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 […]
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 […]
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 […]
Bee Sting Leads to Emergency Room Bill Not Covered by Insurance
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 […]
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 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 […]
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 […]
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