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 […]
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
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 […]
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 […]
$85,000 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 […]
Hospital Billing Advocate Secrets Doctors Don’t 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 […]
Rehab for Drugs and Alcohol $70,000 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?
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 […]
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 […]
$6,000 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 […]