At A Nursing Care Facility with Medicare Advantage Plan?
Hello everyone. Recently I received many phone calls for people who purchase a Medicare Advantage plan. Rather than having a Medicare coverage with a supplement and a prescription plan, I always tell people, you have one card or three cards. When people go into a rehab center and they have a Medicare Advantage plan, they’re […]
Out of Network Provider Not Submitted Your Medical Bills on Time?
I hope you’re having a fabulous day. Have you been seen by an out of network provider who has not submitted your medical bills on time? If, you have not paid the provider yet and they have not submitted the bills, you might want to not even be responsible to pay the provider. I recently […]
Hip Replacement With Authorization Was Denied
I hope you’re having a great day. Uh, you know, one of my recent clients had hip replacement and there was pre-authorization for the hip replacement and it was supposed to be covered, but due to incorrect procedure codes, the bill for $85,000 was denied. The bills were being submitted by an outside billing company […]
Denied Medical Bills Over $90,000 Overturned
Hello everyone. I had a recent case where this person kept on receiving denied medical bills and they had excessive billing from the providers. To make things even worse, his insurance company changed over the time period when he was having these multiple procedures involving surgery. A couple of the providers were out of network […]
Out of Network Emergency Room Covered?
I recently had a client who wound up in emergency room in a hospital, which was out of network since the ambulance took them right to the out-of-Network Emergency Room. I must say it took quite a period of time for me to overturn the case, but I was finally able to have the insurance […]
Incorrect Billing Resulted in $2,000 Overcharge
I recently handled a claim where they felt the billing was incorrect. The mother gave birth to this little baby boy. She received a bill from a private office, which she never saw this provider while she was in the hospital, the bill was $2,000 and when we were able to prove that the services […]
Broken Jaw Medical Bill Denied Because Not Medically Necessary?
I was recently able to help a family who had $35,000 worth of bills. They had a fall, broke their jaw, and believe it or not, this also involved multiple insurers. The insurers kept on denying the claims stating, even though she broke her jaw, it wasn’t necessary for her to have covered charges. Crazy. […]
15 Providers Out of Network Denying Your Medical Claims?
I recently worked with a client who had 15 different providers, and this case was like around 270 to 300 claims. They were denied as out-of-network. She also had limited visits on her physical therapy. It took a tremendous amount of work, but I was able to prove that it was her, that she was […]
Who Covers When Multiple Insurance Policies?
I had a case recently involving three insurance companies. The insured was working as a New York City police, and his wife was covered under his plan it the beginning. The insurance companies would not speak with the other, the other ones, but when we had to go to a higher level, which we did […]
Wheelchair Medical Expense Not Covered?
I was referred a client who was unable to get a wheelchair through his health insurance plan. It was interesting that the reason for that is the insurance company thought he had another insurance carrier when we were able to prove that he only had one health insurance policy. He was finally able to be […]