EHR and EMR Systems Explained for Denied Medical Claims
EHR and EMR systems explained in simple terms can help you understand why a denied medical claim may involve more than just your insurance company. Your medical records, diagnosis codes, treatment notes, referrals, orders, and other information often originate inside electronic healthcare systems. If something is missing, incomplete, or entered incorrectly, the problem may eventually […]
Medical Bills Should Have Reasonable and Customary Charges
I understand you’re facing a denied insurance claim for an $8,000 bill, which has now increased to $10,000 due to interest. Please keep in mind that for emergency room visits, you generally should not be charged more for out-of-network services than what an in-network provider would cost. I recommend contacting MedWise so we can review […]
Did Your Medical Bill Have Incorrect Charges
When you receive a medical bill, it’s really important to review it carefully to ensure it accurately reflects the care you received. Always look for duplicate charges or any other errors. If something on your bill seems incorrect or raises questions, start by contacting the provider’s billing department for clarification. If you don’t get a […]
Pediatric Billing Advocacy for Denied Medical Claims
Pediatric billing advocacy can become critical when your child receives necessary medical care but the insurance company denies the claim, leaving you confused about what happened and what you may owe. When you are already focused on your child’s health, fighting with insurance can feel like a second emergency. Before assuming the bill is correct, […]
Are You In Collections With Medical Bills?
When clients reach out to me regarding an outstanding medical bill, my first question is always, “Are you in collections?” It’s really crucial to avoid the situation, because once a bill goes to collections, settling the case becomes significantly more challenging. If there’s an error on the bill, you can approach the provider directly to […]
What is A Financial Assistance Policy
If you are uninsured or underinsured, you might be eligible for financial assistance directly from the hospital. The Affordable Care Act, ACA, mandates that hospitals maintain a written financial assistance policy, that’s called an FAP, financial assistance policy, and an emergency medical care policy. These programs can potentially offer you free or reduced cost medical […]
Chronic Illness Patient Advocacy for Denied Medical Claims
Chronic illness patient advocacy becomes especially important when managing your health also means fighting repeated insurance denials, confusing medical bills, prior authorization problems, and endless phone calls. For someone living with a chronic condition, one denied claim may be frustrating. Several denials involving medications, specialists, treatments, testing, or medical equipment can quickly become financially and […]
Are You Entitled to COBRA?
I hope this is not happening to you. Are you about to lose your job? What are you going to do for health insurance? Are you entitled to COBRA? Well, what’s COBRA? It’s a federal law offering temporary health coverage continuation after certain life events. Well, who is it for? It’s for employees, spouses, and […]
Durable Medical Equipment Billing Denied? What to Do Next
Durable medical equipment billing can become frustrating fast when an insurer denies a wheelchair, CPAP machine, hospital bed, brace, oxygen equipment, or another medically necessary item. You may have a prescription, a doctor’s recommendation, and a legitimate medical need, yet still receive a denial or unexpected bill. The important thing to understand is that a […]
What is a Facility Fee on Your Medical Bill?
Have you ever heard of a facility fee? A facility fee is an extra charge that hospitals add to cover overhead costs such as equipment, maintenance, support staff, and security. Even if the visit is virtual or at a hospital-owned outpatient clinic, they might have these additional fees. So patients often unknowingly agree to these […]