Having Medicare Advantage Plan Issues
Recently, several Medicare Advantage plans have exited the market, including Premera and the Blue Cross Blue Shield of Kansas City. Also, others have reduced their service areas, such as Aetna and Humana. Prior to the annual enrollment period in 2024, many for-profit health plans signaled their intent to slow growth or even contract membership due to […]
Why Patient Insurance Oversight is Necessary
Okay, you have received pre-authorization for appendicitis. You undergo the surgery, but now your insurance carrier, who approved the surgery, says it wasn’t medically necessary. The bills were over $30,000. I’m asked to help my client with their bills. It took quite a few months, but I was able to get the claim paid. These are just a […]
Is Your Insurance Plan Fully Funded?
One of the misconceptions people experience is whether your health insurance plan is a fully funded plan or if it’s an ERISA plan. This is usually important information that you need to be aware of. When appealing your case, the question is whether to appeal with your health insurance carrier or to go to the Department of […]
Doctor Recommends an MRI?
Your doctor recommends an MRI. Your insurance carrier will not provide pre-authorization. Call Medwise. We are here to get you the services you’re entitled to. Thank you. https://vimeo.com/1117099525?share=copy
How Adria Gross Patient Advocate Beats Insurance Denials
The effectiveness of Adria Gross, patient advocate, stems from a perspective few others possess. When you’re facing a mountain of medical bills or a cold insurance denial, it feels like an unwinnable war against a faceless system. You need more than just a helper; you need a strategist who knows the enemy’s playbook because she […]
Delay of Care Due to Care Denials
You know, over the years I have found that nearly half of respondents who experienced a delay in care following a coverage denial said that their health problems got worse as a result of those delays. Worry and anxiety among those experiencing delays are really universal. Nearly one in six reported cases indicate that care […]
Was Your Medical Bill Much Higher Than it Should Have?
When you know you have been billed much more than you should have, please call midwives. All too often people are taken advantage of on their medical bills. We recently decreased a bill from $1,200 down to $55. Remember, I’m here to help you. Thank you. https://vimeo.com/1117099552?share=copy
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 […]
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 […]
Your Insurance Company Will Not Cover Everything
Some people purchase insurance policies that they think will cover everything. I had a case recently where the policy did not cover for any hospitalization. The original bill was $67,000 and thank you. After negotiations, I was able to bring it down to $6,000. That was a savings of $61,000. If you need help, I’m […]