Peer-to-Peer Review Process for Denied Medical Claims
The peer-to-peer review process can become one of the most important turning points in a denied medical claim. Across the United States, patients are often shocked to discover that a health insurance company denied treatment, testing, or procedures recommended by their physician without ever speaking directly to the doctor first. That denial can delay care, […]
Has Your Health Insurance Been Incorrectly Terminated?
Has your health insurance been incorrectly terminated? Too many times you are paying your health insurance premium and there’s an error on behalf of your insurance carrier. Your insurance carrier did not code receipt of your monthly premium, and now your claims are being denied. Call MedWise and we will straighten out the error and make sure […]
The Hospital Price Transparency Law
Starting January 1st, 2021, each hospital operating in the United States was required to provide clear, accessible pricing information online about the items and services they provide. However, as of July 9th, 2024, only 16.7% of hospitals nationwide comply with the hospital price transparency rule. You should know in advance what the fees are, and […]
How to Find Patient Advocate Agencies Accepting New Clients
Searching for patient advocate agencies accepting new clients can feel like a desperate hunt for a lifeline in a storm. You know you need an expert navigator, but every call hits a full voicemail, and every email inquiry is met with an automated reply about a six-month waitlist. All the while, the clock is ticking […]
Deceptive Practices in Self-Funding Insurance Plan
Please be careful when choosing a medical insurance carrier policy. There are deceptive practices in the marketplace, but the government has a limited role when it comes to self-funding, self-insured ERISA plans, which are controlled by private insurers. If you know you should be covered but are being denied, please fight for your rights. I […]
Self Employed Individuals Health Insurance
Consider a self-employed individual choosing a health plan from the health insurance marketplace without subsidy eligibility. They might select a silver plan costing about a thousand dollars monthly, thinking it covers in-network doctor visits with a reasonable copay. However, a visit to the doctor may reveal a $200 charge because the deductible was not met. […]
Denied? Get a Medical Claim Appeal Service for Hire
Finding the right medical claim appeal service for hire is the single most important decision after a denial. That letter from your insurer, filled with cold, clinical language, is not just a rejection—it’s the start of a complex, time-sensitive process. You know you need to fight back, but the path is shrouded in red tape, […]
Are Insurers Deliberately Denying Claims
Insurers are motivated to avoid paying for care. Many insurers appear to be utilizing increasingly aggressive tactics to do so, deploying technology and applying pressure to company physicians to scrutinize services recommended by patients’ physicians, and often to deny coverage, leaving patients with unexpected bills or delays in care. You need care, and if you’re […]
Incentives for Over Providing Services
A fee-for-service medical cost arrangement exists in the United States. The more services doctors perform, the higher their incomes. Just as patients have an incentive to overconsume, doctors have an incentive to overprovide. If you’re having difficulties paying your medical bills, call me. I’m the owner of Medwise. We save individuals thousands of dollars on […]
Billing Disputes and Denials of Medical Coverage
I hope you’re having a great day. Think about people’s billing disputes and denials of coverage. What emerges is that many realize positive outcomes when they appeal decisions they perceive to be in error. Yet only half of those who believe that they were erroneously billed or denied care actually challenge the decision or have […]