn into fear.Patients often
- [College Students Must Prove What?](https://adriagross.com/college-students-must-prove-what/) - Students in college are normally able to purchase health insurance through their university. I’ve handled many cases involving college health insurance. I must say, the health carriers are very suspicious when the students are submitting claims, and very often, the college student, with each and every claim, has to prove that they are the insured. I couldn’t believe
- [$26,500 Claim Paid for This Reason](https://adriagross.com/26500-claim-paid-for-this-reason/) - A recent case that I worked on involved a medical bill denial for $26,500. Believe it or not, the insurance carrier made an error thinking it was a totally different policy that doesn’t cover for pregnancy. I was so happy to realize their error and have their claim paid. If you need help, please call me. Thank you.
- [Is AI Automatically Denying Your Medical Claims](https://adriagross.com/is-ai-automatically-denying-your-medical-claims/) - Too often the medical claims are denied when your insurance carrier’s AI, artificial intelligence, looks at the diagnosis and medical procedures on your submitted medical bill and they decide to deny it. MedWise is passionate about helping those facing wrongful denials and coverage issues. This is happening right now at a high percentage of submitted claims. I
- [HIPAA Privacy Rules Explained for Insurance Claims and Appeals](https://adriagross.com/hipaa-privacy-rules-explained-for-insurance-claims-and-appeals/) - HIPAA privacy rules explained in simple terms can help patients protect their medical information while navigating denied medical claims, health insurance disputes, and complex billing situations. Across the United States, many people feel confused about what healthcare providers, insurance companies, and third parties are legally allowed to access or share.That confusion often becomes even more
- [Reduced Bill from $8,500 to a $250 Deductible](https://adriagross.com/reduced-bill-from-8500-to-a-250-deductible/) - Hello, my friends. Was your claim inaccurately processed by your health insurance carrier? Call MedWise to help overturn your case. This past week, my client’s bill for stitches in an emergency room went from $8,500 down to their deductible of $250. Please call me. I’m here to help you. Thank you. Adria Gross Medical Billing Advocate See Full
- [Dispute Resolution for Self Paying Individuals](https://adriagross.com/dispute-resolution-for-self-paying-individuals/) - Hello, everybody. I hope you’re having a fabulous day. Dispute resolution establishes a process for solving billing disputes between patients, providers, and insurance plans, and particularly for uninsured or self-paying individuals. MedWise will help you to dispute any of your medical bills. Please call me. I’m here to help you. Adria Gross Medical Insurance Advocate See
- [Peer-to-Peer Review Process for Denied Medical Claims](https://adriagross.com/peer-to-peer-review-process-for-denied-medical-claims/) - The peer-to-peer review process can become one of the most important turning points in a denied medical claim. Across the United States, patients are often shocked to discover that a health insurance company denied treatment, testing, or procedures recommended by their physician without ever speaking directly to the doctor first.That denial can delay care, increase
- [Has Your Claim Been Incorrectly Denied](https://adriagross.com/has-your-claim-been-incorrectly-denied/) - Has your claim been incorrectly denied? Believe it or not, if your claim does not have the Federal Tax ID number and the NPI number, the National Provider Identification number, on the claim, the insurance company will not pay your claim. It makes me so angry when the claim is submitted incorrectly and now you, the
- [Has Your Health Insurance Been Incorrectly Terminated?](https://adriagross.com/has-your-health-insurance-been-incorrectly-terminated/) - Has your health insurance been incorrectly terminated? Too many times you are paying your health insurance premium and there’s an error on behalf of your insurance carrier. Your insurance carrier did not code receipt of your monthly premium, and now your claims are being denied. Call MedWise and we will straighten out the error and make sure
- [Writing a Strong Appeal Letter for Denied Medical Claims](https://adriagross.com/writing-a-strong-appeal-letter-for-denied-medical-claims/) - Writing a strong appeal letter can make the difference between a denied medical claim becoming your financial burden or finally getting approved by your health insurance company. Across the United States, many patients lose appeals not because the claim was impossible to win, but because the appeal letter lacked the right structure, evidence, or language.That
- [What To Do if Your Claim is Denied](https://adriagross.com/what-to-do-if-your-claim-is-denied/) - Consumers should be encouraged to file formal appeals when they believe their claims are wrongfully rejected or processed. Insurance companies are usually required to provide a clear process for this. If your claims are being denied, it’s always best to hire a professional to help you. I wrote a book, “Solve Curing Your Medical Insurance
- [Suspect Your Were Overcharged?](https://adriagross.com/suspect-your-were-overcharged/) - If you ever have any suspicion that you’re being overcharged, negotiate with the providers in the billing department. It’s always best to look at the Medicare rates according to the procedure codes that is on your itemized bill. Very often, you’re able to get a discount if you can prove that the provider is billing
- [First-Level vs Second-Level Appeals for Denied Medical Claims](https://adriagross.com/first-level-vs-second-level-appeals-for-denied-medical-claims/) - First-level vs second-level appeals can determine whether a denied medical claim gets paid or remains your financial responsibility. Many people across the United States give up after the first denial because they assume the insurance company has the final word.That assumption can become expensive very quickly.A denied claim does not always mean the case is
- [Medical Billing Advocate vs Coder vs Biller Explained](https://adriagross.com/medical-billing-advocate-vs-coder-vs-biller-explained/) - The difference between Medical Billing advocate, coder, and biller can mean the difference between paying thousands—or paying nothing—when your claim gets denied. Most people don’t realize they’re calling the wrong professional until it’s too late.If you’ve ever opened a shocking bill or received a denial letter, you already know how fast confusion turns into frustration.
- [Erisa Claim Denial?](https://adriagross.com/erisa-claim-denial/) - Are you now appealing an ERISA claim denial? What was the reason for your denial? Very often, the State Department of Insurance and the attorney general for your state will not assist you with your appeal. You need to find out which Department of Labor to reach out to. Once you have that information, send
- [Why Drug Prices Are Cheaper in Other Countries](https://adriagross.com/why-drug-prices-are-cheaper-in-other-countries/) - One of the major issues causing high premiums on our pharmaceutical drugs is due to research and development. The question is: why are drug prices lower in other countries? Outside the US, the countries pay for the manufacturing cost of the drug and a very small profit on the cost of manufacturing. But here in
- [How the U.S. Healthcare Payment System Works](https://adriagross.com/how-the-u-s-healthcare-payment-system-works/) - How the U.S. healthcare payment system works isn’t just confusing—it’s the reason so many people end up stuck with overwhelming healthcare bills and denied medical claims they don’t understand.You did everything right. You went to the doctor, followed instructions, and trusted your insurance. Then the bill came… or worse, a denial letter. Suddenly, you’re left
- [No Surprises Act Explained](https://adriagross.com/no-surprises-act-explained/) - The No Surprises Act became effective January 1st of 2022, and it protects consumers from surprise medical bills for emergency services and non-emergency services. It limits out-of-network cost-sharing and establishes a dispute resolution process for billing disagreements. This includes protections for uninsured and self-pay individuals who can request a good faith estimate of medical costs
- [Infertility Bill Claims Unpaid?](https://adriagross.com/infertility-bill-claims-unpaid/) - If you come across an unfair medical bill, the first thing you need to do is examine your insurance coverage. Review your plan, understand your deductibles, your co-pays, your co-insurance, and out-of-pocket maximum. I very often overturn cases by proving the policy covers for specific types of procedures. I recently had a case involving infertility
- [Understanding CPT, ICD-10, and HCPCS Codes](https://adriagross.com/understanding-cpt-icd-10-and-hcpcs-codes/) - Understanding CPT, ICD-10, and HCPCS codes can be the difference between a paid claim and a denied one—and most people don’t even know these codes exist until something goes wrong.You open a bill that makes no sense. Then comes the denial. You call your insurance, but the explanation sounds like another language. That’s because, in
- [The Best Chance You'll Have at Overturning Your Case](https://adriagross.com/the-best-chance-youll-have-at-overturning-your-case/) - You are now about to dispute a bill which you received from a collection agency. You need to request verification from the agency, and I recommend you submit a complaint to the Consumer Financial Protection Bureau and the Centers for Medicare and Medicaid Services. By making a complaint with those departments and/or hiring a medical
- [Unfair Medical Charges Eat Away Your Coverage](https://adriagross.com/unfair-medical-charges-eat-away-your-coverage/) - Unfair medical charges can arise from various issues, including billing errors, surprise bills from network providers, and inflated charges. To address these issues, you can start by examining your insurance coverage, contacting your provider and insurance company, and disputing the bill by hiring MedWise. I recently reduced a bill from $37,000 down to $4,000. Call
- [Types of Health Insurance Plans Explained](https://adriagross.com/types-of-health-insurance-plans-explained/) - Types of health insurance plans (HMO, PPO, EPO) can determine whether your claim gets paid—or denied—and most people only learn the difference after a costly mistake.You thought you were covered. Then the bill arrived, or worse, the claim was denied. Now you’re trying to understand rules that were never clearly explained.The reality is simple: your
- [Can Itemized Bills Save You Thousands?](https://adriagross.com/can-itemized-bills-save-you-thousands/) - To help you save a tremendous amount of money, request itemized bills to understand what you have been charged for. All too often, you’re charged for services that were never rendered, and that is why it’s so important that you keep a copy of your medical records. Recently, I saved a client over $10,000, since
- [College Insurance Pros and Cons](https://adriagross.com/college-insurance-pros-and-cons/) - When a student has college insurance, that policy is a primary insurer. Sometimes the parents or guardian might still have them on their policy, which would be secondary to the college health insurance policy. Here are the positives and negatives about college health insurance. College insurance, the advantages are. The policies are written according to what the
- [Premiums, Deductibles, and Copays Explained](https://adriagross.com/premiums-deductibles-and-copays-explained/) - Understanding premiums, deductibles, and copays is the key to knowing why your insurance didn’t pay—and why your healthcare bills may be higher than expected.You pay your monthly premium, assume you’re covered, and then a bill shows up that doesn’t match your expectations. Or worse, your claim is denied and you’re left wondering what went wrong.The
- [Why America's Health Care System is Sick](https://adriagross.com/why-americas-health-care-system-is-sick/) - I hope you’re having a fantastic day. I was reading an article recently that said, “The devil is in the details.” But you know what? The strength is in the essentials. Our healthcare system is complicated, and you don’t want to be caught off guard or taken advantage of. Many people call me to help them evaluate
- [Is AI Causing More Medical Claim Denials?](https://adriagross.com/is-ai-causing-more-medical-claim-denials/) - Artificial intelligence is changing many parts of the insurance industry, and unfortunately, some people feel they are not receiving the treatment they need because of automated claim decisions. If you’re having problems getting approval for care, or if your claims are being denied, please call MedWise. I’m here to help you navigate the process and advocate
- [Why Coding Errors Cause Medical Claim Rejections and How to Fix Them](https://adriagross.com/why-coding-errors-cause-medical-claim-rejections-and-how-to-fix-them/) - Understanding how do insurance companies use diagnosis codes can help you prevent denials, reduce medical debt, and protect your financial future. Many patients are surprised to learn that one small coding detail can determine whether a claim is approved or rejected. The good news is that once you understand this process, you gain leverage and
- [Do This Before You Purchase Any Medical Insurance Policy](https://adriagross.com/do-this-before-you-purchase-any-medical-insurance-policy/) - When you go onto a website to purchase health insurance, please make sure you take a close look at the policy and understand exactly what it covers and what it does not cover. You might be purchasing a plan that will not cover your specific condition, or your medical providers may not be in the
- [Medicare Advantage Plan Refuses Care](https://adriagross.com/medicare-advantage-plan-refuses-care/) - Congress is currently scrutinizing Medicare Advantage plans. I had a new case this week where a patient was being discharged from the hospital because of issues with her insurance coverage. She was having complications with her pacemaker, and the insurance company initially would not authorize a visit with her cardiologist. When I received the call, I
- [Hospital Debt in Collections? Step-by-Step Dispute Guide](https://adriagross.com/hospital-debt-in-collections-step-by-step-dispute-guide/) - Understanding how to dispute hospital collections can help you stop the pressure, protect your credit, and reduce the amount you owe. Many people believe that once a hospital sends a bill to collections, it’s too late to fix the situation. The truth is, you still have powerful rights and options.Medical debt in collections creates fear
- [A $32,000 Medical Claim Overturned](https://adriagross.com/a-32000-medical-claim-overturned/) - I hope you’re having a fantastic day. When I started in the health insurance industry in the claims department, I became a claims supervisor within a short time. During my training, I learned very quickly how companies approach denying claims. It shouldn’t be driven by shareholder interests when people’s health and financial stability are at stake. Unfortunately,
- [How Non-Profit Hospitals Help With Health Care](https://adriagross.com/how-non-profit-hospitals-help-with-health-care/) - I hope your day is going great. When it comes to medical bills being denied by your insurance company, the numbers are staggering. According to the Kaiser Family Foundation, we now have over $220 billion in medical debt, and about 25% of people who need treatment simply can’t afford it. Fortunately, some nonprofit hospitals offer financial assistance
- [Did Your Dental Coverage Deny Your Cleaning Bill?](https://adriagross.com/did-your-dental-coverage-deny-your-cleaning-bill/) - Good afternoon. I spoke with a client the other day who lives in Texas. He has a dental policy, and believe it or not, he was denied coverage for a routine teeth cleaning. Can you imagine being told it’s not medically necessary to clean your teeth? If you need assistance with any of your claim denials, please
- [Is AI Automatically Denying Claims for Autistic Children?](https://adriagross.com/is-ai-automatically-denying-claims-for-autistic-children/) - You know, I’ve been absolutely shocked that some companies are limiting treatment for autistic children. There was a recent case where the New York State Attorney General forced an insurance carrier to pay a $1 million penalty for failing to provide proper coverage. What has been happening is that some insurance companies are denying claims to
- [Medical Claim Was Denied for This Reason](https://adriagross.com/medical-claim-was-denied-for-this-reason/) - I hope you’re having a fabulous day. You know, 99% of all enrollees who have a Medicare Advantage plan need to obtain prior authorization for many services. This most commonly applies to higher-cost treatments, including inpatient hospital stays, skilled nursing facility care, and chemotherapy. Medical providers are responsible for obtaining prior authorization. Patients should not be paying
- [The Challenge with Medicare Advantage Plans](https://adriagross.com/the-challenge-with-medicare-advantage-plans/) - I hope you’re having a fantastic day. I’ve always been shocked by what insurers get away with. When I went into the health insurance industry as a claims analyst, within two weeks the company taught me how to deny claims. This is why I’m here to help you. If your claim is denied, you’re overcharged out of
- [Free Consultation for Medical Bill Denial Could Save You](https://adriagross.com/free-consultation-for-medical-bill-denial-could-save-you/) - A free consultation for medical bill denial could be the turning point between financial stress and total relief. Yet most people never take this step until the situation spirals out of control. If you’ve received a denial letter, the clock is already ticking, and every day you wait limits your options and increases your financial
- [Sign Up for a Medical Bill Review Service and Reduce Your Healthcare Debt](https://adriagross.com/sign-up-for-a-medical-bill-review-service-and-reduce-your-healthcare-debt/) - If you’re overwhelmed by denied claims, surprise charges, or confusing statements, it may be time to sign up for a medical bill review service that protects your finances and your peace of mind. Medical billing errors are common, and insurance denials can leave you facing thousands of dollars in unexpected costs. The good news is
- [Medical Bill Negotiation Service Pricing: How Much Does It Cost?](https://adriagross.com/medical-bill-negotiation-service-pricing-how-much-does-it-cost/) - Understanding medical bill negotiation service pricing can help you make a confident decision before your denied claim turns into long-term financial stress. Many people assume these services are expensive or risky. In reality, the right medical billing advocate often saves far more than they cost.Denied medical bills can feel overwhelming and unfair. You may be
- [How to Check if Insurance Covers Something Before You Get a Denial](https://adriagross.com/how-to-check-if-insurance-covers-something-before-you-get-a-denial/) - Knowing how to check if insurance covers something before a procedure or treatment can protect you from unexpected medical debt. Many people assume their plan will pay, only to receive a denial weeks later. The good news is that there are clear steps you can take to avoid this situation.Denied claims are stressful and confusing.
- [How to Dispute a Medical Bill in Collections and Protect Your Credit](https://adriagross.com/how-to-dispute-a-medical-bill-in-collections-and-protect-your-credit/) - Learning how to dispute a medical bill in collections can stop the damage, reduce stress, and give you a real path forward. Many people feel powerless once a bill reaches collections, but the truth is you still have rights and options. The sooner you take action, the stronger your position becomes.Medical debt can affect your
- [Insurance Claim Documentation Checklist to Prevent Denials](https://adriagross.com/insurance-claim-documentation-checklist-to-prevent-denials/) - Knowing the right documents for insurance claim approval can mean the difference between getting paid and facing thousands in unexpected medical debt. Many claims are denied not because the treatment wasn’t necessary, but because paperwork was incomplete or submitted incorrectly. The good news is that you can take control of this process.Denied claims often create
- [Denied Medical Coverage for Recommended Care?](https://adriagross.com/denied-medical-coverage-for-recommended-care/) - Hello, my friends. Coverage denials can lead to significant delays in getting care while patients and their doctors go through the appeal process. Almost three out of five people who reported that their insurer denied coverage for recommended care said they experienced delays in receiving treatment as a result. If this happens to you, MedWise is here
- [Frustrated By Medical Insurance Denials?](https://adriagross.com/frustrated-by-medical-insurance-denials/) - Hello, my friends. You know, many people have been mistreated by insurers, or their loved ones have. When you’re frustrated by denials and get no assistance from the insurance company, it’s time to call me. I have overturned 95% of the cases that come my way. I’m the owner of MedWise Insurance Advocacy. Please call me. Thank you. Adria
- [Your Insurance Company Needs Arm Twisting?](https://adriagross.com/your-insurance-company-needs-arm-twisting/) - Hello, my friends. Have you or a family member been denied essential care to the point of permanent disability or even death? I used to work for two insurance companies, and within two weeks, they taught me how to deny claims. After that, I also learned how to challenge the insurance carrier and advocate for patients. Please call
- [Financial Ruins from Denied Medical Claims](https://adriagross.com/financial-ruins-from-denied-medical-claims/) - Good afternoon. I hope you’re having a great day. Are you now in financial ruin because your medical claim was denied by your health insurance carrier? Many times, insurance companies deny claims even though, according to your policy, you should be covered. If this happens to you, please call me at MedWise. I’m Adria, and I’m here to help
- [Your Insurance Company Broke Their Promise to Cover You?](https://adriagross.com/your-insurance-company-broke-their-promise-to-cover-you/) - Hello, everybody. You know, I’ve got to tell you, it is absolutely terrible that we’re in a position where our claims are denied and we become frustrated to the point of screaming before getting a satisfactory outcome. Insurance companies make these promises that you’re going to be covered. You go for treatment, you get the bill, and
- [Higher Medical Insurance Premiums?](https://adriagross.com/higher-medical-insurance-premiums/) - Hello my friends. I can remember the day when someone didn’t want to report an accident or injury because their insurance premiums might go up. Now, even if you make no claims, insurance premiums continue to rise at an alarming rate. Ask your insurance carrier what you’re covered for and what you’re not covered for, and always ask
- [How to Appeal Your Denied Medical Claims](https://adriagross.com/how-to-appeal-your-denied-medical-claims/) - You know, if your medical bill is denied, please challenge the health insurance carrier. Many people do not understand that they have the right to overturn the case despite the ACA’s rules. For insurance companies to handle appeals and standardized appeal processes, 40% of those who did not challenge their denial reported that they did not
- [Claim Denied? How to Write a Medical Claim Appeal Letter](https://adriagross.com/claim-denied-how-to-write-a-medical-claim-appeal-letter/) - That thick envelope from your insurance company sits on the table, and the words inside make your stomach sink: “CLAIM DENIED.” It’s a frustrating, infuriating, and often frightening moment. You followed the rules, you paid your premiums, yet a decision made by a faceless entity now threatens your financial stability. This feeling of powerlessness is
- [High Out of Pocket Medical Costs](https://adriagross.com/high-out-of-pocket-medical-costs/) - When faced with high out-of-pocket costs, healthier individuals might opt out of necessary healthcare to avoid expenses, a behavior that insurers indirectly encouraged. This leads to a cycle of rising premiums and decreasing access to care. This is what is titled Adverse selection. What I see all too often is young people think, no worries. I am
- [Out of Network Bill Not Paid?](https://adriagross.com/out-of-network-bill-not-paid-2/) - You’re preparing dinner for your family and ouch. You just cut yourself so deep. You need stitches, you wind up in urgent care, and you later find out that they’re outta network, so you receive a bill for $8,000. My client called me when this happened to them, and guess what? They only had to pay $500. Call me. I’m here
- [Duplicate Bills from Same Procedure?](https://adriagross.com/duplicate-bills-from-same-procedure-2/) - 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 to1,200. 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 me if you need help. I’m here
- [Bee Sting Leads to Emergency Room Bill Not Covered by Insurance](https://adriagross.com/bee-sting-leads-to-emergency-room-bill-not-covered-by-insurance-2/) - I hope you’re having a great day today. Well, let me tell you this one. Wow. You get stung by a bee and you have difficulty breathing. You got swelling of your throat or tongue, you got a rapid pulse, you are dizzy or fainting. Please go directly to the emergency room. I had a
- [ER Medical Bill Not Medical Necessary?](https://adriagross.com/er-medical-bill-not-medical-necessary-2/) - 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
- [Was Your Medical Claim Denied Even After pre-Authorization?](https://adriagross.com/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
- [How to Shop and Compare Hospital Costs](https://adriagross.com/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 Bill Much Higher Than it Should Have?](https://adriagross.com/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. Adria Gross Medical Billing Advocate See Full Bio Adria
- [How to Challenge Your Medical Bill](https://adriagross.com/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
- [Don't Let Medical Bills Bankrupt Your Family](https://adriagross.com/dont-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 Top CEOs in Medical Fields Make More Money](https://adriagross.com/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.
- [What is Hospital Upcoding](https://adriagross.com/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
- [Who's Responsible for the Medical Appeal Process?](https://adriagross.com/whos-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
- [Billing Disputes and Denials of Medical Coverage](https://adriagross.com/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
- [Incentives for Over Providing Services](https://adriagross.com/incentives-for-over-providing-services/) - A fee-for-service medical cost arrangement exists in the United States. The more services doctors perform, the higher their incomes. Just as patients have an incentive to overconsume, doctors have an incentive to overprovide. If you’re having difficulties paying your medical bills, call me. I’m the owner of Medwise. We save individuals thousands of dollars on
- [Unfair Review of Claims for Medical Bills](https://adriagross.com/unfair-review-of-claims-for-medical-bills/) - Many health insurers require a review of claims or prior authorization requests by a nurse and a doctor, both employed by the insurer. Recent media investigations have found that some insurance company doctors are not incentivized to spend the time needed to scrutinize patients’ medical records and follow guidelines for making informed decisions about approving
- [Delay of Care Due to Care Denials](https://adriagross.com/delay-of-care-due-to-care-denials/) - You know, over the years I have found that nearly half of respondents who experienced a delay in care following a coverage denial said that their health problems got worse as a result of those delays. Worry and anxiety among those experiencing delays are really universal. Nearly one in six reported cases indicate that care
- [What Increases Medical Care Costs](https://adriagross.com/what-increases-medical-care-costs/) - The lack of health coverage produces negative consequences. For instance, an individual avoiding upfront medical costs might end up in the emergency room where treatment is much more expensive. This not only increases healthcare costs for everyone but also places a heavier load on public resources and spreads illness. Make sure you have a good
- [What Service Do Private Insurance Companies Provide](https://adriagross.com/what-service-do-private-insurance-companies-provide/) - Hello my friends. What service do private insurers provide in return for the fees they collect? Again, what service do private insurers provide in return for the fees that they collect? You may not realize the extent to which the insurance companies are exposing themselves to the delay and deny strategies. Private insurance is often
- [Are Insurers Deliberately Denying Claims](https://adriagross.com/are-insurers-deliberately-denying-claims/) - Insurers are motivated to avoid paying for care. Many insurers appear to be utilizing increasingly aggressive tactics to do so, deploying technology and applying pressure to company physicians to scrutinize services recommended by patients’ physicians, and often to deny coverage, leaving patients with unexpected bills or delays in care. You need care, and if you’re
- [How the ACA Works for Claim Denials](https://adriagross.com/how-the-aca-works-for-claim-denials/) - The Affordable Care Act (ACA) granted people the right to appeal decisions made by their health insurers regardless of their insurance type or state of residence. The law also established rules for how insurance companies should handle initial appeals and allows insurers to request a reconsideration of decisions to deny payment. If an insurer upholds
- [Didn't Schedule the Medical Procedure Within the Pre Authorization Period?](https://adriagross.com/didnt-schedule-the-medical-procedure-within-the-pre-authorization-period/) - I hope you’re having a fabulous day today. A coverage denial may say the needed care was not provided as a result of not scheduling the services needed within the time period you were originally preauthorized by your insurance carrier. What they do is they send in that you might need pre-authorization, and they give
- [Was Your Health Service Supposed to be Free?](https://adriagross.com/was-your-health-service-supposed-to-be-free/) - Have you received a medical bill or are you being charged a copayment in the past year for a service you thought should have been free or covered by your insurance carrier? If you receive a bill for a health service you thought was free or should have been covered by your health insurance carrier,
- [How to Challenge a Billing Error](https://adriagross.com/how-to-challenge-a-billing-error/) - One of my clients reported a billing error to me and we challenged the insurance carrier and the medical provider. You need to be aware of your right to challenge a bill. We recently decreased a bill from $4,500 down to $100. Please call me. Remember, I’m here to help you. Thank you. Adria Gross
- [Eligibility for Health Savings Accounts](https://adriagross.com/eligibility-for-health-savings-accounts/) - I received many calls involving HSAs. A Health Savings Account (HSA) is a tax-advantaged savings account that allows you to set aside money to pay for qualified medical expenses such as deductibles, copayments, coinsurance, acupuncture, ambulance costs, doctor’s visits, hearing aids, prescription drugs, psychological therapy, psychiatric care, and qualified long-term care services. To be eligible
- [Profits in Insurance Industry Are Booming](https://adriagross.com/profits-in-insurance-industry-are-booming/) - Profits in the insurance industry are booming. UnitedHealthcare’s operating profit margin was about 5.8% on revenues of $281.4 billion in 2023. Insured individuals not only pay high premiums, but they also face deductibles, copays, and unexpected bills. Insurers exploit the system by enrolling primarily young, healthy individuals, and they manipulate costs, largely enabled by policies
- [Self Employed Individuals Health Insurance](https://adriagross.com/self-employed-individuals-health-insurance/) - Consider a self-employed individual choosing a health plan from the health insurance marketplace without subsidy eligibility. They might select a silver plan costing about a thousand dollars monthly, thinking it covers in-network doctor visits with a reasonable copay. However, a visit to the doctor may reveal a $200 charge because the deductible was not met.
- [Deceptive Practices in Self-Funding Insurance Plan](https://adriagross.com/deceptive-practices-in-self-funding-insurance-plan/) - Please be careful when choosing a medical insurance carrier policy. There are deceptive practices in the marketplace, but the government has a limited role when it comes to self-funding, self-insured ERISA plans, which are controlled by private insurers. If you know you should be covered but are being denied, please fight for your rights. I
- [Where Does Insurance Company CEO Salaries Come From?](https://adriagross.com/where-does-insurance-company-ceo-salaries-come-from/) - The multiple giant insurance companies feed finances to the executives of the insurance company as well as the stockholders. Much of that money and the pay for the multiple senior executives at the insurance companies, who almost all make over a million dollars a year, came from saying no to people who file claims for
- [Doctor Recommends an MRI?](https://adriagross.com/doctor-recommends-an-mri/) - 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. Adria Gross Medical Billing Advocate See Full Bio Adria Gross
- [Got a Bill from a Doctor You've Never Seen](https://adriagross.com/got-a-bill-from-a-doctor-youve-never-seen-2/) - Have you ever been hospitalized and received a bill for a doctor you never saw? I recently overturned a case where the doctor was charging over $5,000, but that doctor never saw the patient. When looking at the medical records, we were able to prove that the doctor never performed any services, and they finally
- [The Colonoscopy That Was Almost Not Covered](https://adriagross.com/the-colonoscopy-that-was-almost-not-covered-2/) - I hope you’re having a fantastic day. You know, Medicare Advantage is often touted as beneficial, but most people believe it to be a scam. It’s 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
- [Out of Network Medical Bill Reduced from $6,000 to $240](https://adriagross.com/out-of-network-medical-bill-reduced-from-6000-to-240/) - We are literally the only developed country in the world with an entire multi-billion dollar for-profit health insurance industry. Some hospitals are not for-profit, and I wish it was the same for the health insurance companies. The for-profit health insurance industry has attached itself to us like a giant bloodsucking tick. I recently worked with
- [Frustration for Denied Insurance Claims Escalate](https://adriagross.com/frustration-for-denied-insurance-claims-escalate-2/) - Americans are crushed by skyrocketing premiums, crippling medical debt, and denial of care, which devastates millions of lives. It should be no surprise that frustration has reached a boiling point, igniting a widespread demand for real systemic change. Ordinary people understand that insurance companies don’t exist to protect their health, but to maximize profits for
- [The Hospital Price Transparency Law](https://adriagross.com/the-hospital-price-transparency-law/) - 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 provide. However, as of July 9th, 2024, only 16.7% of hospitals nationwide comply with the hospital price transparency rule. You should know in advance what the fees are, and
- [How to Win at Filing a Complaint Against a Health Insurance Company](https://adriagross.com/how-to-win-at-filing-a-complaint-against-a-health-insurance-company/) - The frustration is suffocating. When it comes to filing a complaint against a health insurance company, you’re not just fighting a denial; you’re battling a system designed to exhaust you. The endless phone trees, the vague explanations, the soul-crushing bureaucracy—it feels intentional. This guide isn’t about simply filling out forms. It’s about turning their own
- [Read this Guide to Surprise Medical Billing Laws FIRST](https://adriagross.com/read-this-guide-to-surprise-medical-billing-laws-first/) - That bill you’re staring at feels like a betrayal. This essential guide to surprise medical billing laws is for anyone who has felt that gut punch of a medical bill they never saw coming. You did everything right—you went to an in-network facility—but now you’re facing a financial threat from a ghost provider you never
- [The Truth: Medical Billing Advocate Success Rates](https://adriagross.com/the-truth-medical-billing-advocate-success-rates/) - Evaluating the medical billing advocate success rate for MedWise Insurance Advocate requires looking past the numbers everyone else quotes. You’re facing a mountain of medical debt, feeling cornered by jargon-filled letters and relentless phone calls. The question isn’t just about winning; it’s about how much you truly save and whether the fight is worth the
- [Powerful Alternatives to Hiring a Medical Claims Lawyer](https://adriagross.com/powerful-alternatives-to-hiring-a-medical-claims-lawyer/) - When a staggering medical bill arrives, discovering effective alternatives to hiring a medical claims lawyer can feel like finding a secret passage out of a maze. The instinct is to seek legal force, but this is often a costly, slow, and unnecessarily blunt approach. You feel trapped between an insurer’s cold denial and the daunting
- [Why Medical Billing Advocate Services for Cancer Patients?](https://adriagross.com/why-medical-billing-advocate-services-for-cancer-patients/) - The right medical billing advocate services for cancer patients do more than just manage paperwork; they are a crucial shield in a two-front war. While you focus on the physical battle, a second, insidious fight against financial toxicity begins. The relentless flood of complex bills, insurance denials, and administrative red tape is overwhelming, stealing precious
- [Don't Waste a Free Consultation with a Medical Billing Advocate](https://adriagross.com/dont-waste-a-free-consultation-with-a-medical-billing-advocate/) - Securing a free consultation with a medical billing advocate is your first strategic move, but most people squander this critical opportunity. You’re holding a stack of confusing, intimidating medical bills, and that offer of a no-cost conversation feels like a lifeline. It’s a chance to finally get answers and see a path forward. But the
- [Denied? Get a Medical Claim Appeal Service for Hire](https://adriagross.com/denied-get-a-medical-claim-appeal-service-for-hire/) - Finding the right medical claim appeal service for hire is the single most important decision after a denial. That letter from your insurer, filled with cold, clinical language, is not just a rejection—it’s the start of a complex, time-sensitive process. You know you need to fight back, but the path is shrouded in red tape,
- [Need a Hospital Bill Negotiation Company? Read this First!](https://adriagross.com/need-a-hospital-bill-negotiation-company-read-this-first/) - Hiring a hospital bill negotiation company is your most powerful move against a system built on arbitrary pricing. You’ve seen the bill, a document where a single Tylenol tablet can cost more than the entire bottle. The shock and powerlessness are overwhelming. You’re facing a five or six-figure sum that feels both absurd and non-negotiable,
- [How Adria Gross Patient Advocate Beats Insurance Denials](https://adriagross.com/how-adria-gross-patient-advocate-beats-insurance-denials/) - The effectiveness of Adria Gross, patient advocate, stems from a perspective few others possess. When you’re facing a mountain of medical bills or a cold insurance denial, it feels like an unwinnable war against a faceless system. You need more than just a helper; you need a strategist who knows the enemy’s playbook because she
- [Why the Difference Between a Copay and Coinsurance Matters](https://adriagross.com/why-the-difference-between-a-copay-and-coinsurance-matters/) - Understanding the difference between a copay and coinsurance isn’t just about learning insurance jargon; it’s about seizing control of your financial destiny in a healthcare system designed to be confusing. The anxiety of opening a medical bill, bracing for a number you can’t possibly predict, is a universal fear. This single piece of knowledge is
- [Adria Gross vs Contingency Fee Medical Bill Lawyer: Truth](https://adriagross.com/adria-gross-vs-contingency-fee-medical-bill-lawyer-truth/) - Choosing between Adria Gross vs contingency fee medical bill lawyer is more than a simple comparison of professionals; it is the single most important strategic decision you will make in your fight against a catastrophic medical bill. The crushing weight of that bill isn’t just about the numbers; it’s the suffocating feeling of injustice. You
- [How to Find Patient Advocate Agencies Accepting New Clients](https://adriagross.com/how-to-find-patient-advocate-agencies-accepting-new-clients/) - Searching for patient advocate agencies accepting new clients can feel like a desperate hunt for a lifeline in a storm. You know you need an expert navigator, but every call hits a full voicemail, and every email inquiry is met with an automated reply about a six-month waitlist. All the while, the clock is ticking
- [How to Get Your Claim Paid: Insurance Denial Appeal Help](https://adriagross.com/how-to-get-your-claim-paid-insurance-denial-appeal-help/) - When you need insurance denial appeal help, you are not just fighting a decision; you are fighting for your health, your financial stability, and your future. That denial letter feels like a cold betrayal by the very company you paid to protect you. The sense of powerlessness can be utterly paralyzing, which is precisely what
- [Hospital Billing Advocate Secrets Doctors Don’t Tell You](https://adriagross.com/hospital-billing-advocate-secrets-doctors-dont-tell-you/) - A hospital billing advocate is a professional who assists patients in reviewing, understanding, and negotiating medical bills to ensure accuracy and fairness. By leveraging their expertise, these advocates help patients navigate the complexities of hospital billing, potentially saving them significant amounts of money and reducing stress.What Is a Hospital Billing Advocate?A hospital billing advocate is
- [Why Every Texan Needs a Medical Advocate Texas Today](https://adriagross.com/why-every-texan-needs-a-medical-advocate-texas-today/) - In the vast and often complex healthcare landscape of Texas, patients frequently encounter challenges that can be overwhelming. From deciphering intricate medical bills to coordinating care among multiple providers, the journey can be daunting. Enter the role of a medical advocate in Texas—a professional dedicated to guiding patients through these complexities, ensuring they receive the
- [Patient Advocate vs Medical Billing Advocate: Read This First](https://adriagross.com/patient-advocate-vs-medical-billing-advocate-read-this-first/) - Navigating the murky waters of the healthcare system can feel like you’re drowning. The debate over a patient advocate vs medical billing advocate is more than semantics; it’s about choosing the right champion for your specific battle. You’re facing a mountain of incomprehensible paperwork, cryptic denial letters from your insurer, and bills that read like
- [Top Rated Patient Advocates for Claim Denials: Don't Hire Yet](https://adriagross.com/top-rated-patient-advocates-for-claim-denials-dont-hire-yet/) - Searching for top rated patient advocates for claim denials feels like looking for a ghost. You’ve just received that soul-crushing denial letter—a cold, bureaucratic gut-punch that feels like a final verdict. The insurance company has thrown up a brick wall, cloaked in confusing jargon, and left you feeling powerless, panicked, and completely alone. This isn’t
- [Your Ally: Medical Billing Advocate for Cancer Treatment Bills](https://adriagross.com/your-ally-medical-billing-advocate-for-cancer-treatment-bills/) - In the midst of your fight against cancer, the last thing you should be battling is a mountain of paperwork. A specialized medical billing advocate for cancer treatment bills is not a luxury; it’s a critical member of your care team. You’re focusing all your energy on healing, yet a second, relentless battle is being
- [Use These Tips for Negotiating Medical Bills with a Hospital](https://adriagross.com/use-these-tips-for-negotiating-medical-bills-with-a-hospital/) - That oversized envelope contains more than just a bill; it holds a staggering number that can feel like a judgment, sparking immediate fear and stress. When you need tips for negotiating medical bills with a hospital, the last thing you want is generic advice. You need to know the hidden rules of the game. The
- [Understanding My Rights as a Patient with Medical Bills NOW](https://adriagross.com/understanding-my-rights-as-a-patient-with-medical-bills-now/) - That thick envelope from a hospital or clinic arrives, and your stomach plummets. It’s a feeling of pure dread—a mix of confusion, frustration, and helplessness. For too long, understanding my rights as a patient with medical bills has felt like an impossible code to crack. You’re left staring at a staggering number, with no clear
- [Difference Between in-network and out-of-network Charges SCAM](https://adriagross.com/difference-between-in-network-and-out-of-network-charges-scam/) - That gut-wrenching moment you open a medical bill and see a number so staggering it feels like a typo isn’t an accident. Understanding the difference between in-network and out-of-network charges is the only defense you have against a system that profits from your confusion. This isn’t just about healthcare; it’s about protecting your financial future
- [Prior Authorization Denial, What to Do Next](https://adriagross.com/prior-authorization-denial-what-to-do-next/) - That cold dread washing over you as you read the denial letter isn’t just disappointment—it’s a profound sense of injustice. When facing a prior authorization denial what to do next feels like an impossible question, a fight against a faceless corporate giant that holds your health in its hands. This moment of paralysis is exactly
- [The Policy Did Not Cover MRI?](https://adriagross.com/the-policy-did-not-cover-mri/) - I have never seen this before. The policy did not cover for an MRI when we were able to prove the necessity for the MRI. The insurance company finally agreed and paid the claim. If you ever have any problems with any of your medical bills, please call me. I’m here to help you. Adria
- [Your Insurance Company Will Not Cover Everything](https://adriagross.com/your-insurance-company-will-not-cover-everything/) - Some people purchase insurance policies that they think will cover everything. I had a case recently where the policy did not cover for any hospitalization. The original bill was $67,000 and thank you. After negotiations, I was able to bring it down to $6,000. That was a savings of $61,000. If you need help, I’m
- [Are You Really Covered by Your Medicare Advantage Plan?](https://adriagross.com/are-you-really-covered-by-your-medicare-advantage-plan/) - When people decide that they want to take a Medicare Advantage plan, they do not realize that so many hospitals are no longer accepting the Advantage plans. I recently had a case where the person was admitted to the hospital. The hospital was participating and accepted a Medicare Advantage plan, but within two days after
- [Denied Medical Claim While on Health Marketplace](https://adriagross.com/denied-medical-claim-while-on-health-marketplace/) - A case recently involved my client being in a hospital for emergency brain tumor surgery. They had a policy through the Affordable Care Act in New York State, and I could not believe that they were denying the claims. It took about 10 months to cover to turn the case over, but finally, the bill
- [Medical Bill Reduced from $150,000 to $5,000 With Travel Insurance](https://adriagross.com/medical-bill-reduced-from-150000-to-5000-with-travel-insurance/) - You know, much too often people purchase travel insurance and they come here, the United States. Every case that has come to me when the visitor is in the United States, they always wind up in emergency room and they’re hospitalized for a pre-existing condition, which is always an exclusion on the policy. I’ve recently
- [Are New Employees Covered by Self Insurance Coverage?](https://adriagross.com/are-new-employees-covered-by-self-insurance-coverage/) - I hope you’re having a fabulous day today. It is so difficult to fight for coverages when your company is so large and they have a self-funded, self-insured or risk plan. Many employers do not want to pay large claims for recent hired employees unless they are so well liked that the employer is willing
- [Out of Network Providers Can Still be Paid by Insurance](https://adriagross.com/out-of-network-providers-can-still-be-paid-by-insurance/) - I recently had a case where surgery was required. None of the in-network providers were able to perform the services. It took four months, but we were finally able to get a single case agreement with an out of network provider, and the insurance company finally agreed to pay the in-network fees. If you ever
- [Misinformed About What Medical Insurance Covers](https://adriagross.com/misinformed-about-what-medical-insurance-covers/) - One of my recent clients was informed the provider was in network. They went for the surgery and later found out that the provider was really out of network and they were never covered. The fact that they were misinformed, I was able to get the bill from $29,000 down to zero due to their
- [$85,000 Pre-authorized Medical Bill Denied](https://adriagross.com/85000-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](https://adriagross.com/rehab-for-drugs-and-alcohol-70000-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?](https://adriagross.com/coma-patient-with-a-300000-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](https://adriagross.com/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 BillingHospital-based billing, also known as institutional billing, pertains to charges incurred for services provided within a hospital setting. This includes inpatient stays,
- [The Colonoscopy That Was Almost Not Covered](https://adriagross.com/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 cause
- [$6,000 Podiatry Bill Reduced to $750](https://adriagross.com/6000-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
- [Hire a Medical Billing Advocate to Cut Hidden Costs](https://adriagross.com/hire-a-medical-billing-advocate-to-cut-hidden-costs/) - In today’s intricate healthcare landscape, patients often find themselves overwhelmed by medical jargon, insurance complexities, and administrative hurdles. To effectively manage these challenges, many individuals choose to hire a medical billing advocate. These professionals serve as dedicated allies, guiding patients through the healthcare system to ensure they receive appropriate care and support.Understanding the Role of
- [ER Medical Bill Not Medical Necessary?](https://adriagross.com/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](https://adriagross.com/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
- [Why You Should Hire a Healthcare Advocate Today](https://adriagross.com/why-you-should-hire-a-healthcare-advocate-today/) - Patients often find themselves overwhelmed by medical jargon, insurance complexities, and administrative hurdles. To effectively manage these challenges, many individuals choose to hire a healthcare advocate. These professionals serve as dedicated allies, guiding patients through the healthcare system to ensure they receive appropriate care and support.Understanding the Role of a Healthcare AdvocateA healthcare advocate is
- [Duplicate Bills from Same Procedure?](https://adriagross.com/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](https://adriagross.com/15000-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
- [Cut Medical Costs with a Healthcare Billing Advocate](https://adriagross.com/cut-medical-costs-with-a-healthcare-billing-advocate/) - The U.S. healthcare system is a patchwork of disconnected billing systems, coding procedures, and third-party payment networks. Providers input codes, insurers process them with automated systems, and the patient ends up holding the bag for any mismatches or oversights.Hidden Causes Behind Sky-High BillsCPT and ICD coding errors that inflate chargesOut-of-network providers billing full price at
- [Food Poison $11,000 Medical Bill Down to $1,100](https://adriagross.com/food-poison-11000-medical-bill-down-to-1100/) - One of my clients had food poisoning. It was so bad that they were collapsing at home and wound up going to an emergency room. The ER did not have a contract with the insurance company, and my client was billed $11,000. I negotiated the bill down and they only needed to pay $1,100 10%
- [Bee Sting Leads to Emergency Room Bill Not Covered by Insurance](https://adriagross.com/bee-sting-leads-to-emergency-room-bill-not-covered-by-insurance/) - You get stung by a bee and you have difficulty breathing. You got swelling of your throat or tongue, you got a rapid pulse, you are dizzy or fainting. Please go directly to the emergency room. I had a case recently where the emergency room wasn’t paid and the insurance company believed that the condition
- [How Health Insurance Claim Advocates Win Appeals](https://adriagross.com/how-health-insurance-claim-advocates-win-appeals/) - Even the most legitimate claims—routine checkups, necessary surgeries, pre-authorized procedures—can be rejected. This isn’t just inconvenient; it can delay care, create financial pressure, and leave patients footing bills they thought were covered.The Hidden Triggers Behind Denied or Underpaid ClaimsIncorrect or missing CPT/ICD codesLack of prior authorization despite provider verification“Experimental” treatment designations for approved proceduresOut-of-network care
- [Got a Bill from a Doctor You've Never Seen](https://adriagross.com/got-a-bill-from-a-doctor-youve-never-seen/) - Have you ever been hospitalized and received a bill for a doctor that you never saw? I recently overturned a case where the doctor was charging over $5,000, and believe it or not, that doctor never saw the patient. When looking at the medical records, we were able to prove that the doctor never performed
- [$9,400 Medical Bill Reduced to $200](https://adriagross.com/9400-medical-bill-reduced-to-200/) - Do you have a very high deductible and you cannot afford to pay your medical bills? I had a case recently for $9,400 and thank you. Was able to bring it down to 200. Please call Medwise. I’m here to help you. Thank you. Adria Gross Medical Billing Advocate See Full Bio Adria Gross
- [How a Health Insurance Billing Advocate Saves You Big](https://adriagross.com/how-a-health-insurance-billing-advocate-saves-you-big/) - These aren’t just assistants or support staff. A health insurance billing advocate is a trained expert who understands medical coding, insurance contract language, state laws, and appeals procedures. They serve as your liaison, investigator, and negotiator when billing goes sideways.Key Services Offered by Billing Advocates:Bill Auditing: They scrutinize every line of your itemized bills for
- [If Your Medical Bill Should Have Been Paid Here's What to Do](https://adriagross.com/if-your-medical-bill-should-have-been-paid-heres-what-to-do/) - Have you been denied on a medical bill which you should have been paid? I recently had a case for an emergency room where the insurer felt it wasn’t medically necessary to go to the emergency room. When we discussed the severity of the case and how my client was unable to go to an
- [Out of Network Bill Not Paid?](https://adriagross.com/out-of-network-bill-not-paid/) - You’re preparing dinner for your family and ouch. You just cut yourself so deep. You need stitches, you wind up in urgent care, and you later find out that they’re out of network, so you receive a bill for $8,000. My client called me when this happened to them, and guess what? They only had
- [Why You Need a Health Insurance Advocate Right Now](https://adriagross.com/why-you-need-a-health-insurance-advocate-right-now/) - It’s easy to confuse titles, but the roles are different—and so are their loyalties.Q: Is a health insurance advocate the same as a broker?A: No. A broker helps you select a plan, while an advocate helps you use the plan you already have.Q: What about a hospital case manager?A: They assist with discharge planning and
- [Frustration for Denied Insurance Claims Escalate](https://adriagross.com/frustration-for-denied-insurance-claims-escalate/) - Americans are crushed by skyrocketing premiums, crippling the medical debt and denial of care that really this devastates millions of lives. It should be no surprise that frustration has reached a boiling point, igniting a fierce, widespread demand for real systemic change. Ordinary people are clear that insurance companies don’t exist to protect their health,
- [Will COBRA Cover You Over Age 65?](https://adriagross.com/will-cobra-cover-you-over-age-65/) - So you’re over 65 years old and you’re working for an employer who has over 20 employees. Now you’re about to retire and you’re applying for Cobra. The question is, will Cobra cover you? Because you are now over the age of 65, please call me and let’s discuss the next steps you should take.
- [Health Advocate Bill Saver Can Slash Your Medical Bills](https://adriagross.com/health-advocate-bill-saver-can-slash-your-medical-bills/) - The health care billing system isn’t just confusing—it’s designed that way. Charges often vary based on your insurance plan, location, and provider contract rates, making it nearly impossible for patients to determine what’s fair.Common Billing Traps:Out-of-network charges from in-network visitsCPT coding errors that trigger denied claims or inflated chargesFacility fees added for services that could
- [Unexpected Medical Bills May Not be Real](https://adriagross.com/unexpected-medical-bills-may-not-be-real/) - Did you receive an unexpected bill in the mail after you thought all your claims were processed? Some medical providers are bought out by a new company and that new company might feel that you owed additional money. I had a case like this, uh, recently where my client’s claims were all taken care of, and
- [Emergency Room Charges of $9,500 Dropped to $1,800](https://adriagross.com/emergency-room-charges-of-9500-dropped-to-1800/) - I worked on a case recently where the maximum charges for the emergency room should have been no more than a thousand dollars.The hospital was paid 90 509,500 and they were still billing my client for an additional $1,800. When I reached out to the billing of the emergency room charges that were $1,800, believe it
- [How to Dispute Medical Bill Collections Like a Pro](https://adriagross.com/how-to-dispute-medical-bill-collections-like-a-pro/) - Most patients assume that if they paid their copay and their insurance handled the rest, the issue is resolved. Unfortunately, billing systems don’t always work that cleanly.Common Triggers That Lead to Medical Collections:Insurer Delays or Denials: A claim that takes too long—or is denied—can lead to the provider forwarding your bill to collections.Missing EOB (Explanation
- [Where You Charged for a Medical Bill You've Already Paid?](https://adriagross.com/where-you-charged-for-a-medical-bill-youve-already-paid/) - You know, I help people to make sure that once they have paid a claim, they never pay it again. Too often people are charged multiple times for one individual bill and they do not realize that they have already paid it. I recently worked with a client who didn’t realize they had paid out $8,000 for
- [Anesthesiolgist Bill Not Covered](https://adriagross.com/anesthesiolgist-bill-not-covered/) - Have you received the bill for anesthesiology after being covered for pregnancy and delivery? If they never informed you that the provider was out of network and now you’re being charged a tremendous bill, please reach out to MedWise because there’s a great chance that we will either get your bill reduced to a very small
- [Can You Sue a Medical Billing Company for Overcharges?](https://adriagross.com/can-you-sue-a-medical-billing-company-for-overcharges/) - Yes, but the complexity of these cases often requires legal expertise—especially if you’re seeking more than just a correction or refund.When Legal Counsel Is AdvisableThe billing error has caused serious financial damageYou’ve suffered credit score damage due to reportingYou’ve been harassed or misled by debt collectorsYour dispute has been ignored for more than 30 daysYou’ve
- [Navigating Healthcare Challenges: The Story of Adria Gross](https://adriagross.com/navigating-healthcare-challenges-the-story-of-adria-gross/) - In this episode, we hear the compelling story of Adria Gross, a nationally recognized medical insurance advocate and author, who has transformed her life challenges into advocacy for individuals struggling with medical insurance claims.
- [Navigating Healthcare Challenges: The Story of Adria Gross](https://adriagross.com/navigating-healthcare-challenges-the-story-of-adria-gross-2/) - In this episode, we hear the compelling story of Adria Gross, a nationally recognized medical insurance advocate and author, who has transformed her life challenges into advocacy for individuals struggling with medical insurance claims. Gross shares her personal battle with encephalitis, epilepsy, and the life-changing brain surgery that set her on a path to help
- [Air Ambulance Charges Not Covered](https://adriagross.com/air-ambulance-charges-not-covered/) - Have you recently received an air ambulance bill for thousands of dollars? All too often people receive air ambulance charges, which should be covered on their policy. I recently overturned an air ambulance bill for $75,000. The laws change in 2020 and they have no right to overbill you at all, please call me. I’m here to help you.
- [Your Explanation of Benefits](https://adriagross.com/your-explanation-of-benefits/) - Hello, my friends. Did this ever happen to you? You have been in a situation where your explanation of benefits indicates you have a zero balance, but the medical provider is still billing you for tens of thousands of dollars. I recently overturned a case where the explanation of benefits said my client owed zero,
- [New Jersey Medical Billing Advocates Expose Hidden Fees](https://adriagross.com/new-jersey-medical-billing-advocates-expose-hidden-fees/) - These professionals serve as your guide through the billing maze. They understand how health systems, insurers, and collection agencies work—and use that knowledge to protect your wallet.Core Functions of a Medical Billing Advocate:Audit Bills for Errors: Line-by-line review to identify overcharges, duplicate services, or incorrect codesChallenge Insurance Denials: File formal appeals with supporting documents to
- [Are You Really Responsible for Those Medical Bills?](https://adriagross.com/are-you-really-responsible-for-those-medical-bills/) - Have you received multiple bills being in a hospital? Are you questioning whether or not you are really responsible to pay these bills? Very often people receive their explanation of benefits and feel that they have to pay for additional services. I had a client recently who looked at their explanation of benefits for $6,000. Guess what? They
- [Have You Ever Challenged Your Denied Claim](https://adriagross.com/have-you-ever-challenged-your-denied-claim/) - Have you ever challenged your denied claim? Reach out to Medwise and we will negotiate fair payment plans. Many times you might think that you’re responsible to pay this bill, but all too often I look at the charges and determine that they should be covered on your policy.Recently I had a case where the client was
- [New York Medical Billing Advocates Can Slash Your Bill](https://adriagross.com/new-york-medical-billing-advocates-can-slash-your-bill/) - If you’ve been hit with an unexpected hospital bill, denied a claim without explanation, or charged for services you never received, you’re not alone. New York medical billing advocates are helping thousands of patients challenge unjust charges, recover thousands of dollars, and restore peace of mind—without needing to navigate the system alone.In a city where
- [Reducing Your Medical Bills](https://adriagross.com/reducing-your-medical-bills/) - This interview focuses on ways to reduce medical bills, as discussed in Adria Gross’s book. Edison Guzman introduces the topic, emphasizing its relevance given the new administration and potential changes in healthcare policies. Adria Gross, as an expert in medical insurance advocacy, shares her insights on various strategies to lower medical expenses. Medical Billing Advocacy
- [Who’s Processing Your Medical Bills?](https://adriagross.com/whos-processing-your-medical-bills/) - In a conversation between Edison Guzman and Adria Gross of MedWise Insurance Advocacy, they discuss the significant impact of who processes medical bills. Adria highlights that when third-party billing companies handle claims, especially those paid on a percentage basis (a common practice outside of states like New York), it becomes exceedingly difficult for patients to
- [Who's Processing Your Medical Bills?](https://adriagross.com/whos-processing-your-medical-bills-2/) - In a conversation between Edison Guzman and Adria Gross of MedWise Insurance Advocacy, they discuss the significant impact of who processes medical bills. Adria highlights that when third-party billing companies handle claims, especially those paid on a percentage basis (a common practice outside of states like New York), it becomes exceedingly difficult for patients to
- [Is Balanced Billing Legal?](https://adriagross.com/is-balanced-billing-legal/) - Have you ever been balance billed? That is illegal. If you have met your deductibles for the year, I recently overturned a case where my client was being balance billed for $16,000. Please call me if you have any suspicion that they’re charging you too much. I’m here to help you. Thank you. Adria Gross Medical Billing
- [What if the Emergency Room Provider Is Out of Network?](https://adriagross.com/what-if-the-emergency-room-provider-is-out-of-network/) - Have you recently received a bill from an emergency room group of providers because they were out of network a week ago? I received a claim for over $26,000 because the providers in the emergency room were out of network. If this happens to you, please reach out to me.I reduce that bill from $26,000
- [Can You Negotiate Health Care Bills? 7 Tricks That Work](https://adriagross.com/can-you-negotiate-health-care-bills-7-tricks-that-work/) - You can negotiate before receiving care, immediately after the bill arrives, or after insurance pays their portion.Q: Can you negotiate a hospital bill even if you have insurance?A: Yes. Especially if your deductible is high or a portion was denied. You can dispute non-covered charges or request a self-pay discount on the remaining balance.Q: What
- [Do You Know Your Medical Policy's Benefits?](https://adriagross.com/do-you-know-your-medical-policys-benefits/) - Very often people do not realize what the benefits are on their policies. The policy might cover you for other services besides just the bill for a specific procedure code. Please reach out to Med Midwife, so look at your entire policy and explanation of benefits. Many cases where the claims are partially paid and
- [MedWise Resolves Medical Claims Bills for You](https://adriagross.com/medwise-resolves-medical-claims-bills-for-you/) - Medwise continuously resolves medical bill disputes. Very often when the insurance company looks at the bill, it’s immediately denied. Medwise examines the charges, and most of the cases that Medwise handles are resolved, saving my clients thousands of dollars. Please remember me, Medwise, I’m here to help you.Thank you. Adria Gross Medical Billing Advocate See Full
- [Why the Best Medical Bill Advocate Saves You Thousands](https://adriagross.com/why-the-best-medical-bill-advocate-saves-you-thousands/) - If you’ve been overwhelmed by confusing charges, unexpected fees, or denied claims, you’re not alone. The best medical bill advocate can help you reclaim control, cut through billing chaos, and potentially save you thousands of dollars on services you didn’t even realize you were overpaying for.For those navigating complicated hospital invoices or disputing denied insurance
- [Don't be Afraid to Ask Your Medical Provider a Question](https://adriagross.com/dont-be-afraid-to-ask-your-medical-provider-a-question/) - You know, all too often seniors are frightened to ask questions to their medical providers before every visit. It’s best that you think about the questions you plan on asking your medical provider. Patients need to be educated about their legal rights. If something doesn’t seem right, and especially if you feel that you’re being
- [Are You Still Covered for Your Doctor?](https://adriagross.com/are-you-still-covered-for-your-doctor/) - You know, all clients need to be educated on the doctors, hospitals and treatment that they are covered for. So often you might see a list of doctors and hospitals, which are no longer covered on your policy. One of my recent clients was in an emergency room and the pathologist was charging my client
- [What Advocates for Insurance Benefits Know That You Don’t](https://adriagross.com/what-advocates-for-insurance-benefits-know-that-you-dont/) - Insurance policies are marketed as safety nets—but they’re built on a foundation of legal language, policy exclusions, and fine print that most consumers simply don’t understand. When illness strikes or treatment becomes necessary, many are shocked to find their claims denied, partially paid, or lost in red tape.What Happens When You Go It Alone?Most policyholders
- [CT Scan Bill Reduced from $18,000 to $400](https://adriagross.com/ct-scan-bill-reduced-from-18000-to-400/) - My friends too often when people come to me as they’re realizing that they had been charged $18,000 for a CT scan. When looking at your charges, very often they’re erroneous and you are being gouged on your bill. I recently saved my client tons of money by reducing his CT scan bill of $18,000 down to
- [Are You Sure Your Medical Bill is Accurate?](https://adriagross.com/are-you-sure-your-medical-bill-is-accurate/) - Are you sure your bill is accurate? Much too often people are double and triple billed for services. Some of the services are very often not even supposed to be charged. Reach out to MEDWISE for accuracy on your bills. Midwives saves tons of money for people on their medical charges. I recently had a case where one procedure code
- [Advocate Health Care Billing Secrets Every Patient Should Know](https://adriagross.com/advocate-health-care-billing-secrets-every-patient-should-know/) - Behind every medical invoice is a complex system few understand—one designed more for compliance and profitability than patient clarity. At the center of it: automated billing codes, contracted rates, and insurance loopholes that often result in charges being passed on to unsuspecting patients.How the System Works (And Why It Doesn’t Work for You)Advocate Health Care,
- [Where You Charged for Your Annual Wellness Care Bill?](https://adriagross.com/where-you-charged-for-your-annual-wellness-care-bill/) - You know, all too often people call me up with a procedure that they never expected to pay. On our policies, we have WellCare visits, which are usually handled annually. People come to me where they’re being charged for services they should not have been billed at all. All too often, I overturn those cases
- [Can Support Groups Help With Your Medical Condition?](https://adriagross.com/can-support-groups-help-with-your-medical-condition/) - You know, sometimes people are so emotional about their condition. I often try to find them support groups and other social support to enable my clients to receive help with their physical and emotional conditions. You might even be interested in my latest book that came out, Apparently Different. These are the type of stories
- [How to Appeal a Medical Claim Denial](https://adriagross.com/how-to-appeal-a-medical-claim-denial/) - I work daily with people facing one of the most frustrating aspects of healthcare: the dreaded insurance denial. Receiving a letter stating your medical claim won’t be paid can induce panic, anger, and confusion. You followed the rules, you saw the doctor, maybe you even got pre-approval – yet here you are, potentially facing a
- [Traumatic Brain Injury Medical Bills](https://adriagross.com/traumatic-brain-injury-medical-bills/) - You incur a traumatic brain injury and wind up in a subacute care facility. Now you are no longer making sufficient progress, which I’m really sorry when that happens, and your insurer decides to no longer cover you. I recently had a case where I was able to help the person with their health insurance
- [What to do if Your Surgeon is Not Covered by Insurance](https://adriagross.com/what-to-do-if-your-surgeon-is-not-covered-by-insurance/) - Well, you’re about to have surgery. Everything is scheduled for you in advance. Your insurance company has already approved you, but now at the last minute, you’re being contacted by the surgeon’s office explaining your insurance carrier will not cover you for the surgery. I recently had a case like this and with my advice
- [How CPT Code Errors Can Lead to Medical Claim Denials](https://adriagross.com/how-cpt-code-errors-can-lead-to-medical-claim-denials/) - If you’ve ever looked closely at a medical bill or an Explanation of Benefits (EOB), you’ve likely seen lines filled with five-digit numbers. These aren’t random sequences; they are crucial codes that dictate how, and if, healthcare services get paid. Specifically, many of these are CPT codes, and errors involving them are a significant, yet
- [What If Your Insurer Ask for Their Money Back](https://adriagross.com/what-if-your-insurer-ask-for-their-money-back/) - Many people are reaching out to me when everything was scheduled for their surgery, and they undergo the procedure. Six to 12 months later go by, and now the insurer is asking for the money back. There are a lot of different reasons why this is occurring. If this happens to you, please call me.I’m
- [What You Need to Know About Insurance Before Turning 65](https://adriagross.com/what-you-need-to-know-about-insurance-before-turning-65/) - I’ve had many cases in the past five years involving people working after the age of 65. If your employer has less than 20 employees, when you turn 65, there’s a good chance you’re going to have to go directly onto Medicare, part A and part B. I always recommend people to contact Medicare three
- [Insurance Claim Denied? Don't Give Up! Steps to Get Denied Medical Claims Paid](https://adriagross.com/insurance-claim-denied-dont-give-up-steps-to-get-denied-medical-claims-paid/) - For years, I’ve helped clients navigate the complex world of health insurance. One of the most disheartening moments for any patient is receiving that notice: “Your claim has been denied.” It can feel like a final judgment, leaving you facing unexpected and often significant medical bills.But here’s something I emphasize constantly, based on years of
- [Decoding Your Hospital Bill - Understanding CPT Codes, EOBs, and Overcharges](https://adriagross.com/decoding-your-hospital-bill-understanding-cpt-codes-eobs-and-overcharges/) - Feeling lost or outraged when you look at a hospital bill? You’re not alone, and help is here! Watch this crucial interview with Edison Guzman and insurance advocate Adria Gross to uncover the secrets hospitals might not want you to know. Learn exactly what to demand on your bill (using specific codes!) to verify every
- [Heart Surgery Recommendation Was Not Necessary](https://adriagross.com/heart-surgery-recommendation-was-not-necessary/) - One of my clients was told he had to have heart surgery. He went through multiple tests and when he went back to the cardiologist, he was recommended multiple times to have heart surgery. It was very confusing since he was able to walk more than three miles a day and never was out of
- [Struggling with Medical Bills? You Have Options](https://adriagross.com/struggling-with-medical-bills-you-have-options/) - As the founder of Medwise Insurance Advocacy, I’ve spent years helping countless individuals navigate the often-turbulent waters of healthcare costs. One of the most common and stressful situations people face is figuring out how to pay medical bills, especially unexpected or large ones. The sticker shock from a hospital stay or complex procedure can be
- [Do This to Know What's Covered in Your Policy](https://adriagross.com/do-this-to-know-whats-covered-in-your-policy/) - Insurance companies very often give you a brochure or it’s like a six to 10 page, so-called policy, which describes what’s covered and what’s not covered on the policy. On that six to 10 page, so-called policy, there will be a list of coverages and exclusions. It’s so important to look at the entire insurance
- [Need a Second Opinion for Orthopedic Surgeon?](https://adriagross.com/need-a-second-opinion-for-orthopedic-surgeon/) - Years ago I had a baker cyst on my right knee. I went to an orthopedic doctor who drained my knee three times. The fluid kept on coming back. He recommended that I see an orthopedic surgeon. They were about to do surgery and I met up with a doctor friend of mine who is
- [Overwhelmed by Medical Bills? You're Not Alone](https://adriagross.com/overwhelmed-by-medical-bills-youre-not-alone/) - For years, through Medwise Insurance Advocacy, I’ve dedicated my career to helping patients navigate the often confusing and overwhelming world of medical bills and health insurance. If you’ve ever opened a medical bill and felt your heart sink, confused by codes, charges, and jargon you don’t understand, please know: you are certainly not alone. The
- [$52,000 Overturned After 3 Times Denied Medical Claim](https://adriagross.com/52000-overturned-after-3-times-denied-medical-claim/) - I have to tell you many times I have people come to me where they know that their medical bill should be covered. According to the health insurance policy, very often the policy indicates that you should be covered for a certain procedure, but the insurance companies deliberately deny your claim. I was educated on
- [Knowing Your Patients Rights Saves Over $34,000](https://adriagross.com/knowing-your-patients-rights-saves-over-34000/) - Being a patient advocate, I’m always concerned about patient’s rights and protect them from unfair billing practices. If I see a case where there are issues with medical billing, I always step in to help my clients. I recently overturned a case where my client was being charged an excessive amount by an emergency room,
- [How Medical Claim Laws Will Affect You in the Future](https://adriagross.com/how-medical-claim-laws-will-affect-you-in-the-future/) - The healthcare landscape is constantly evolving, and with it, the laws governing medical claims. As a patient, it’s essential to stay informed about these changes to ensure you receive the care and coverage you deserve. Medwise Insurance Advocacy is here to help you navigate the complexities of medical claim laws and understand how they may
- [How I Reduced a Medical Bill from $40,000 to $2,000](https://adriagross.com/how-i-reduced-a-medical-bill-from-40000-to-2000/) - You know, being in the health insurance industry for over 30 years, I am quite successful in negotiating medical bills. In many cases, I normally get 80% off the bill, and sometimes you might be responsible for no charges whatsoever. I recently reduced a bill from $40,000 down to $2,000. Please reach out to me.
- [Why You Need to Read Your Insurance Policy](https://adriagross.com/why-you-need-to-read-your-insurance-policy/) - You know, it’s so important that you take the time to read your insurance policy. When I was working for two insurance companies, I helped write those insurance policies. You truly need to know what’s covered and what’s not covered. If you ever have any questions and have no idea what your policy really means,
- [Getting Medically Covered When Traveling Outside of the Country](https://adriagross.com/getting-medically-covered-when-traveling-outside-of-the-country/) - Traveling outside of the country can be a great way to experience new cultures and see new places. However, it is important to be aware of the potential risks associated with traveling abroad, including the risk of medical emergencies.If you are planning a trip outside of the country, it is important to make sure you
- [What to do If Emergency Room is Out of Network](https://adriagross.com/what-to-do-if-emergency-room-is-out-of-network-2/) - You know I recently spoke to a friend who works for a major corporation on her policy. Every emergency room visit is considered to be out of network. Instead of going to an emergency room, the insured’s must go to an urgent care facility. She went to the local urgent care facility and then was
- [What to do If Emergency Room is Out of Network](https://adriagross.com/what-to-do-if-emergency-room-is-out-of-network/) - I recently spoke to a friend who works for a major corporation on her policy every emergency room visit is considered to be out of network instead of going to an emergency room the insurance must go to an urgent care facility and then was sent to the emergency room when I was able to
- [How to Get Your Medical Bills Paid After a Denial of Benefits](https://adriagross.com/how-to-get-your-medical-bills-paid-after-a-denial-of-benefits/) - Receiving a denial of benefits for your medical bills can be a frustrating and confusing experience. However, it is important to remember that you have rights as a patient, and there are steps you can take to get your bills paid.Understanding the Denial Process Before you can take action, it is important to understand why
- [$29,000 for Two Emergency Room Visits?](https://adriagross.com/29000-for-two-emergency-room-visits/) - A recent case I worked on the client was charged for two of emergency room visits a total of 29,000 when I looked at the reasonable customer charges I realize that my client only had to pay $800 out of $29,000 medical practice are gouging much too often and I am here to help you
- [How $50,000 in Medical Debt Went Down to $0](https://adriagross.com/how-50000-in-medical-debt-went-down-to-0/) - One of my clients have denied claim with the original charges were over $50,000 when I was able to prove that those charges should be covered according to the wording of the health insurance policy my client wound up always zero out of $50,000 any questions you have please call me I’m here to help
- [Why You Need a Medical Billing Advocate When Insurance Says "No"](https://adriagross.com/why-you-need-a-medical-billing-advocate-when-insurance-says-no/) - Navigating the labyrinth of medical billing can feel like deciphering an alien language. One minute you’re recovering from a procedure, the next you’re staring at a denial letter from your insurance company, leaving you bewildered and, frankly, terrified. At MedWise Insurance Advocacy, we understand the frustration and confusion that comes with denied medical claims. That’s
- [What's the Best Type of Drug Plan for You and Your Family?](https://adriagross.com/whats-the-best-type-of-drug-plan-for-you-and-your-family/) - In today’s world, understanding your health insurance can feel like deciphering a complex code. When it comes to drug plans, the confusion only deepens. That’s why we sat down with Adria Guzman of Math Wise Insurance Advocacy to shed some light on this crucial topic. Adria’s expertise in navigating the intricacies of medical insurance is
- [Medical Bill Issues](https://adriagross.com/medical-bill-issues/) - Hello everyone. Hydrocephalus is water on the brain, and many times it occurs as a result of an injury. If you’re having issues with your medical charges or coverage for medication, please reach out to Medwise. We are here to help you with all of your medical bills. Thank you so much. Adria Gross Medical Billing Advocate
- [The Power of Price Transparency - Taking Control of Your Healthcare Costs](https://adriagross.com/the-power-of-price-transparency-taking-control-of-your-healthcare-costs/) - Healthcare costs can be unpredictable and often feel opaque. You might know you need a procedure, but have no idea what it will actually cost until you receive a surprise bill weeks later. This lack of price transparency has left many patients feeling helpless. However, the landscape is changing. Increased awareness and new regulations are
- [Pre-Authorization Surgery Not Covered](https://adriagross.com/pre-authorization-surgery-not-covered/) - You have pre-authorization for a surgery. It just so happens that the doctor has an emergency and is not able to perform the surgery as scheduled. You go back to the hospital 10 days later, and the surgery is performed. However, because the surgery was not performed on the original scheduled date, the insurance company
- [Can Your State Buy Out Your Medical Bills](https://adriagross.com/can-your-state-buy-out-your-medical-bills/) - The state of Rhode Island is suggesting using federal COVID-19 funds to pay off unpaid outstanding medical bills. Under the proposal, the state could purchase the debt for pennies on the dollar using American Rescue Plan Act funds and then eliminate the debt entirely for certain Rhode Island residents. New York City has also been
- [Using a Health Savings Account (HSA) or Flexible Spending Account (FSA)](https://adriagross.com/using-a-health-savings-account-hsa-or-flexible-spending-account-fsa/) - Healthcare expenses can be a significant burden, but there are tools available to help you manage these costs effectively. Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) are tax-advantaged savings accounts that allow you to set aside money for qualified medical expenses. At Medwise Insurance Advocacy, we understand the importance of maximizing your healthcare
- [Whats a Zebra in Medical Terms?](https://adriagross.com/whats-a-zebra-in-medical-terms/) - One of the chapters in my book, Apparently Different, involves a doctor who, after years of twisting his neck while performing colonoscopies—looking at the patient, then the machine—wound up with a severe condition called Barrett’s esophagus. It took quite a long time to determine his condition. This condition is considered a “zebra,” a medical term
- [Does Your Health Care Bill Hurt Your Credit?](https://adriagross.com/does-your-health-care-bill-hurt-your-credit/) - Healthcare bills won’t harm your credit as long as you don’t wait too long to settle them. Most of the time, you’re dealing directly with the medical provider, and they aren’t likely to report your payment activity—or lack thereof—to the credit bureaus. This means that while you owe the provider, your credit report will not
- [Negotiating Medical Bills: Tips and Tricks for Lowering Your Healthcare Costs](https://adriagross.com/negotiating-medical-bills-tips-and-tricks-for-lowering-your-healthcare-costs/) - Medical bills can be a significant source of stress, especially when they seem unexpectedly high or contain errors. At Medwise Insurance Advocacy, we empower you to take control of your healthcare finances. Negotiating medical bills is often possible, and this blog post will provide valuable tips and tricks to help you lower your out-of-pocket expenses.Why
- [$85,000 Childbirth Bill Reduced to $5,000](https://adriagross.com/85000-childbirth-bill-reduced-to-5000/) - A recent client of mine gave birth to her child, which initially cost her $85,000. This was a premature baby, and the hospitals and doctors were taking advantage of her situation. The family was paying $25 a month, and when I was able to prove that she would never be able to pay that $85,000,
- [Lyme Disease Medical Bill Reimbursement Help](https://adriagross.com/lime-disease-medical-bill-reimbursement-help/) - If you haven’t heard yet, Apparently Different is my new book that came out recently. I have a client in the book who wound up with a debilitating life due to Lyme disease. I helped this client in receiving reimbursement for her medical bills. If you need help with denied claims, please call me, Adria. I’m
- [What to Do When Your Insurance Denies a Claim](https://adriagross.com/what-to-do-when-your-insurance-denies-a-claim/) - Receiving a claim denial from your health insurance company can be frustrating and confusing. It can feel like a roadblock in accessing necessary medical care. At Medwise Insurance Advocacy, we understand the stress and uncertainty that come with claim denials. This blog post will provide a step-by-step guide on what to do when your insurance
- [Reducing Your Medical Bills](https://adriagross.com/reducing-your-medical-bills-2/) - This interview focuses on ways to reduce medical bills, as discussed in Adria Gross’s book. Edison Guzman introduces the topic, emphasizing its relevance given the new administration and potential changes in healthcare policies. Adria Gross, as an expert in medical insurance advocacy, shares her insights on various strategies to lower medical expenses. Medical Billing Advocacy
- [$10,000 Emergency Room Just for Medicine](https://adriagross.com/10000-emergency-room-just-for-medicine/) - I don’t know if this has ever happened to you, but have you ever received a bill from an emergency room for over $10,000, and all they did in that emergency room was give you medication? I’ve had many cases like this, and in this particular case, I was able to get a major reduction
- [Emergency Room 3 Day Visit Denies $27,000 Bill](https://adriagross.com/emergency-room-3-day-visit-denies-27000-bill/) - It was the middle of the night, and a patient goes to an emergency room in excruciating pain. The ER could not diagnose the condition. My client was kept in the hospital for three days, and the insurance company said there was no need for her to be at the hospital. Even though she went
- [Understanding Deductibles, Co-pays, and Coinsurance](https://adriagross.com/understanding-deductibles-co-pays-and-coinsurance/) - Navigating the world of health insurance can feel like deciphering a foreign language. Terms like “deductible,” “co-pay,” and “coinsurance” are frequently used, but their meanings are often misunderstood. At Medwise Insurance Advocacy, we believe that understanding these key concepts is crucial for managing your healthcare expenses effectively. This blog post will break down these terms
- [Explanation of Benefits Letter Denies Your Claim](https://adriagross.com/explanation-of-benefits-letter-denies-your-claim/) - You are treated and preauthorized for a medical procedure. You go to the hospital where the procedure will take place. They perform the procedure, but then you receive an explanation of benefits from the insurance company stating that the procedure was not medically necessary. I recently overturned a case where the bill was $28,000, and the
- [Denied Medical Claim Because of Non-Preauthorization](https://adriagross.com/denied-medical-claim-because-of-non-preauthorization/) - Have you ever been in a situation where you were never informed that a pre-authorization was required? Well, this claim was denied because my client did not have pre-authorization. If this happens to you, please reach out to Medwise. I recently overturned a case that was over $60,000. Please call me, Adria at Medwise Insurance
- [Common Medical Billing Errors to Watch Out For](https://adriagross.com/common-medical-billing-errors-to-watch-out-for/) - Medical billing can be a minefield of codes, jargon, and potential errors. At Medwise Insurance Advocacy, we understand how frustrating and overwhelming it can be to decipher medical bills and ensure their accuracy. This blog post will highlight some of the most common medical billing errors to watch out for, empowering you to take control
- [Twisted Intestine $150,000 Bill Reduced to $10,000](https://adriagross.com/twisted-intestine-150000-bill-reduced-to-10000/) - You know, it took quite a bit of time, but my client who had a twisted intestine with a medical debt of over $150,000—I was finally able to prove that there was no way my client could afford to pay that amount. Thank goodness, I brought her bill down to $10,000. She took a loan
- [Emergency Room for $8,000 Turns to Zero](https://adriagross.com/emergency-room-for-8000-turns-to-zero/) - My client in California went to the emergency room and received a bill for over $5,000. But believe it or not, every month she received a bill that added additional charges of over a thousand dollars a month. Her policy was Medicaid, and when I was able to prove that she could not afford the
- [Navigating In-Network vs. Out-of-Network Costs](https://adriagross.com/navigating-in-network-vs-out-of-network-costs/) - Healthcare costs can be confusing, especially when it comes to understanding the difference between in-network and out-of-network providers. At Medwise Insurance Advocacy, we’re dedicated to helping you navigate these complexities and make informed decisions about your healthcare. This blog post will explain the distinctions between in-network and out-of-network costs, empowering you to minimize your out-of-pocket
- [Out of Network Hospital Bills Denied](https://adriagross.com/out-of-network-hospital-bills-denied/) - You vomit and have diarrhea. You go to the emergency room, and the hospital does all these medical tests on you. You were in the hospital for three days only being treated, and now the hospital is saying to you that they were out of network. Wow. I was able to overturn the case and save
- [$60,000 Breast Cancer Bills Down to $2,100](https://adriagross.com/60000-breast-cancer-bills-down-to-2100/) - I recently had a case where my client had breast cancer, and her bills were over $60,000. Her oncologist was fighting, not accepting a lower amount. When I was able to prove that there was no way she would be able to afford to pay this bill, we went from $60,000 to $2,100. So if you
- [Decoding Your EOB (Explanation of Benefits)](https://adriagross.com/decoding-your-eob-explanation-of-benefits/) - At Medwise Insurance Advocacy, we understand that navigating the world of medical bills and insurance can be overwhelming. One of the most confusing, yet essential, documents you’ll encounter is the Explanation of Benefits (EOB). It’s not a bill itself, but rather a breakdown of how your insurance company processed a claim. Think of it as
- [Over $2500 Medical Debt Reduced to Zero Within 3 Weeks](https://adriagross.com/over-2500-medical-debt-reduced-to-zero-within-3-weeks/) - Hello, my friends. You know, my client had a debt of over $2,500. She didn’t know where to turn. When she came to me, I was able to determine that the $2,500 should never have been charged. So within three weeks, I brought her bills down to zero. Please call me if you need help. Adria, Medwise
- [Why Medical Insurance Companies Deny Claims](https://adriagross.com/why-medical-insurance-companies-deny-claims/) - In this insightful interview, Edison Guzman speaks with Adria Gross, founder of Medwise Insurance Advocacy, about the challenges and solutions surrounding denied medical claims. Adria shares her expertise as a former insurance claims processor who now helps individuals fight back against unjust claim denials.The discussion begins with common reasons for claim denials, including procedural errors, preexisting
- [New Book Apparently Different Released](https://adriagross.com/new-book-apparently-different-released/) - For those of you who don’t know, I recently published a new book titled Apparently Different. My new book, Apparently Different, is available on Amazon. Just go to amazon.com, type in Apparently Different, and you can read the description. If you’re interested, you can purchase it there. Everybody knows someone with a disability who has
- [Overcoming Medical Insurance Denial](https://adriagross.com/overcoming-medical-insurance-denial/) - If you’ve ever received a medical insurance denial, you know the frustration, confusion, and stress it can bring. A denied insurance claim, especially for essential medical care, can disrupt not only your financial stability but also your peace of mind. At Medwise Insurance Advocacy, we have dedicated over 25 years to helping individuals and families
- [$400,000 Cancer Bills Reduced to $19,000](https://adriagross.com/400000-cancer-bills-reduced-to-19000/) - I recently had a client with bills over $400,000 involving cancer. I was so excited to be able to reduce that bill down to $19,000, which is being paid over a three-year period. If you ever need help, please call me, Adrian at Medwise Insurance Advocacy. Thank you. Adria Gross Medical Billing Advocate See Full Bio Adria
- [$135,000 Medical Bill Was Finally Settled Down to $20,000](https://adriagross.com/135000-medical-bill-was-finally-settled-down-to-20000/) - One of my clients recently had a bill for $135,000. This was a faith-based coverage, which, of course, is not handled through an insurance company. It was a long, drawn-out fight to get this settled, but thankfully, the hospital agreed to $20,000, and my client was able to get funding from his family to pay
- [Navigating Insurance Claims with Confidence](https://adriagross.com/navigating-insurance-claims-with-confidence/) - If you’ve ever faced a challenging insurance claim, you know how complex and overwhelming the process can be. From confusing jargon to lengthy paperwork and frustrating denials, dealing with insurance claims can quickly become a full-time job. That’s where an insurance claim advocate comes in—a trained professional with expertise in navigating the claims process, ensuring
- [Water Skiing Accident Turns Into Denied Medical Charges](https://adriagross.com/water-skiing-accident-turns-into-denied-medical-charges/) - One of the chapters in my book, Apparently Different, is titled A Prisoner in My Own Body from Traumatic Brain Injury. My client was water skiing at the age of 16 and wound up injuring themselves, becoming, I hate to say this, partially paralyzed, and believe it or not, they even went into a coma. I hope
- [Medical Bills for Rape Were Written Off Because of This](https://adriagross.com/medical-bills-for-rape-were-written-off-because-of-this/) - I have to say this is one of the worst stories I ever heard. My client was raped, and the bills were over $82,000. The case went to court, and finally, the judge she went before felt so sorry for her. They were able to arrange for the bill to be written off, and it
- [Understanding Insurance Denials](https://adriagross.com/understanding-insurance-denials/) - 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
- [Surgery for Large Intestine Medical Bill Denied Was Approved After This](https://adriagross.com/surgery-for-large-intestine-medical-bill-denied-was-approved-after-this/) - I had a client who had a very serious infection in her large intestines. The surgery was performed, which her insurance company said wasn’t medically necessary. The bills were over $60,000, and when I was able to prove that it was medically necessary and what could happen to my client if the procedure was never
- [Need Help With Surgery Bills Watch this](https://adriagross.com/need-help-with-surgery-bills-watch-this/) - Have you ever heard of spina bifida? It’s a birth defect in which a developing baby’s spinal cord fails to develop properly. It occurs when a developing baby’s spinal cord fails to develop or close properly while it’s in the womb. There is no cure for spina bifida, but there are treatments for related conditions. Spina
- [Why Consult a Health Insurance Advocate?](https://adriagross.com/why-consult-a-health-insurance-advocate/) - Even with comprehensive coverage, many individuals find themselves facing significant out-of-pocket expenses. This is where a health insurance advocate becomes invaluable, guiding patients through the intricate healthcare system and ensuring they receive the benefits they’re entitled to. Understanding the Role of a Health Insurance Advocate A health insurance advocate is a professional dedicated to assisting
- [Tips for Reversing Health Insurance Claims Denials](https://adriagross.com/tips-for-reversing-health-insurance-claims-denials-2/) - By Heather Sullivan – Published December 9, 2024 10:27am CST – Sullivan’s Smart Sense FOX 26 Houston The murder of UnitedHealthcare CEO Brian Thompson, and the suspicion that it may have been over insurance claim denials, is shining a new spotlight on the issue. There’s no way to know what percentage of health insurance claims are denied, as carriers are not required
- [Tips for Reversing Health Insurance Claims Denials](https://adriagross.com/tips-for-reversing-health-insurance-claims-denials/) - By Heather Sullivan – Published December 9, 2024 10:27am CST – Sullivan’s Smart Sense FOX 26 Houston The murder of UnitedHealthcare CEO Brian Thompson, and the suspicion that it may have been over insurance claim denials, is shining a new spotlight on the issue. There’s no way to know what percentage of health insurance claims are denied, as carriers are not required
- [Car Accident Medical Claims Not Paid](https://adriagross.com/car-accident-medical-claims-not-paid/) - You know, you ride a bike, and please God, may this never happen to you—have a very bad car accident. So due to that accident, this is what I’ve seen happening: You lose your job. You do not have any health insurance. If this ever happens to you, please reach out to Medwise, and I am sure
- [Mental Health Facility Coverage Denied](https://adriagross.com/mental-health-facility-coverage-denied/) - You know, I have seen so many denials for mental health. Very often, someone is unable to receive 24-hour facility coverage, and sometimes even when it comes to outpatient therapy, some insurance companies refuse to cover the services. If you are in that position, please call me, and let’s try to get those claims paid. I’ll
- [The Role of a Healthcare Advocate is to Reduce or Eliminate Medical Bills](https://adriagross.com/the-role-of-a-healthcare-advocate-is-to-reduce-or-eliminate-medical-bills/) - A healthcare advocate serves as a vital ally, guiding patients through medical processes, ensuring their rights are upheld, and facilitating effective communication between patients and healthcare providers. Understanding the Role of a Healthcare Advocate A healthcare advocate is a professional dedicated to assisting patients in various aspects of their healthcare journey. Their responsibilities include: Educating
- [140 Mile and Hour Car Crash Turns into Thousands in Denied Medical Bills](https://adriagross.com/140-mile-and-hour-car-crash-turns-into-thousands-in-denied-medical-bills/) - You know, I’ll tell you, chapter 12 in my book, Apparently Different, speaks about an individual who was in a 140-mile-per-hour car crash. He was going 140 miles an hour. And let me just tell you, I hope that you always try to be a good driver and never drink or use drugs while driving.
- [Congenital Defect Bills Not Being Paid](https://adriagross.com/congenital-defect-bills-not-being-paid/) - I was introduced many years ago by an attorney to someone who’s in my book, Apparently Different. She was an attorney who wound up having epilepsy. I myself, due to an insect bite, lived with epilepsy for almost 25 years. But luckily, thank you Lord, I had a left temporal lobectomy and was then taught how to
- [Why An Insurance Claims Advocate Serves as a Crucial Ally](https://adriagross.com/why-an-insurance-claims-advocate-serves-as-a-crucial-ally/) - An insurance claims advocate serves as a crucial ally, guiding policyholders through the claims process, ensuring fair treatment, and maximizing entitled benefits. Understanding the Role of an Insurance Claims Advocate An insurance claims advocate is a professional dedicated to assisting policyholders in managing and resolving insurance claims. Their responsibilities include: Claims Management: Overseeing the entire
- [Epilepsy Patient Taught to Deny Medical Claims](https://adriagross.com/epilepsy-patient-taught-do-deny-medical-claims/) - I was introduced many years ago by an attorney to someone who’s in my book, Apparently Different. She was an attorney who wound up having epilepsy. I myself, due to an insect bite, lived with epilepsy for almost 25 years. But luckily, thank you Lord, I had a left temporal lobectomy and was then taught how to
- [Major Brain Damage Medical Bills Denied](https://adriagross.com/major-brain-damage-medical-bills-denied/) - You know, insufficient oxygen can cause major brain damage. Someone in my book, Apparently Different, experienced that issue, which caused this person to have cerebral palsy. Please think about Medwise if you’re having problems with any of your medical bills or you’re looking for doctors. I’m here to help you, and hopefully, this will not happen to
- [Can a Medical Billing Advocate Help With Bills?](https://adriagross.com/can-a-medical-billing-advocate-help-with-bills/) - A medical billing advocate serves as a crucial ally, assisting patients in understanding and managing their medical expenses, ensuring accuracy, and advocating for fair treatment within the healthcare system. Understanding the Role of a Medical Billing Advocate A medical billing advocate is a professional dedicated to assisting patients with various aspects of medical billing and
- [Is Artificial Intelligence Denying Your Medical Bills](https://adriagross.com/is-artificial-intelligence-denying-your-medical-bills/) - I recently spoke on a major topic involving AI, artificial intelligence, which almost immediately denies medical bills. It is truly awful that insurance companies decide whether or not they want to pay a bill according to your diagnosis. Too many times people wind up in a hospital, are admitted, and then claims are denied. If this ever happens
- [Over $200000 in Fraudulent Medical Bills Waived](https://adriagross.com/over-200000-in-fraudulent-medical-bills-waived/) - Hi, my friends. You know, I couldn’t believe this case. My client owed over $200,000 when I was able to prove all of this fraud billing from the hospital. I discussed it with the hospital, and they finally backed off and gave my client a zero balance. Please, if you have any problems with your bills, call me. I’m
- [Do You Know the Role of a Patient Advocate?](https://adriagross.com/do-you-know-the-role-of-a-patient-advocate/) - A patient advocate serves as a crucial ally, guiding individuals through the healthcare system, ensuring their rights are upheld, and facilitating effective communication between patients and healthcare providers. Understanding the Role of a Patient Advocate A patient advocate is a professional dedicated to assisting patients in various aspects of their healthcare journey. Their responsibilities include:
- [Prepaid Medical Procedure Reduced by 50%](https://adriagross.com/prepaid-medical-procedure-reduced-by-50/) - You prepaid your medical procedure for $7,700 for that same procedure. You get a bill in the mail only for $15,000. I hear about these cases so many times and luckily when I have proof of payments, I will make sure that you do not owe them any more money. On that one case, I
- [Colonoscopy Charged $7,000 and Reduced to $0](https://adriagross.com/colonoscopy-charged-7000-and-reduced-to-0/) - You’re going to a colonoscopy at the office of your doctor and the office says to you, it’s covered on your plan and you do not need to pay any money at all. I just overturn a case where they were informed there would be no fee but was charged over $7,000. Please get that
- [Understanding the Role of a Health Insurance Advocate](https://adriagross.com/understanding-the-role-of-a-health-insurance-advocate/) - The Role of a Health Insurance Advocate helps navigate the complexities of health insurance. This can be daunting, especially when unexpected medical bills arise. Even with comprehensive coverage, many individuals find themselves facing significant out-of-pocket expenses. This is where a health insurance advocate becomes invaluable, guiding patients through the intricate healthcare system and ensuring they
- [Can't Understand Your Explanation of Benefits?](https://adriagross.com/cant-understand-your-explanation-of-benefits/) - Are you having a difficult time understanding your explanation of benefits and the reason for the denials on your bill for over a hundred thousand dollars? I used to write the policies for the insurance companies and was taught how to deny claims on behalf of the insurance companies. I normally reduce the medical bills
- [Double Payment on Medical Bills and Can't Get a Refund?](https://adriagross.com/double-payment-on-medical-bills-and-cant-get-a-refund/) - Are you in a situation where you paid your medical provider when having a procedure at their office, but now you receive a bill in the mail for those services you already paid for? You call your doctor or billing company and they won’t admit that they were double paid. Don’t allow them to pull
- [Leveraging Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs)](https://adriagross.com/leveraging-health-savings-accounts-hsas-and-flexible-spending-accounts-fsas/) - Navigating the healthcare system involves numerous choices, from selecting the right insurance plan to managing out-of-pocket costs. Two financial tools that can help you manage healthcare expenses are Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs). However, it’s essential to know if these accounts are compatible with your insurance plan and how best to
- [PCOS Coverage Non-Existent](https://adriagross.com/pcos-coverage-non-existent/) - Good morning everybody. Have you ever heard of Cushing’s syndrome? It’s a pituitary irregularity. The sad thing is that there’s no cure for it. It also goes under the condition title, polycystic ovarian syndrome, which has the initials PCOS. Many conditions keep people from being covered according to our health insurance policies. I hate to
- [Having Problems Getting the Generic Drug](https://adriagross.com/having-problems-getting-the-generic-drug/) - I hope you’re having a wonderful day today. All too often you may need a medication and they only want to provide you with the generic drug. If you’re having problems where you are unable to take that generic drug, please reach out to me. I will help you. I have great relationships with the
- [What You Can Do If Your Medical Bills Are Denied](https://adriagross.com/what-you-can-do-if-your-medical-bills-are-denied/) - In this interview, Edison Guzman speaks with Adria Gross, an insurance advocate, about navigating medical claim denials. Adria explains the common reasons for denials, such as insurance companies rejecting claims without proper review or doctors submitting bills late. She outlines the steps individuals should take when faced with a denial, including contacting the insurance company
- [What Does Adria Gross Do as a Medical Insurance Advocate?](https://adriagross.com/what-does-adria-gross-do-as-a-medical-insurance-advocate/) - In this interview, Edison Guzman speaks with Adria Gross, a seasoned health insurance expert and founder of Medwise Insurance Advocacy. Adria shares insights from her 30+ years of experience in the health insurance industry, starting from her time working for insurance companies where she learned how claims were denied. Over time, she transitioned to becoming
- [Is Mental Health Coverage Included in My Insurance Plan?](https://adriagross.com/is-mental-health-coverage-included-in-my-insurance-plan/) - Mental health is increasingly recognized as an essential aspect of overall well-being, yet many people are uncertain about whether their insurance plans provide adequate coverage in this area. The inclusion of mental health services varies widely among insurance policies. This blog post aims to help you understand if your insurance plan includes mental health coverage
- [What You Can Do If Your Medical Bills Are Denied](https://adriagross.com/what-you-can-do-if-your-medical-bills-are-denied-2/) - In this interview, Edison Guzman speaks with Adria Gross, an insurance advocate, about navigating medical claim denials. Adria explains the common reasons for denials, such as insurance companies rejecting claims without proper review or doctors submitting bills late. She outlines the steps individuals should take when faced with a denial, including contacting the insurance company
- [If COBRA Is Not Paying Your Medical Bills Do This](https://adriagross.com/if-cobra-is-not-paying-your-medical-bills-do-this/) - I hope this never ever happens to you. You leave a job and now you have Cobra, but they’re not paying your bills. If this happens to you, call me. I know all about it, and I guarantee you when I get my teeth into that case, your bills are gonna be paid. Thank you.
- [Are You Paying Double Medical Premiums on Social Security](https://adriagross.com/are-you-paying-double-medical-premiums-on-social-security/) - It’s, I hope you’re having a fantastic day today. You know, very often when you begin to receive Social Security, you’ve already been paying out your premium for Medicare. Well, let me tell you this. There has been major confusion where whoever your insurer is, you might be paying double monthly premium. Please reach out
- [Is Emergency Medical Care Covered When Traveling Abroad](https://adriagross.com/is-emergency-medical-care-covered-when-traveling-abroad/) - Traveling can be one of life’s greatest joys, but it’s important to remember that accidents and illnesses can happen, even when you’re exploring a new corner of the world. A common question many travelers have is, “Is emergency medical care covered by my insurance when I’m abroad?” The answer can be complex and varies depending
- [Medicare Advantage Double Coverage Ends in Double Payment](https://adriagross.com/medicare-advantage-double-coverage-ends-in-double-payment/) - I hope this never happens to you. I received a phone call where someone worked for two different companies and wound up, believe it or not, having two different Medicare Advantage plans. The other crazy part about that, it was the same insure one of the plans was requesting back $200,000.The crazy thing is it’s
- [ACL Surgery Was Overcharged Until This](https://adriagross.com/acl-surgery-was-overcharged-until-this/) - I recently overturned a case where the person had ACL surgery on the knee, and even though all the bills were paid, they were still asking for additional money. We don’t want this to happen to you. If anything like this occurs, whatever surgery it is, and now they’re asking you for more money where
- [How to Verify if a Doctor or Medical Facility is In-Network](https://adriagross.com/how-to-verify-if-a-doctor-or-medical-facility-is-in-network/) - Finding a healthcare provider that aligns with your medical needs is only half the battle when navigating the complex world of health insurance. The other crucial aspect is ensuring that the doctor or medical facility you choose is within your insurance network. Going out-of-network can lead to substantially higher out-of-pocket costs, making it vital to
- [What If the Insurance Company Wants Their Money Back?](https://adriagross.com/what-if-insurance-company-wants-money-back/) - I hope you’re having a fantastic day after your bills were paid due to an injury. Has the insurance company ever asked you for the money back? Very often I receive cases which involve coordination of benefits. I understand how confusing this can be and if this ever happens to you, please reach out to
- [Unpaid Claims for PANDA](https://adriagross.com/unpaid-claims-for-panda/) - Too many times I have received unpaid claims for Panda. People come to me when it’s not being paid. Panda stands for Pediatric Autoimmune Neuropsych Psychiatric Disorders, and it’s associated with strep infections. Too often insurance companies do not wanna pay claims for that condition. If that happens to you or even other conditions, please
- [How to Lower Your Monthly Health Insurance Premiums](https://adriagross.com/how-to-lower-your-monthly-health-insurance-premiums/) - Finding an affordable health insurance plan without compromising the quality of coverage can be a tricky endeavor. However, there are strategies to optimize your insurance costs while maintaining essential coverage for your healthcare needs. This blog post aims to guide you through various avenues to lower your monthly premiums without sacrificing crucial benefits.Assess Your NeedsBefore
- [From Denying Claims to Patient Advocate, Adria Gross on Navigating Medical Insurance](https://adriagross.com/from-denying-claims-to-patient-advocate-adria-gross-on-navigating-medical-insurance/) - Interview Participants: Edison Guzman (interviewer) and Adria Gross from Medical Insurance Advocacy (interviewee).Adria’s Background:Worked for two insurance companies where she was trained to deny claims.Gained extensive knowledge about insurance policies, including coverage details, premiums, deductibles, and copays.Transitioned from working within insurance companies to advocating for individuals with denied claims.Services Offered by Adria Gross:Helps individuals overturn
- [What Does Adria Gross Do as a Medical Insurance Advocate?](https://adriagross.com/what-does-adria-gross-do-as-a-medical-insurance-advocate-2/) - In this interview, Edison Guzman speaks with Adria Gross, a seasoned health insurance expert and founder of Medwise Insurance Advocacy. Adria shares insights from her 30+ years of experience in the health insurance industry, starting from her time working for insurance companies where she learned how claims were denied. Over time, she transitioned to becoming
- [Saved over $80,000 in Severe Depression Medical Bills](https://adriagross.com/saved-over-80000-in-severe-depression-medical-bills/) - I hope everything’s going well for you. Janet, a client of mine who’s in my recent book, apparently different discusses how we should treat a person who is apparently different. Janet has had years of depression, which causes severe mental health. She has a borderline personality disorder, but I have to tell you this, her
- [Medicare Advantage Plans Are not Accepted by 75% of Doctors](https://adriagross.com/medicare-advantage-plans-are-not-accepted-by-75-of-doctors/) - You know, 50% of the doctors and hospitals no longer accept the Medicare Advantage plans. You have only one Medicare card if you have the Medicare Advantage plans. But the issue is if you wind up in a rehab and if they’re using AI at the insurance company, artificial intelligence, within three days after you
- [How to Determine if a Medical Procedure or Medication is Covered](https://adriagross.com/how-to-determine-if-a-medical-procedure-or-medication-is-covered/) - Navigating the intricacies of health insurance can be a daunting task, especially when you’re trying to figure out if a particular medical procedure or medication is covered under your plan. Knowing what is and isn’t covered can save you from unexpected medical bills and ensure that you’re getting the most out of your insurance. This
- [$250,000 Insurance Claim Denied When Turned Age 65?](https://adriagross.com/250000-insurance-claim-denied-when-turned-age-65/) - I recently received a phone call from an attorney where the health insurance carrier never informed the patient that at the age of 65 they needed to switch over to Medicare. So here’s a case where the person paid over $250,000, which the insurance company kept. Well, I could think about how incredibly unfair it
- [A Little Love Inspires Everyone](https://adriagross.com/a-little-love-inspires-everyone/) - Hello, everybody in my book apparently Different. There’s a chapter about Allison Murphy. The title of the chapter is Allie. A Little Love Inspires everyone. I’ve known Allie since she was an infant. She and my son were both in early intervention. Allie was born with cerebral palsy. She has been in a wheelchair her
- [How Does Your Health Insurance Plan Handle Pre-existing Conditions?](https://adriagross.com/how-does-your-health-insurance-plan-handle-pre-existing-conditions-2/) - Understanding how your health insurance plan handles pre-existing conditions is crucial, especially if you or a family member have a chronic illness or a medical history that needs ongoing care. This blog post aims to guide you through the complexities of insurance coverage for pre-existing conditions, offering advice on what to look for and the
- [Mix Up With Overlapping Insurance](https://adriagross.com/mix-up-with-overlapping-insurance/) - I hope you’re having a fabulous day. Too many times I have seen cases where there’s a mix up on one medical insurer overlapping another one. So I recently had a situation where my client paid over $20,000 in double premiums for these two that were overlapping. If this ever happens to you, call me.
- [Why Medicare May Not Cover Your Rehab Expenses](https://adriagross.com/why-medicare-may-not-cover-your-rehab-expenses/) - I hope you’re having a fabulous day. So you’re in the hospital and now you need to go to a rehab when you leave the hospital. So please make sure that the hospital had you in the hospital as an inpatient for three midnights or more. If you do not have three midnights in a
- [Filing a Medical Insurance Claim](https://adriagross.com/filing-a-medical-insurance-claim-2/) - Dealing with medical issues can be stressful enough without adding the complexities of insurance paperwork. However, understanding the process of filing a medical insurance claim is essential for ensuring you receive the benefits you’re entitled to. In this comprehensive blog post, we’ll walk you through the steps of filing a medical insurance claim so that
- [Need Your Major Insurance Company to Pay](https://adriagross.com/need-your-major-insurance-company-to-pay/) - Now you’re sick and you need a major medical test, but your insurance company doesn’t wanna pay for it. I help people when matters like this happen. Please think of me, Adria Gross Medwise Insurance advocacy. They’re not paying. Call me. Thanks. Adria Gross Medical Billing Advocate See Full Bio Adria Gross
- [What is Outpatient Under Observation](https://adriagross.com/what-is-outpatient-under-observation/) - You are a senior, but make sure that when you wind up in a hospital, you are an inpatient for at least two midnights or more. Otherwise, you’ll be considered an outpatient under observation and will not be covered for your hospitalization. Please call me if you know anybody who this happens to. I’m here
- [Documentation Needed for Filing a Medical Insurance Claim](https://adriagross.com/documentation-needed-for-filing-a-medical-insurance-claim-2/) - Filing a medical insurance claim can be a daunting process, especially when you’re not sure what paperwork you need. To help streamline this essential task, this blog post offers a comprehensive guide on the types of documentation you’ll need to gather when filing a claim.Why Proper Documentation MattersIncorrect or incomplete documentation can result in delays,
- [Bipolar Depression Claims](https://adriagross.com/bipolar-depression-claims/) - I hope everybody’s having a great day out there. I have to say bipolar depression occurs much too often. I have helped many people who have that disorder. If your claims are being denied on mental health issues, please call me Adria, Medwise Insurance Advocacy. I’m here to help you. Thank you. Adria Gross Medical
- [Medical Bill Issues? Here's How to Get Them Down to $0](https://adriagross.com/medical-bill-issues-heres-how-to-get-them-down-to-0/) - Are you having medical bill issues? Has your case been sent to a collection agency? If we work together and I’m unable to prove that you are unable to afford the bills, I will get your bills either down to zero or not too much above it. I just worked on a case where I
- [Do I Need a Referral to See a Specialist?](https://adriagross.com/do-i-need-a-referral-to-see-a-specialist-2/) - Navigating the healthcare landscape can be complicated, especially when you need specialized care. One common question many people have is whether they need a referral from a primary care physician (PCP) to consult a specialist. The answer varies depending on your insurance plan and healthcare needs. This blog post delves into the factors that determine
- [New Book Apparently Different](https://adriagross.com/new-book-apparently-different/) - Hi everybody, please by my book, apparently different. There are so many incredible stories of people, many of which have been clients of mine. A very kind young gentleman while he was in his late teens, early twenties, started getting tumors multiple times a day. And it was all because of a cancerous tumor growing
- [Denied Insurance Claim? Don’t Panic](https://adriagross.com/denied-insurance-claim-dont-panic-2/) - Discovering that your insurance claim has been denied can be disheartening, especially when you’re relying on it to cover medical expenses. However, a denial isn’t necessarily the end of the road. Many denials can be successfully appealed, giving you another opportunity to secure coverage for your medical costs. This blog post outlines the essential steps
- [Neurological Lime Disease Insurance Claims](https://adriagross.com/neurological-lime-disease-insurance-claims/) - I worked with a gentleman who was considered the Jeopardy king, and he’s in my book that recently came out. Apparently different. He was Jeopardy’s King on the Jeopardy Tournament of Champions, but I’m sorry to say this. He wound up having neurological Lyme disease. He was on so many different medications and went to
- [How Prescription Drug Coverage Works in Your Insurance Plan](https://adriagross.com/how-prescription-drug-coverage-works-in-your-insurance-plan/) - Understanding how prescription drug coverage works in your health insurance plan can be a bit like solving a complex puzzle. Given the rising cost of medications, it’s crucial to comprehend this component of your healthcare coverage. This blog post aims to demystify the subject, giving you the knowledge you need to navigate prescription drug coverage
- [Disability Does Not Define a Person](https://adriagross.com/disability-does-not-define-a-person/) - In my new book that just came out, apparently different is a chapter titled Disability Does Not Define a Person. A gentleman calls me one day involving his client, Mr. Santini. Here was a situation where after serving in the military falling a hundred feet and waking up after the injury, he severely damaged his
- [Understanding "Deductible," "Co-Pay," and "Co-Insurance"](https://adriagross.com/understanding-deductible-co-pay-and-co-insurance-2/) - Health insurance can be a lifesaver in a medical emergency, but understanding the terms and conditions of your policy can feel like navigating a maze. Terms like “deductible,” “co-pay,” and “co-insurance” often pop up, creating confusion for many policyholders. In this blog post, we’ll demystify these common insurance terms so you can make informed decisions
- [Massive Brain Tumor Medical Bills](https://adriagross.com/massive-brain-tumor-medical-bills/) - In my book, apparently different, just recently published, I discussed my own experience having epilepsy while writing my book. I met with an educator, Janet Schiff. The chapter that is about her is titled, whatever Happened to Me, to My White Picket Fence, my Brain Injury From My Massive Brain Tumor. Janet writes, the white
- [Changing Your Primary Care Physician- What You Need to Know](https://adriagross.com/changing-your-primary-care-physician-what-you-need-to-know/) - Choosing a primary care physician (PCP) is a critical decision that impacts your overall healthcare experience. However, there may be reasons you’d like to change your PCP, be it due to relocation, dissatisfaction, or a need for specialized care. The good news is that most insurance plans offer the flexibility to do so. In this
- [Normal or Autism Spectrum Insurance Bills](https://adriagross.com/normal-or-autism-spectrum-insurance-bills/) - I just published a new book called Apparently Different, and there’s a chapter in my book, which involves Jesse Sine. Jesse himself has written two books. Both books involve discussing what it’s like to be normal versus what it’s like to have Asperger’s.I received many phone calls with people who have an autism spectrum disorder.
- [Appealing an Insurance Company Decision](https://adriagross.com/appealing-an-insurance-company-decision-2/) - At some point, many of us will face the frustrating situation of having an insurance claim denied or a medical service deemed “not covered” by our healthcare policy. These decisions can have a significant financial and emotional impact, leaving us wondering what to do next. The good news is that you have the right to
- [Dental Coverage Not Covering?](https://adriagross.com/dental-coverage-not-covering/) - I hope all is well with you today. Dental coverage is very limited. Most policies will never cover you for more than $3,500. It’s best to discuss the fees and get it in writing before procedure is performed. Many people come to me with bills over $35,000. Some dental providers are willing to reduce the
- [Adding a Family Member to Your Insurance Policy](https://adriagross.com/adding-a-family-member-to-your-insurance-policy-2/) - As life changes, so do your healthcare needs. Whether you’ve just gotten married, welcomed a new baby, or have other family changes, you may find yourself wondering how to add a family member to your existing insurance policy. This blog post aims to guide you through the various options, timing, and procedures involved in expanding
- [Reasonable and Customary Charges Reduce Bill from Over $100,000 to $11,000](https://adriagross.com/reasonable-and-customary-charges-reduce-bill-from-over-100000-to-11000/) - My friends, one of my clients went for surgery and they were never informed in advance that it was an out-of-network provider. The doctor was charging over a hundred thousand dollars and when I looked at the reasonable customary charges, I was able to get the bill reduced from a hundred thousand down to 11,000.
- [PPO or HMO?](https://adriagross.com/ppo-or-hmo/) - Good morning, everybody. I gotta tell you, I worked with a client who thought they had a PPO rather than HMO. You really need to understand your policy and realize what you are covered for and what you’re not covered for. Uh, the person was in a 24 hour psych facility and the fact that
- [Emergency Room Expense Not Medically Necessary and Not Covered?](https://adriagross.com/emergency-room-expense-not-medically-necessary-and-not-covered/) - Hopefully this will never happen to you, but your appendix burst and then you go to the emergency room, but your insurer is not paying your bill. They’re claiming it wasn’t medically necessary. Please call me and I’m sure that I can help you retrieve money for your claim. I had a client who needed
- [Got Hurt at Work With No Workers Comp Insurance?](https://adriagross.com/got-hurt-at-work-with-no-workers-comp-insurance/) - I hope you’ve had a fabulous day today and this didn’t happen to you. So you’re at work and you fall off a ladder. You don’t have workers’ comp, and your insurance company doesn’t wanna pay the claim. So if this happens to you, please call me and Medwise will help you. Believe it or
- [Medical Claims Not Being Processed by Your Insurance Carrier?](https://adriagross.com/medical-claims-not-being-processed-by-your-insurance-carrier/) - I hope you’re having a fabulous say so. You have sent a stack of bills to your health insurance carrier, but your claims are not being processed, and you have made multiple phone calls to the insurance company. If this happens to you, please call me. I’m very successful in getting your claims processed by
- [Emergency Room Bills and No Insurance?](https://adriagross.com/emergency-room-bills-and-no-insurance/) - Good afternoon, so you have no insurance and you wind up in an emergency room. If this happens to you, please reach out to Medwise. I am sure I will a be able to get a reduction for you. Believe it or not, I recently saved a client over $75,000, so if you need help,
- [Overwhelmed With Medical Bills and Charges?](https://adriagross.com/overwhelmed-with-medical-bills-and-charges/) - If you were overwhelmed with your medical bills and you need assistance, whether it be filing your claims or you’re all confused, please reach out to Medwise. We can certainly help you with your medical bills and charges. Saving you so much time and effort. Adria, Medwise Insurance Advocacy. Thank you. Adria Gross Medical Billing
- [Does Employer Health Insurance Cover You Out of the Country?](https://adriagross.com/does-employer-health-insurance-cover-you-out-of-the-country/) - If you are still under the age of 65 and working and receiving health insurance from your employer, I’m able to help people when they’re out of the country to be covered for their services. Many employers have terrific policies, which will cover you when you’re on vacation or you’re out for business. And if
- [Adria Goldman Gross, Serial Author And Medical Insurance Advocate Featured On Platform Geared To Kindness & Compassion](https://adriagross.com/adria-goldman-gross-serial-author-and-medical-insurance-advocate-featured-on-platform-geared-to-kindness-compassion/) - Apparently DIFFERENT highlights the human need for understanding, acceptance and compassion. Newark, NJ (1888PressRelease) May 14, 2024 – Adria Goldman Gross, President and CEO of Medwise Insurance Advocacy, and serial author, has just published her third book ‘Apparently DIFFERENT.’ ISBN #: 978-1-9772-0051-8, Recently, Adria was featured in the article, “Embracing Empathy: A Conversation on Kindness and Compassion.”
- [Are Critical Illness Policies Worth It?](https://adriagross.com/are-critical-illness-policies-worth-it/) - I was wondering if you ever heard of someone who has a critical illness policy. Those policies are gonna cost you a lot less money, but sometimes the critical illness policies will not pay out your claims. So if you call me, I will help you work out either getting your claim paid or at
- [Need Assistance with Social Security Disability?](https://adriagross.com/need-assistance-with-social-security-disability/) - Hello everyone. I hope this doesn’t happen to you, but if you need assistance to make your first request, first request for Social Security Disability. Believe it or not, medwise has helped many people with their applications. Um, call medwise. If you have worked for 10 years or 40 quarters, there’s one quarter a year.
- [Overcharged for Prescribed Medicine?](https://adriagross.com/overcharged-for-prescribed-medicine/) - I hope you’re having a fantastic day. Are you being overcharged on your medicine expenses? All your prescription plans? medwise is usually able to find by performing extensive research to find a lower cost for your medicine. If you need assistance, please call me. I just saved someone over $1,800 on one prescription. My phone
- [Multiple Insurers and Confused Who Pays First?](https://adriagross.com/multiple-insurers-and-confused-who-pays-first/) - Good day everyone. Many people are confused when they have multiple insurance carriers. You have to know who is your primary, who is your secondary, and who is your tertiary. If you are having issues understanding who should be paying first, please reach out to me. I’m sure I’ll be able to help you and
- [Not Getting Properly Reimbursed for Medical Bill Expenses?](https://adriagross.com/not-getting-properly-reimbursed-for-medical-bill-expenses/) - Good day, I hope. I hope you’re having the most positive day ever. People come to me when it’s not too positive, so sometimes your health insurance carrier is not correct correctly processing your claims, and you are having problems getting reimbursed. So if this happens to you, please reach out to me. I recently
- [Out of Network Medical Bills Either Reduced or Written Off With This](https://adriagross.com/out-of-network-medical-bills-either-reduced-or-written-off-with-this/) - Hi everyone. Uh, you’re in the hospital with colitis and the hospital and doctors are outta network. Please remember, out of network, think of Medwise. You might be able to either get your insurance company to cover the bill or get a major reduction on your charges. I recently saved, believe it or not, over
- [Can't Afford Your Huge Medical Debt?](https://adriagross.com/cant-afford-your-huge-medical-debt/) - Good morning. I hope you’re doing great today. If you owe a huge medical debt on a hospital bill and you are unable to pay for it, please call me. I am so happy that I’ve been able to reduce bills to a very small amount and sometimes zero when this happens. Adria, Medwise Insurance
- [Overcharged on Your Medical Bills? Do This](https://adriagross.com/overcharged-on-your-medical-bills-do-this/) - Hi everyone. Have you been unable to pay your, your price procedures that went towards the deductible? Very often, especially the beginning of the year, if you’re, if you haven’t seen a doctor, it goes directly to your deductible. If you have been overcharged, I frequently am able to get reductions on your bills.So even
- [Surprise Medical Bill?](https://adriagross.com/surprise-medical-bill/) - I hope you’re having a terrific day today. If you have received a surprise medical bill, please call me. If someone is outta network and you’re in the emergency room, they have no right to charge you whatever they feel like. If the doctors are out of network and it’s an emergency, please remember you
- [At A Nursing Care Facility with Medicare Advantage Plan?](https://adriagross.com/at-a-nursing-care-facility-with-medicare-advantage-plan/) - Hello everyone. Recently I received many phone calls for people who purchase a Medicare Advantage plan. Rather than having a Medicare coverage with a supplement and a prescription plan, I always tell people, you have one card or three cards. When people go into a rehab center and they have a Medicare Advantage plan, they’re
- [Have You Received a Medical Bill One to Five Years After Procedure?](https://adriagross.com/have-you-received-a-medical-bill-one-to-five-years-after-procedure/) - I hope you’re having a terrific day. Uh, I just wanna tell you people reach out to me when they first receive a bill going back a year to five years after the procedure was provided. You might not be responsible for that bill. Last week I saved my client $25,000. So if you are in this
- [Out of Network Provider Not Submitted Your Medical Bills on Time?](https://adriagross.com/out-of-network-provider-not-submitted-your-medical-bills-on-time/) - I hope you’re having a fabulous day. Have you been seen by an out of network provider who has not submitted your medical bills on time?If, you have not paid the provider yet and they have not submitted the bills, you might want to not even be responsible to pay the provider.I recently saved a
- [Hip Replacement With Authorization Was Denied](https://adriagross.com/hip-replacement-with-authorization-was-denied/) - I hope you’re having a great day. Uh, you know, one of my recent clients had hip replacement and there was pre-authorization for the hip replacement and it was supposed to be covered, but due to incorrect procedure codes, the bill for $85,000 was denied. The bills were being submitted by an outside billing company
- [Denied Medical Bills Over $90,000 Overturned](https://adriagross.com/denied-medical-bills-over-90000-overturned/) - Hello everyone. I had a recent case where this person kept on receiving denied medical bills and they had excessive billing from the providers. To make things even worse, his insurance company changed over the time period when he was having these multiple procedures involving surgery. A couple of the providers were out of network
- [Out of Network Emergency Room Covered?](https://adriagross.com/out-of-network-emergency-room-covered/) - I recently had a client who wound up in emergency room in a hospital, which was out of network since the ambulance took them right to the out-of-Network Emergency Room. I must say it took quite a period of time for me to overturn the case, but I was finally able to have the insurance
- [Rehab and $52,000 Hospital Bill Covered](https://adriagross.com/rehab-and-52000-hospital-bill-covered/) - I hope you’re having enjoying yourselves and all is going well. Well, one of my clients was in an out of network hospital and wound up in a rehab here I was fighting for my client involving the hospital bill, and finally was able to have his insurer cover the entire hospital bill of $52,000.
- [Mental Health Outpatient Charges Covered](https://adriagross.com/mental-health-outpatient-charges-covered/) - I had a recent case where a gentleman had $12,000 in mental health outpatient charges. The worst thing was he had no insurance. By us contacting the Department of Social Services, we were able to get Medicaid to pay off all his claims. If you ever need help, please call me Adria, Medwise Insurance Advocacy.
- [$23,000 Denied Medical Bill Overturned](https://adriagross.com/23000-denied-medical-bill-overturned/) - I hope you’re having a great day. I recently overturned a case that was $23,000. This was an awful situation where the woman had been abused by her husband and since they had health insurance under her husband’s policy. For some odd reason the insurance company was not paying it. This case was sent to
- [Incorrect Billing Resulted in $2,000 Overcharge](https://adriagross.com/incorrect-billing-resulted-in-2000-overcharge/) - I recently handled a claim where they felt the billing was incorrect. The mother gave birth to this little baby boy. She received a bill from a private office, which she never saw this provider while she was in the hospital, the bill was $2,000 and when we were able to prove that the services
- [Broken Jaw Medical Bill Denied Because Not Medically Necessary?](https://adriagross.com/broken-jaw-medical-bill-denied-because-not-medically-necessary/) - I was recently able to help a family who had $35,000 worth of bills. They had a fall, broke their jaw, and believe it or not, this also involved multiple insurers. The insurers kept on denying the claims stating, even though she broke her jaw, it wasn’t necessary for her to have covered charges. Crazy.
- [Have a PPO Plan and Had a Baby?](https://adriagross.com/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?](https://adriagross.com/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?](https://adriagross.com/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?](https://adriagross.com/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?](https://adriagross.com/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 medically
- [Overnight Medical Bill for $43,000 Fully Covered](https://adriagross.com/overnight-medical-bill-for-43000-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?](https://adriagross.com/what-if-youre-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
- [How Does Your Health Insurance Plan Handle Pre-existing Conditions?](https://adriagross.com/how-does-your-health-insurance-plan-handle-pre-existing-conditions/) - Understanding how your health insurance plan handles pre-existing conditions is crucial, especially if you or a family member have a chronic illness or a medical history that needs ongoing care. This blog post aims to guide you through the complexities of insurance coverage for pre-existing conditions, offering advice on what to look for and the
- [Saved $600 Per Month for Compound Pharmacy Medication](https://adriagross.com/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
- [Filing a Medical Insurance Claim](https://adriagross.com/filing-a-medical-insurance-claim/) - Dealing with medical issues can be stressful enough without adding the complexities of insurance paperwork. However, understanding the process of filing a medical insurance claim is essential for ensuring you receive the benefits you’re entitled to. In this comprehensive blog post, we’ll walk you through the steps of filing a medical insurance claim so that
- [Not Covered After Being Told That You're Covered?](https://adriagross.com/not-covered-after-being-told-that-youre-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
- [Documentation Needed for Filing a Medical Insurance Claim](https://adriagross.com/documentation-needed-for-filing-a-medical-insurance-claim/) - Filing a medical insurance claim can be a daunting process, especially when you’re not sure what paperwork you need. To help streamline this essential task, this blog post offers a comprehensive guide on the types of documentation you’ll need to gather when filing a claim.Why Proper Documentation MattersIncorrect or incomplete documentation can result in delays,
- [Covid Client Billed $54,000 With No Insurance Reduced to $0](https://adriagross.com/covid-client-billed-54000-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
- [Do I Need a Referral to See a Specialist](https://adriagross.com/do-i-need-a-referral-to-see-a-specialist/) - Navigating the healthcare landscape can be complicated, especially when you need specialized care. One common question many people have is whether they need a referral from a primary care physician (PCP) to consult a specialist. The answer varies depending on your insurance plan and healthcare needs. This blog post delves into the factors that determine
- [$500,000 Medical Bill Reduced, Even When Insurance Payout Was Insufficient](https://adriagross.com/500000-medical-bill-reduced-even-when-insurance-payout-was-insufficient/) - A recent client had an injury while sightseeing on a van. They had a fall and they sued the bus company and tour operator. My client received insufficient funds to pay all the medical bills, so thank you. I was able to reduce his bill from $500,000 down to a hundred thousand dollars. Now it
- [Denied Insurance Claim? Don’t Panic](https://adriagross.com/denied-insurance-claim-dont-panic/) - Discovering that your insurance claim has been denied can be disheartening, especially when you’re relying on it to cover medical expenses. However, a denial isn’t necessarily the end of the road. Many denials can be successfully appealed, giving you another opportunity to secure coverage for your medical costs. This blog post outlines the essential steps
- [Couldn't Pay Insurance Premiums After Brain Surgery](https://adriagross.com/couldnt-pay-insurance-premiums-after-brain-surgery/) - A recent client had brain surgery and they were so sick for a period of time, they couldn’t even read their mail and pay their health insurance, so now they’re at a point that they can back pay, and they reached out to me and when I was able to prove that my client was
- [Prescription Drug Coverage-How it Works in Your Insurance Plan](https://adriagross.com/prescription-drug-coverage-how-it-works-in-your-insurance-plan/) - Understanding how prescription drug coverage works in your health insurance plan can be a bit like solving a complex puzzle. Given the rising cost of medications, it’s crucial to comprehend this component of your healthcare coverage. This blog post aims to demystify the subject, giving you the knowledge you need to navigate prescription drug coverage
- [Case Overturned for Business Owner with No Workers Compensation](https://adriagross.com/case-overturned-for-business-owner-with-no-workers-compensation/) - I recently overturned a case where my client was the owner of a company and he did not have workers compensation for himself. It’s not required by quite a few states, that the owner of a business not have worker’s comp. So, believe it or not, I was able to lower his medical bills from
- [Understanding "Deductible," "Co-Pay," and "Co-Insurance"](https://adriagross.com/understanding-deductible-co-pay-and-co-insurance/) - Health insurance can be a lifesaver in a medical emergency, but understanding the terms and conditions of your policy can feel like navigating a maze. Terms like “deductible,” “co-pay,” and “co-insurance” often pop up, creating confusion for many policyholders. In this blog post, we’ll demystify these common insurance terms so you can make informed decisions
- [$144,000 Medical Bill Reduced With No Health Insurance Plan](https://adriagross.com/144000-medical-bill-reduced-with-no-health-insurance-plan/) - I’m working on a case that just came to me and the bill’s $144,000 and the client had no health insurance. He doesn’t have any health insurance at all. So very often when you approach the billing department for the medical provider, you will need to discuss the allowable amounts which are normally built because
- [What if it Wasn't Medical Necessary, But You're Billed?](https://adriagross.com/what-if-it-wasnt-medical-necessary-but-youre-billed/) - I have to tell you right now I am receiving quite a few clients whose insurance company is saying it wasn’t medically necessary for you to be in the hospital, and you could have been there for two to seven evenings. You go to the emergency room, they admit you to the hospital, and they’re
- [$25,000 Medical Fee Reduced to $1,700 Due to the No Surprise Act](https://adriagross.com/25000-medical-fee-reduced-to-1700-due-to-the-no-surprise-act/) - I don’t know if anybody heard about this, but January 1st, 2022, a new bill was passed. It’s called the No Surprise Act. It is a national, um, uh, act. Uh, and a doctor has no right to charge you for services if they didn’t tell you in advance that they were outta network and
- [Who's Responsible for Preauthorization for Your Medical Procedure?](https://adriagross.com/whos-responsible-for-preauthorization-for-your-medical-procedure/) - if a provider does not have pre-authorization for services rendered, which are usually the following procedures, surgery when they’re, uh, doing a procedure and they have to put dye in you, MRI, CAT scan, and, and also involving many other services, your claim is going to be denied if you didn’t have pre-authorization. I recently
- [Outdated CPT Codes May Cost You Thousands](https://adriagross.com/outdated-cpt-codes-may-cost-you-thousands/) - Believe it or not, some medical providers are still using outdated CPT or ICD nine codes. A C P T code is the procedure performed and the I C D nine codes are no longer in existence. Now they have these I C D 10 codes and the I C D is your diagnosis. The
- [What If Your Provider Does Not Send Out the Bill on Time to the Insurance Company?](https://adriagross.com/what-if-your-provider-does-not-send-out-the-bill-on-time-to-the-insurance-company/) - Have you ever been in a situation where your provider did not send the bill out to the insurance company on time? Insurance company usually demand that they receive the bills for services within 3, 4, 6, 9 or 12 months. So this client was directed and was billed over $75,000. When we discussed this
- [How to Avoid Paying the Same Medical Bill Twice](https://adriagross.com/how-to-avoid-paying-the-same-medical-bill-twice/) - If it’s possible, I highly recommend that you keep track of claims that you have received and paid. It’s always best not to pay your medical provider until you receive the explanation of benefits. Sometimes providers duplicate the bills and occasionally they’re paid twice. I had a case recently where they were paid by the
- [$25,000 Medical Claim Reduced to Zero With This](https://adriagross.com/25000-medical-claim-reduced-to-zero-with-this/) - I recently had a case where the provider did not have medical records for which they were billing the patient for. It was very difficult for them to not be able to find any medical records, even though they kept on billing my client over $25,000. So there was a lot of fighting back and
- [Medicare Advantage Plan May be an Issue for Nursing Homes](https://adriagross.com/medicare-advantage-plan-may-be-an-issue-for-nursing-homes/) - I have to tell you, you know, this is crazy out there. People do not realize when they’re, when they turn 65 and they think, oh, this is gonna be great. If I go on a Medicare Advantage plan, let me tell you, if you wind up in a rehab, it’s not great because they
- [Billed for Services Never Rendered? We Can Help.](https://adriagross.com/billed-for-services-never-rendered-we-can-help/) - I recently had insured reach out to me since they were built for services, never rendered. It was difficult to prove, but luckily, by examining the medical records, we were able to reduce the bill from $11,000 to only $2,000. If you’re ever having problems with your medical bills, please call me, Adria, Medwise Insurance
- [What to Do if Medical Claim Not Paid Due to Missed Insurance Payment](https://adriagross.com/what-to-do-if-medical-claim-not-paid-due-to-missed-insurance-payment/) - I recently overturned the case where the patient forgot to submit premium due to cancer treatment. You know what happens is when you’re going through the treatment, your brain really becomes clouded and you can’t think straight. So thank God after speaking with the insurance company, we were able to pay the missed premiums and
- [Complications Due to Overseas Medical Bills?](https://adriagross.com/complications-due-to-overseas-medical-bills/) - I’ve had people call me up and request assistance since they had medical service rendered out of the country and when we return to the United States, they still needed medical services. Due to complications of the surgeries performed overseas, I was able to reduce a, a bill recently down to 25%. The original USA
- [$17,000 Emergency Room Bill Reduced to CoPay](https://adriagross.com/17000-emergency-room-bill-reduced-to-copay/) - All too often you could be receiving a bill from the emergency room. Since the providers were out of network, you know, a lot of times the hospitals will cover you, but the pro provide the providers in the emergency room, were totally out of network. So I was recently able to reduce a bill
- [Bills Went to Collections, but Never Received from Hospital?](https://adriagross.com/bills-went-to-collections-but-never-received-from-hospital/) - Have you ever been in a situation where you receive a bill from a collection agency and never from the medical provider? I have a case where my client is being charged only $280,000. I went back to the medical provider and explained what occurred. Guess what? The bills are being paid by the insurance
- [If Your Medication is Not Covered by Insurance, Do This](https://adriagross.com/if-your-medication-is-not-covered-by-insurance-do-this/) - Medication’s not covered on your plan. You can go online and try to order the medication in Canada. Take a look at, certified International Canadian Pharmacy and pharmacychecker.com. What’s happening now here in the us? You can also reach out to GoodRx. When I am at my pharmacy and I feel that they’re overcharging me,
- [$27,000 in Medication Expenses Reduced to $0](https://adriagross.com/27000-in-medication-expenses-reduced-to-0/) - I had a recent case where the medication was not covered on the patient’s health insurance policy. After reaching out to the pharmaceutical company that manufactures that medication, I was so thrilled. I was able to obtain free medication for my client for at least one year. That was a major savings of over $27,000.
- [Multiple Medical Procedures at No Cost Due to This](https://adriagross.com/multiple-medical-procedures-at-no-cost-due-to-this/) - I recently had a bill that included multiple procedures on the same day of service with the same provider. When I reviewed the bill from the billing company, they would not look into that making changes on the medical bill. They, they keep on thinking to themselves, they wanna get their money, and they’re usually
- [Federal No Surprise Act Does Not Include Land Ambulances](https://adriagross.com/federal-no-surprise-act-does-not-include-land-ambulances/) - When the federal No Surprise Act was effective on January 1st, 2022, land ambulances were not included. So that means that the air, the l uh, the land ambulances are still allowed to charge you whatever their heart desires. I recently worked on a bill where the ambulance company had gouged the patient, and believe
- [Air Ambulance Has Legal Limitations for Charges](https://adriagross.com/air-ambulance-has-legal-limitations-for-charges/) - Air ambulance became part of the federal no surprise Act, January 1st, 2022. An air ambulance is always considered to be an emergency, and now they have legal limitations on how much they’re allowed to charge an individual. I had a recent phone call involving this exact matter. If you ever are in a situation
- [Didn't Use an In-Network Insurance Provider?](https://adriagross.com/didnt-use-an-in-network-insurance-provider/) - If possible, before your services are rendered, request whether a medical provider is out of network or in-network, you want this in writing. Otherwise, you might be paying the medical provider bill rather than your insurance company. It’s always best to see an in-network provider. Contact Adria Adria Gross Medical Billing Advocate See Full Bio
- [Saved Over $20,000 in Medical Bills for Doctor Outside of Network](https://adriagross.com/saved-over-20000-in-medical-bills-for-doctor-outside-of-network/) - I was handling Insurance on an older billing for a family of five one of the children wound up in a New York City Hospital. And they were being billed a lot of money by the surgeon and just so happened that the surgeon did not take any insurance. They knew this in advance, but
- [Having Problems Getting Medical Bills Covered After Age 65?](https://adriagross.com/having-problems-getting-medical-bills-covered-after-age-65/) - I worked on a case where the wife was the primary insurer through her employer. This was crazy when the wife died the husband was sitting with outstanding bills of over $300,000. It took a lot of time and effort to prove that the family was entitled to the insurance from her employer and the
- [Nanny Wasn't Covered for $10,000 in Medical Bills Until Adria Came Along](https://adriagross.com/nanny-wasnt-covered-for-10000-in-medical-bills-until-adria-came-along/) - I worked with a family where their Nanny was from a foreign country and the hospital they overbuilt her so high $10,000, but when I was able to explain to the hospital that she didn’t have any insurance and her income was really low. They finally agreed to write off the bill of 10,000 hours. So
- [Does Hospital Volunteering Help With Medical Bills?](https://adriagross.com/does-hospital-volunteering-help-with-medical-bills/) - Have you ever done volunteer work at a hospital? Sometimes the hospital will take that into consideration. And not bill you especially let’s say you don’t have any health insurance. So this was a case where the patient was being balanced bill of $34,000. The fact that they volunteered their time to the hospital the
- [$75,000 of Medical Bills Not Medically Necessary?](https://adriagross.com/75000-of-medical-bills-not-medically-necessary/) - I don’t know if any of you have ever had an outstanding medical bill like for $75,000 did the insurance company tell you that the procedure was not medically necessary. Please I beg you fight and do not allow the insurance company to try and improve you wrong fight for your rights. Medwise is here
- [$60,000 Medical Bills in California Gets Written Off](https://adriagross.com/60000-medical-bills-in-california-gets-written-off/) - I worked with a client in California where their medical bills were over sixty thousand dollars and it was involving their son where the hospital believe it or not. They were billing him an additional 60,000 the boy had a rare disease, but finally I was able to get the insurance company to pay the
- [Tennessee Family Saves $23,000 in Doctor Bills](https://adriagross.com/tennessee-family-saves-23000-in-doctor-bills/) - Well, I worked with a family in Tennessee and the family involved a family of six. We had the husband his wife and his four kids, but he was the only family member who was making income. So the husband lines up in a major Hospital most of his medical bills are covered except for
- [$2,500 Emergency Room Bill Reduced to $230](https://adriagross.com/2500-emergency-room-bill-reduced-to-230/) - So some of the health insurance policies are very limited. One of my clients. He was living in New York City and he had an emergency in New Jersey. And he received the bill for almost $2,500. By fighting with this insurance company and explaining that this was an emergency. Since that was the reason
- [Organizing Life's Daily Demands with Peter Gordon and Adria Gross](https://adriagross.com/organizing-lifes-daily-demands-with-peter-gordon-and-adria-gross/) - In this episode of “Organizing Life’s Daily Demands” Peter Gordon interviews Adria Gross, Medical Bill Advocate, President/CEO at MedWise Ins Advocacy, and Co-Author of “Solved! Curing Your Medical Insurance Problems”. Adria helps clients reduce medical bills, avoid overcharges and negotiates bills down to a reasonable amount.Peter Gordon, Founder and President of New York Financial Organizers,
- [Medical Bills from 24 Hour Psych Facilities?](https://adriagross.com/medical-bills-from-24-hour-psych-facilities/) - So all too often people are having problems with 24 hours psych facilities, and they call me up for assistance involving medical bills.The one thing you have to try and remember is before you ever go into one of these 24-hour facilities. You must get authorization from your health insurance carrier. You have to make
- [$15,408 Medical Bill Overcharge is Overturned](https://adriagross.com/15408-medical-bill-overcharge-is-overturned/) - So, you know when a provider’s telling you that they’re definitely a network and all you’re going to have is this small copay, make sure you get all that information writing before you allow that surgeon to perform the services.I recently overturned a case where my client was being gouged. The doctor received $5,000 for
- [How Adria Saved Client $18,000 on Frequent Doctor Visit Invoices](https://adriagross.com/how-adria-saved-client-18000-on-frequent-doctor-visit-invoices/) - Hey everyone, this is Edison Guzman with Adria Gross. How are you today? Adria? Nice and sunny and beautiful. Excellent. What do you have for us today? So a recent client was having issues with the balance that he was being charged. He had to see a doctor three times a week and his bills were
- [Overcharged by Psychiatrists and Psychologists?](https://adriagross.com/overcharged-by-psychiatrists-and-psychologists/) - One of my clients was seeing a psychiatrist and also psychologist and I just want to give you some information. You don’t know it yet. Psychology bills normally range between $600 to $250 a visit and psychiatric bills are usually for psychiatrists. They’re usually between per visit between $200 to $500. So this client was being charged a thousand dollars per visit. She never
- [Liable for $27,000 Gets Reduced to $0 and Surgeon is Paid in Full](https://adriagross.com/liable-for-27000-gets-reduced-to-0-and-surgeon-is-paid-in-full/) - one of my clients had to have a major surgery performed and they were not informed in advance that she was going to be liable for $27,000. I contacted her doctor and the insurance company. It was a tremendous amount of work, but I was able to finally save her the $27,000. And I was able to have the surgeon paid in full by the
- [A Surprise with The Surprise Bill Law](https://adriagross.com/a-surprise-with-the-surprise-bill-law/) - If a procedure is an emergency, there’s been laws in States and all began when New York states started the surprise Bill law April 1st 2015, April Fool’s Day. One of my clients had excellent coverage and need emergency surgery. She even had multiple types of coverage. She did not just one policy. So the insurers paid
- [Is Cyberknife Radiosurgery Covered?](https://adriagross.com/is-cyberknife-radiosurgery-covered/) - I don’t know if he ever heard of this one, but cyber knife radio surgery I handle the case recently and was able to get my client covered for a hundred thousand dollars. You have to be careful as for what your insurance policy will cover.Every insurance policy differs on what they’ll cover. You know
- [Out of Network Gynecologist Gets Paid Even with an HMO Policy](https://adriagross.com/out-of-network-gynecologist-gets-paid-even-with-an-hmo-policy/) - So this is a crazy case where my client had difficulty with pregnancy. She needed surgery and she found the gynecologist that was out of network. The gynecologist told my client that even though he was out of network, he would come in to do the surgery after the first surgeon made the incision.The first
- [$500,000 Out of State Medical Bill Gets Covered in Full](https://adriagross.com/500000-out-of-state-medical-bill-gets-covered-in-full/) - I worked on a case involving in New York City hospital where this person had brain surgery. Even though the hospital was paid money from her insurance company, which was out of state. She came from the Midwest to New York and her out of state insurance company paid for at the hospital was still
- [Medical Insurance Advocate and Attorney Work Together to Reduce a $370,000 Claim to $12,000](https://adriagross.com/medical-insurance-advocate-and-attorney-work-together-to-reduce-a-370000-claim-to-12000/) - See now, I do a lot of work for law firms. They often. Call me in. I am considered to be an expert witness in cases. So this Law Firm came to me asking me to consult a case involving a surgeon’s bill for $373,000. When I was able to prove how much the provider
- [How to Get a $25,000 Medical Bill Paid if Denied by Health Insurance](https://adriagross.com/how-to-get-a-25000-medical-bill-paid-if-denied-by-health-insurance/) - Hi, everyone, one of my clients had surgery and her major insurance company would not pay it. When I was able to prove that this surgery was medically necessary. That’s how they often deny saying it wasn’t medically necessary. So when I was able to prove that this surgery was medically necessary the insurance company
- [Why You Shouldn't Pay Your Medical Bill Right Away](https://adriagross.com/why-you-shouldnt-pay-your-medical-bill-right-away/) - I tell people all the time don’t ever go ahead and pay your medical bill. Very frequently they’re just overcharging you. So, I was recently hired by an attorney for a case in which the client was being charged $61,922. After reviewing the reasonable customer charges, I was able to reduce the bill where the
- [$176,000 Bill Reduced to $0 After Speaking with a Medical Bill Advocate](https://adriagross.com/176000-bill-reduced-to-0-after-speaking-with-a-medical-bill-advocate/) - This is the case which involved Believe It or Not $176,000, and after receiving the medical records from the hospital and determining what the provider had a right to bill for the bill believe it or not. It was reduced from $176,000 to zero. So, when you see these astronomical bills do not hesitate to
- [Bloodwork Lab Fees too High? See How to Reduce Them](https://adriagross.com/bloodwork-lab-fees-too-high-see-how-to-reduce-them/) - Have you ever seen blood work lab fees where you might be charged thousands of dollars? Very often lab charges might not be covered under your insurance or it might be part of your deductible which some of them are so high. So I recently had a case where I saved a client $4,000 just
- [Watch This if You've Ever Had Major Dental Work](https://adriagross.com/watch-this-if-youve-ever-had-major-dental-work/) - If you’ve had major dental work, you might want to think about what I’m about to say. You send your claims in and there are issues on how the bills are submitted very often. You might be covered through your medical policy for dental services due to an injury. Now, you might have dental insurance. That’s
- [How to Reduce Medical Bills Even if the Doctor is Out of Network](https://adriagross.com/how-to-reduce-medical-bills-even-if-the-doctor-is-out-of-network/) - So I’m going to tell you a really crazy story. I handled a case where this woman had a blockage in her fallopian tubes. She was having a rough time getting pregnant. So she had an HMO policy and the doctor she hired was not on her plan.The doctor who is performing the surgery did
- [Need Reimbursements for Medical Charges?](https://adriagross.com/need-reimbursements-for-medical-charges/) - Too many times people are incapable of submitting their medical bills, and you know when you think about it, you know, someone has dementia there are unable to find time. They might be too sick or there’s like multiple reasons. I have a case right now where this woman lost her husband and she’s so
- [Why You Should Never Allow Medical Bills to Go to Collections](https://adriagross.com/why-you-should-never-allow-medical-bills-to-go-to-collections/) - This was a recent case where these two gentlemen were skydiving. One of the gentleman’s claims was totally paid for but the other one was not. I just want to tell you it involved two different insurance companies. So, you know, everybody always says to me which one’s better. I can’t tell you, but this
- [This Medical Bill Advocate Was able to Get a $26,000 Bill Paid After Insurance Denial](https://adriagross.com/this-medical-bill-advocate-was-able-to-get-a-26000-bill-paid-after-insurance-denial/) - So, a recent case involved a bill for $26,000. The issue was a problem with the medical billing company for the medical provider. Believe it or not, they had incorrect information about who the insurance carrier was for the patient. So the client never informed the medical provider of this new coverage, and finally I
- [What to do When Medical Insurance Doesn't Pay What Doctors Charge](https://adriagross.com/what-to-do-when-medical-insurance-doesnt-pay-what-doctors-charge/) - So, I recently had a case where a gentleman started out with bills of over $33,000. All the medical providers were gouging on this gentleman’s charges. I mean, you’ll see this all the time where they gouge. So I was able to reduce the bills from over $33,000 down to $11,000. The problem was that
- [What to do if You Can't Use a Specific Doctor Outside of Your Network](https://adriagross.com/what-to-do-if-you-cant-use-a-specific-doctor-outside-of-your-network/) - There are times when a patient is unable to see a doctor who’s on their plan. So when this happens, it’s best to contact your insurance company and see if you can request an exception. And if you’re able to prove that there’s no other doctor who can provide these Services who’s on your plan.
- [Surgeon Bill of $273,000 Reduced to $27,000](https://adriagross.com/surgeon-bill-of-273000-reduced-to-27000/) - I’m very often hired by an attorney to help their clients with their bills. And I was called into a case where the doctor performed back surgery, and this doctor was requesting over $273,000. After reviewing all the bills, I was able to make a reduction, of, you started out at $273,000, I reduced it
- [The Easiest Way to Get Your Insurance Company Paying Your Claims](https://adriagross.com/the-easiest-way-to-get-your-insurance-company-paying-your-claims/) - An attorney recently brought me into a case, which was almost twelve thousand dollars. The claim was definitely payable, but the issue was the insurance company kept on denying it. Just remember, this is when you are able to prove that according to your health insurance policy this procedure is covered. You can get that
- [Will Your Insurance Cover Hearing Aids for Your Child?](https://adriagross.com/will-your-insurance-cover-hearing-aids-for-your-child/) - I recently had a case where this four year old boy could not get a cochlear implant. The crazy part about the insurance policy was If the child was deaf in one ear but not the other the insurance company would not cover the procedure. So I asked you if you have the time and
- [How to Reduce a $240,000 Medical Bill to $15,000 When You Have Travel Insurance](https://adriagross.com/how-to-reduce-a-240000-medical-bill-to-15000-when-you-have-travel-insurance/) - I handled a case for a client who had bills from over 15 medical providers. It has to be like maybe 17 or 18 and this is really I need to it’s good to listen to this because I’m sure you have relatives who come here to the United States and they have travel insurance.
- [What to Do if Rehab or Nursing Homes Deny Long Term Care Policies](https://adriagross.com/what-to-do-if-rehab-or-nursing-homes-deny-long-term-care-policies/) - Adria Gross discusses what to do if rehab or nursing homes deny long term care policies on the Greenburgh Report with Supervisor Paul Feiner. admin See Full Bio
- [What’s an Ambulatory Surgery Center, and How Does it Affect Your Medical Bills](https://adriagross.com/whats-an-ambulatory-surgery-center-and-how-does-it-affect-your-medical-bills/) - Adria explains what an ACS is on your medical bills. If the provider or billing company wants you to pay these bills, this is what you can do about it. Contact Adria Adria Gross Medical Insurance Advocate See Full Bio Adria Gross
- [Will Your Medical Bills be Fully Covered After A Legal Settlement?](https://adriagross.com/will-your-medical-bills-be-fully-covered-after-a-legal-settlement/) - Will your settlement be enough to cover all your medical bills? Watch Adria explain what you can do if this happens to you. Contact Adria admin See Full Bio
- [A $7,000 Medical Bill Written Off Because of This](https://adriagross.com/a-7000-medical-bill-written-off-because-of-this/) - Adria explains how she helped a client get a hospital to write off $7,000 in medical bills. Contact Adria Adria Gross Medical Insurance Advocate See Full Bio Adria Gross
- [Proving That You Really Have a Disability](https://adriagross.com/proving-that-you-really-have-a-disability/) - How can you prove you have a disability? Watch this video where Adria explains how she helped a client with a disability and help them claim a monthly income. Contact Adria Adria Gross Medical Insurance Advocate See Full Bio Adria Gross
- [Can Medicare Bills be Paid Off By the Hospital](https://adriagross.com/can-medicare-bills-be-paid-off-by-the-hospital/) - Adria has helped hundreds of people reduce or eliminate their medical bills, but is it possible to get a Medicare bill marked as “Paid” by the hospital? Watch the video and find out. Contact Adria Adria Gross Medical Insurance Advocate See Full Bio Adria Gross
- [How to Legally Bring a Medical Bill Down from $5,300 to $2,000](https://adriagross.com/how-to-legally-bring-a-medical-bill-down-from-5300-to-2000/) - The size of the bill doesn’t matter to the person who can’t afford it. See how Adria was able to help her client decrease the medical bill for a hospital employee. You’ll be surprised about the added benefit she was able to deliver for this client. Contact Adria Adria Gross Medical Insurance Advocate See Full
- [How to Get Your Medical Bills out of Collections and Fully Paid](https://adriagross.com/how-to-get-your-medical-bills-out-of-collections-and-fully-paid/) - Here’s a “funny” story about a gentleman in the West Coast who had a extremely limited medical insurance and worked for a hospital. The large bill was sent to collections and Adria was able to help him with most of the balance. See how she was able to help in this video. Contact Adria Adria
- [What You Can do if Medicaid Doesn't Pay the Medical Bill](https://adriagross.com/what-you-can-do-if-medicaid-doesnt-pay-the-medical-bill/) - Medicaid bills are rare, but when it does happen, Adria explains what you can do if you ever get a medical bill that was supposed to be covered. Contact Adria Adria Gross Medical Insurance Advocate See Full Bio Adria Gross
- [Adria Helps Texas Client Reduce Bill from $35,000 to $3,000](https://adriagross.com/adria-helps-texas-client-reduces-bill-from-35000-to-3000/) - As a medical bill advocate, Adria Gross helped a Texas client reduce their medical bill from $35,000 to only $3,000. Watch this short video and see how she did it. Contact Adria Adria Gross Medical Insurance Advocate See Full Bio Adria Gross
- [Have Questions About Long Term Care Policies?](https://adriagross.com/have-questions-about-long-term-care-policies/) - What questions would you like answered about Long Term Care policies? Adria Gross has helped individuals from New York to Texas answer their Long Term Care policy questions. This video explains how you can get help. Contact Adria Adria Gross Medical Insurance Advocate See Full Bio Adria Gross
- [Medical Bill Advocate Helps Client in California with $700,000 Bill](https://adriagross.com/medical-bill-advocate-helps-client-in-california-with-700000-bill/) - It doesn’t matter if you’re in New York, or California, Adria Gross can help you with medical bills. This video shows how Adria helped a client with a $700,000 medical bill. You’ll be surprised how she was able to help. Contact Adria Adria Gross Medical Insurance Advocate See Full Bio Adria Gross
- [This is Adria's Story As Presented to Master Networks](https://adriagross.com/this-is-adrias-story-as-presented-to-master-networks/) - Adria Gross has been helping individuals with their unpaid medical bills for a long time now, but have you heard how she started this business? This video presentation tells the full story behind her beginnings and why she wants to help as many people as possible, as a medical insurance advocate. Contact Adria Adria Gross
- [What to Do When Medicare Doesn't Pay Because They Say It's Pre-Existing from 20 Years Ago](https://adriagross.com/what-to-do-when-medicare-doesnt-pay-because-they-say-its-pre-existing-from-20-years-ago/) - Have you ever received a medical bill that wasn’t covered because Medicare says it was from a pre-existing condition? This video shows what you can do to get that bill paid so that you can have peace of mind. Contact Adria Adria Gross Medical Insurance Advocate See Full Bio Adria Gross
- [A Two Million Dollar Denied Medical Claim Gets Paid After Getting Adria Involved](https://adriagross.com/a-two-million-dollar-denied-medical-claim-gets-paid-after-getting-adria-involved/) - The fear of not knowing how to get through with paying your medical bills, regardless of the amount you owe, can be debilitating. This video shows how Adria was able to help one of her clients with medical debts totaling over 2 million dollars. Contact Adria Adria Gross Medical Insurance Advocate See Full Bio Adria
- [Canadian Woman with Deformity Gets Surgery in U.S. Reduces Bill from $125K down to 7K](https://adriagross.com/canadian-woman-with-deformity-gets-surgery-in-u-s-reduces-bill-from-125-down-to-7k/) - What happens when residents from Canada visit the U.S. for surgery and the bill is astronomical? Adria explains a case study for one of her clients, and shows you what you can do in the same situation. Contact Adria Adria Gross Medical Insurance Advocate See Full Bio Adria Gross
- [Can Electronic Convulsive Therapy Help With Depression and be Covered by Medical Insurance?](https://adriagross.com/can-electronic-convulsive-therapy-help-with-depression-and-be-covered-by-medical-insurance/) - There are times when people are so depressed, and they’ve tried all types of medication. Sometimes they have no other options and try ECT. These are frequently performed in a hospital. It’s mostly an outpatient treatment, but due to COVID, it may have been in-patient. See how Adria can help if you have this type
- [How Long Do You Have to Submit Your Medical Claims for Payment](https://adriagross.com/how-long-do-you-have-to-submit-your-medical-claims-for-payment/) - What happens if you let your claims pile on over time, and don’t submit them to be paid by the insurance company in a timely manner. This is what happened to one of Adria’s clients. See how you can avoid this situation by watching this video now. Contact Adria Adria Gross Medical Insurance Advocate See
- [How to Overturn a $30k Denied Medical Claim](https://adriagross.com/how-to-overturn-a-30k-denied-medical-claim/) - What do you do when you have a $30,000 medical insurance bill, which was denied and can’t get it paid by the insurance company? Watch this video and see what it takes to get it paid. Adria Gross Medical Insurance Advocate See Full Bio Adria Gross
- [What to Do for Health Insurance When Traveling From Another Country](https://adriagross.com/what-to-do-for-health-insurance-when-traveling-from-another-country/) - Do you have parents, or elderly relatives traveling from another country into the U.S.A.? What do you for health insurance? This video warns you about what not to do, and reveals the best way to protect yourself against medical expenses that can ruin your visit. Adria Gross Medical Billing Advocate See Full Bio Adria Gross
- [The Business Power Hour with Adria Gross](https://adriagross.com/the-business-power-hour-with-adria-gross/) - Adria Gross Medical Billing Advocate See Full Bio Adria Gross
- [A Dose of Advice How to Avoid Unexpected Medical Bills](https://adriagross.com/a-dose-of-advice-how-to-avoid-unexpected-medical-bills/) - In an interview at Lasell University, Adria Gross explains how to avoid unexpected medical bills for you and your family. The presentation is followed by Q&A where more answers follow great medical insurance advocacy questions. Adria Gross Medical Billing Advocate See Full Bio Adria Gross
- [How to Get Out of State Medical Claims Paid](https://adriagross.com/how-to-get-out-of-state-medical-claims-paid/) - In this interview, Adria discusses how she was able to get out of state medical claims paid. If you’ve ever had issues with your bills not being covered because you were out of state, this is a must see interview. Adria Gross Medical Billing Advocate See Full Bio Adria Gross
- [What is Balance Billing?](https://adriagross.com/what-is-balance-billing/) - Have you ever received a large bill from the hospital, and have your insurance pay a portion, and leave you with the bulk of the balance? That is balance billing, and watch this episode to discover how Adria is helping a client with a $102,000 medical insurance debt. Like this? Please share. Adria Gross Medical
- [Medical Bills and Arbitration: Surprise Billing is Coming to an End, What is the Solution?](https://adriagross.com/medical-bills-and-arbitration-surprise-billing-is-coming-to-an-end-what-is-the-solution/) - Individuals have the power to make contracts with people over almost anything, so long as all parties mutually agree and are aware of the stipulations within the agreement. The issue with medical billing in an emergency is that people are agreeing to receive care from professionals when they are not in an equal bargaining position,
- [Surprise Medical Bills and Balance Billing or Just Billed](https://adriagross.com/surprise-medical-bills-and-balance-billing-or-just-billed/) - When you go to a hospital that is In-Network it only seems natural to think that everyone you work with at the hospital is covered within the facility. However, that is not the case. Clients have even come to me where they received medically necessary care at an in-network facility only to be taken to
- [Faith-Based Health Cost Sharing Vs. Associated Health Plans](https://adriagross.com/faith-based-health-cost-sharing-vs-associated-health-plans/) - Taking care of our health can be a costly endeavor. The ability to pay can become a matter of life and death if bills rack up over long term care that falls into collections. That is why having insurance is so important during unexpected emergencies or when someone has a chronic illness. Medwise Insurance Advocacy,
- [10 Tips to Lower Mental Health Costs](https://adriagross.com/10-tips-to-lower-mental-health-costs/) - Is Mental Health Care Covered? Mental Health Care has a huge range of care possibilities and little coverage options. Insurance often pays for services that are medically necessary in an emergency or when referred to specialists as medically necessary from a primary care physician. Patients have to ensure that the doctors that treat them are
- [How to Get Your Denied Bill Claims Paid](https://adriagross.com/medical-insurance-advocacy-adria-gross-interview/) - Why Hire Medical Insurance Advocate Adria Gross? If you’ve ever had medical bills denied by your insurance company, this video interview reveals why it’s important to hire a medical insurance advocate. Insurance advocacy is a necessary service many people are not aware of, and certainly need. This short interview will tell you how to utilize
- [Adria Gross Case Study as a Medical Insurance Advocate](https://adriagross.com/adria-gross-case-study-as-a-medical-insurance-advocate/) - Another Reason to Hire a Medical Insurance Advocate Adria Gross reveals a case study that you need to hear about if you’ve ever had denied medical bill claims. As a medical insurance advocate, Adria breaks down exactly what she’s doing to get a large claim paid for one of her medical billing client. Like this?
- [Have a Health Sharing Plan? Here's How to Get Your Denied Claim, Paid.](https://adriagross.com/have-a-health-sharing-plan-heres-how-to-get-your-denied-claim-paid/) - This video covers a case study about a person who is a member of a share health plan. See how Adria was able to get them to cover the maximum benefit amount for her client. If you have similar issues, contact Adria right away by clicking here. Like this? Please share. Adria Gross Medical Insurance
- [How Deductibles and Copays Affect Medical Bills](https://adriagross.com/how-deductibles-and-copays-affect-medical-bills/) - How do deductibles and copays affect your out of pocket medical expenses? This video reveals a case study where a high deductible was interfering with getting medical claims paid, and what Adria did to reduce the out of pocket expense for her client. Like this? Please share. Adria Gross Medical Insurance Advocate See Full Bio
- [What Are Reasonable and Customary Charges for Specific Procedure Codes?](https://adriagross.com/what-are-reasonable-and-customer-charges-for-specific-procedure-codes/) - This is a very interesting story where you’ll discover how procedure Codes affect reasonable and customary charges when you go to the hospital. See how Adria reduced a massive hospital bill by applying her knowledge and experience as a medical insurance advocate. Like this? Please share. Adria Gross Medical Insurance Advocate See Full Bio Adria

## Pages

- [Home](https://adriagross.com/) - Medical Insurance Advocate, Adria Gross can help if you've been denied medical claims, or not properly reimbursed. Contact Adria today.
- [Media](https://adriagross.com/media/) - Like this? Please share. Hospital Billing Advocacy for Denied Medical Claims Hospital billing advocacy can help you determine whether a denied medical claim should be corrected, appealed, reduced, or paid before More » September 9, 2026 Important Questions About College Student Medical Insurance I hope I helped you with some information today. When it comes to
- [Q&A](https://adriagross.com/questions-and-answers/) - If you have declined medical bills by your insurance company, these interviews will answer many questions on how to get the denied medical bills paid. Watch each video and see if your questions are answered. If you still need help, click here to reach out to Adria and she will help with your specific needs.
- [Books Published](https://adriagross.com/books-published/) - Books Published Physical or mental handicaps can make one seem apparently different from others and lead to being excluded or included with an inferior status. Apparently DIFFERENT, written by over a score of authors who know this situation intimately, will make its readers realize the importance of treating all of us as precious human beings.As
- [Contact Adria](https://adriagross.com/contact-adria/) - Contact Adria If you’d like Adria to speak at your organization, for education or fund-raising purposes or if you have a medical billing or insurance advocate need, or would like to contact her please call (845) 238-2532 , or complete this form. Full Name Email If inquiring about help with medical bills, how much do
- [Testimonials](https://adriagross.com/testimonials/) - Testimonials I had the good fortune to speak with Ms. Gross on some insurance issues that were plaguing me, and she recommended that I buy her book. Thanks to Ms. Gross’ advice over both the phone and in print, I was able to successfully negotiate my unreasonable hospital bill down by a significant percent.There is
- [Awards](https://adriagross.com/awards/) - Awards 2008 – Insurance Professional of the Year Award (from the Insurance Professionals of Orange County, N.Y.)2009 – Pinnacle Leadership Orange Award2011 – Autism Move-a-thon of Orange County – Volunteer of the Year Award from Mental Health Association of Orange County2013 – YMCA Special Award in Appreciation for Spirit, Drive and Dedication in Bringing a Y Presence to Southern
- [Privacy Policy](https://adriagross.com/privacy-policy-2/) - Definitions and legal references This Website (or this Application) The property that enables the provision of the Service. Owner (or We) MedWise Insurance Advocacy - The natural person(s) or legal entity that provides this Website and/or the Service to Users. User (or You) The natural person or legal entity that uses this Website. Service The

## Categories

- [Medical Billing Advocate](https://adriagross.com/category/medical-billing-advocate/)
- [Insurance Advocate](https://adriagross.com/category/insurance-advocate/)
- [Medical Bill Advocate](https://adriagross.com/category/medical-bill-advocate/)
- [Videos](https://adriagross.com/category/videos/)
- [Blog](https://adriagross.com/category/blog/)
- [Blogs](https://adriagross.com/category/blogs/)
- [Q&A](https://adriagross.com/category/qa/)

## Tags

- [arbitration](https://adriagross.com/tag/arbitration/)
- [medical bills](https://adriagross.com/tag/medical-bills/)
- [surprise billing](https://adriagross.com/tag/surprise-billing/)
- [insurance advocate](https://adriagross.com/tag/insurance-advocate/)
- [billing advocate](https://adriagross.com/tag/billing-advocate/)
- [mental health care](https://adriagross.com/tag/mental-health-care/)
- [mental health costs](https://adriagross.com/tag/mental-health-costs/)
- [Adria Gross](https://adriagross.com/tag/adria-gross/)
- [Health Claim Advocate](https://adriagross.com/tag/health-claim-advocate/)
- [Medical Bill Advocate](https://adriagross.com/tag/medical-bill-advocate/)
- [Reduce Medical Bill](https://adriagross.com/tag/reduce-medical-bill/)
- [Get Medical Bills Paid](https://adriagross.com/tag/get-medical-bills-paid/)
- [Denied medical claims](https://adriagross.com/tag/denied-medical-claims/)
- [health insurance advocate](https://adriagross.com/tag/health-insurance-advocate/)
- [medicare advantage](https://adriagross.com/tag/medicare-advantage/)