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 […]
Read this Guide to Surprise Medical Billing Laws FIRST
That bill you’re staring at feels like a betrayal. This essential guide to surprise medical billing laws is for anyone who has felt that gut punch of a medical bill they never saw coming. You did everything right—you went to an in-network facility—but now you’re facing a financial threat from a ghost provider you never […]
Prior Authorization Denial, What to Do Next
That cold dread washing over you as you read the denial letter isn’t just disappointment—it’s a profound sense of injustice. When facing a prior authorization denial what to do next feels like an impossible question, a fight against a faceless corporate giant that holds your health in its hands. This moment of paralysis is exactly […]
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 […]
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 […]