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 […]
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
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
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?
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?
I recently worked with a case where the person gave birth and since the provider was outta network, they were billing her only $15,000. I was able to prove by sufficient medical records and a review of the health insurance policy that she should have been covered for this provider, even though they were out […]
15 Providers Out of Network Denying Your Medical Claims?
I recently worked with a client who had 15 different providers, and this case was like around 270 to 300 claims. They were denied as out-of-network. She also had limited visits on her physical therapy. It took a tremendous amount of work, but I was able to prove that it was her, that she was […]
Who Covers When Multiple Insurance Policies?
I had a case recently involving three insurance companies. The insured was working as a New York City police, and his wife was covered under his plan it the beginning. The insurance companies would not speak with the other, the other ones, but when we had to go to a higher level, which we did […]
Wheelchair Medical Expense Not Covered?
I was referred a client who was unable to get a wheelchair through his health insurance plan. It was interesting that the reason for that is the insurance company thought he had another insurance carrier when we were able to prove that he only had one health insurance policy. He was finally able to be […]
Hospital Bill Determined as Not Medically Necessary?
I hope you’re having a beautiful day today. I had a case recently where the gentleman was in the hospital due to severe leg pain. He spent two nights at the hospital and was stuck with over $45,000 in medical bills. The insurance company was stating that the two nights at the hospital were not […]