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 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 […]
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 […]
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 […]
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. https://vimeo.com/1092598745?share=copy#t=0
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 […]
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 […]
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
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
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?
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 […]