College Students Must Prove What?
Students in college are normally able to purchase health insurance through their university. I’ve handled many cases involving college health insurance. I must say, the health carriers are very suspicious when the students are submitting claims, and very often, the college student, with each and every claim, has to prove that they are the insured. I couldn’t believe […]
Why a Letter of Medical Necessity May Save You Thousands
Medical claims that require pre-approvals or claims involving newly developed drugs or treatment, and many types of behavioral health treatment may require a letter of medical necessity from the treating doctor before the claim is approved. Claimants should be aware that their physicians are ready and willing to back up their claims. You do not want to […]
State vs Federal Regulations for Health Insurance Claims
State vs federal regulations can dramatically affect how denied medical claims, insurance appeals, billing protections, and patient rights are handled across the United States. Many patients assume all health insurance rules operate under one unified system, only to discover that state laws and federal laws sometimes overlap, conflict, or apply differently depending on the insurance […]
HIPAA Privacy Rules Explained for Insurance Claims and Appeals
HIPAA privacy rules explained in simple terms can help patients protect their medical information while navigating denied medical claims, health insurance disputes, and complex billing situations. Across the United States, many people feel confused about what healthcare providers, insurance companies, and third parties are legally allowed to access or share. That confusion often becomes even […]
Dispute Resolution for Self Paying Individuals
Hello, everybody. I hope you’re having a fabulous day. Dispute resolution establishes a process for solving billing disputes between patients, providers, and insurance plans, and particularly for uninsured or self-paying individuals. MedWise will help you to dispute any of your medical bills. Please call me. I’m here to help you. https://vimeo.com/1188114630?share=copy&fl=sv&fe=ci
Always Ask for the SPD
Hello, my friends. Have you ever heard of an SPD? Summary Plan Description. Ask for this information from your health insurance carrier. This description will help you to understand what you are covered and not covered for on your health insurance policy. When I am appealing your claims, this information will help me to better understand your […]
What is a Good Faith Estimate?
Good faith estimate requires providers to provide uninsured or self-pay patients with a good faith estimate of the total cost of care before services are rendered. I recommend always asking in advance how much your procedure will cost, and you should never be billed more than that amount. Please ask for it in writing, and I’m here […]
Premiums, Deductibles, and Copays Explained
Understanding premiums, deductibles, and copays is the key to knowing why your insurance didn’t pay—and why your healthcare bills may be higher than expected. You pay your monthly premium, assume you’re covered, and then a bill shows up that doesn’t match your expectations. Or worse, your claim is denied and you’re left wondering what went […]
College Insurance Pros and Cons
When a student has college insurance, that policy is a primary insurer. Sometimes the parents or guardian might still have them on their policy, which would be secondary to the college health insurance policy. Here are the positives and negatives about college health insurance. College insurance, the advantages are. The policies are written according to what the […]
Can Itemized Bills Save You Thousands?
To help you save a tremendous amount of money, request itemized bills to understand what you have been charged for. All too often, you’re charged for services that were never rendered, and that is why it’s so important that you keep a copy of your medical records. Recently, I saved a client over $10,000, since […]