Mental Health Billing Challenges After a Claim Denial
Mental health billing challenges can interrupt treatment, create unexpected debt, and leave patients wondering whether their insurance company applied the same standards it uses for physical healthcare. A denial may arrive while therapy, psychiatric care, medication management, or substance-use treatment is still urgently needed. Paying immediately may feel like the easiest path, but the claim […]
How I Used the Media to get a $225,000 Medical Bill Paid
Too often when denials occur, we have to go through multiple appeals to resolve the issue. I often ask for help from the media because, many times, that is the only way the insurance company pays the claim. Last summer, I was published in NJ.com, and the article came out in September 2024 about a $25,000 denial […]
The Best Way to Protect Yourself from a Medical Claim Denial
The best way to protect yourself against a denial is to get pre-approval for medical services from your insurer in non-emergency situations. If it is an emergency, it is truly the responsibility of the medical provider to obtain the pre-authorization. Even if your provider is planning to perform surgery on you, it is their responsibility. I recently […]
Surgical Billing Complexity After an Insurance Denial
Surgical billing complexity can turn one medical procedure into several bills, conflicting insurance decisions, and a balance that is difficult to verify. A denial may make it appear that you owe every charge from the hospital, surgeon, anesthesiologist, laboratory, and imaging provider. But one coding problem, authorization dispute, network mistake, or missing document can ripple […]
How to Use a Good Faith Estimate to Reduce Your Bill
A medical provider has to give you a good faith estimate of your costs before you receive services, and you can dispute a bill if it is significantly higher than that estimate. I recently had a case where a dentist told my client the bill would be $8,000, but they were actually charged $22,000. By referencing […]
Different Causes for Disputing a Medical Bill
Here are different reasons you can dispute a bill. You can dispute a bill if you received care and did not have or did not use your health insurance to pay for it. You can also dispute it if, before receiving care, you told the provider you would not be using insurance. Another situation is if you […]
Is The No Surprises Act Working
The No Surprises Act has been helpful in overturning cases and reducing fees when a patient is responsible for part of a bill. It provides protection against surprise bills from out-of-network providers or facilities. I recently handled a case where a client went to the emergency room and, after being denied three times, I reduced the bill […]
Charity Care Qualification After a Denied Medical Claim
Charity care qualification could reduce or eliminate a hospital bill, even when you have health insurance and the insurance company denied your claim. A denial can make the hospital’s full balance feel immediate and unavoidable. You may be urged to begin payments, use a medical credit card, or accept responsibility before anyone explains your financial-assistance […]
The Most Common Reasons for Denied Medical Bill Claims
Why do claims get denied? The most common reasons include missing information, incorrect billing codes, lack of pre-authorization, or service being out of network. Sometimes, the insurer simply doesn’t believe the service was medically necessary. Knowing these reasons can help you spot errors and avoid denials before they even happen. Please call me. I’m here to […]
Getting Denied Is Not the End
Getting denied isn’t the end of the road. You have the right to appeal. That means asking the insurer to reconsider the decision. Start by calling the insurer to understand the denial. Then submit an appeal, usually in writing, with all the supporting documents. Be polite, clear, and timely. You would be surprised how many denials are overturned. […]