Are Low Cost Associated Health Plans Worth It?

Your health is great, until it isn’t. Health care plans that are pitched to someone who is healthy may not necessarily cover them when sick, especially if a low cost Associated Health Plan (AHP) is purchased. The latest news in healthcare is the introduction of AHPs that offer alternative coverage that is not governed by the Affordable Care Act. These plans boast being a cost saver for small businesses and sole entrepreneurs. Although plans will be flexible and inexpensive, [...]

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How Medical Billing Advocates Negotiate to Help Pay Medical Bills

Medical bills become a problem after claims have been denied from insurance carriers and paying off the bills becomes a game of negotiation. This is where a medical billing and insurance advocate can help negotiate and appeal medical claim denials.   Why Medical Claims are Denied Claims may be denied because the insurance carrier decides that it is not medically necessary, the care was out-of-network or experimental, the procedure was done in an inappropriate health care setting (in-home vs. hospitalization), policy cancelled [...]

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Is a Settlement or Court Ordered Judgment Protected from Subrogation?

Can Medical or Insurance Providers Claim Rights over Settlement or Judgment Money? Medical providers ask a lot of questions about how and why you are seeing them. During this inquisition it gives them information needed to care for you, as well as, an insight into the likelihood that someone else is responsible for the injury. Insurance carriers will also ask a series of questions to determine the same things. Medical providers are barred from double-billing and balance billing, restricting their [...]

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Save on Prescription Medications

Venturing out to cut costs for prescriptions can be like wandering down a dark ally while haggling for the best price at the busiest market. The price of a medication can vary greatly, even within the same zip code depending on the available retailers. Pharmaceutical companies price medications at a high rate because they do not want to list a price below what the standard price an insurance [...]

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Affordable Care Act Open Enrollment and NYC Workshop

Don’t Miss My Upcoming Workshop or Health Insurance Open Enrollment Although there are ways to lower health care costs when someone doesn’t have coverage, check out the multiple resources I have gathered to help people when they are sick; it is ideal for people to have some form of coverage. For more information on how to lower medical bills, understand how to negotiate denied medical coverage for care, rules for Medicare and NYS Surprise Bill and more come to my next [...]

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Appealing Self-Insured Benefits Denials

Big corporations are no stranger to self-insuring their employees. When an employer only contracts with an insurance carrier for insurance services such as enrollment, claims processing and provider networks with a third party administrator, the employer is agreeing to be the party to payout any medical bills incurred by their employees. Keep in mind, that a self-insured employer doesn’t even have to contract with an insurance company to administer such services and can self-administer their self-insurance. To look up if [...]

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Is Your Medical Benefits Advocate Conflicted?

Companies are relying on advocates from their insurance company to get employee medical bills approved and paid. This is bad news for employees, as in-house human resource positions are removed and the people who are fighting for bills to be approved are conflicted by their true employer… the insurance company. Read more about this conflict of interest and how a third party advocate can save companies and employees money by getting medical bills covered by appropriate parties.   Who Advocates for [...]

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Where to Find Help Paying Medical Bills

 We Need All the Help We Can Get To Pay Medical Bills   I have spoken with people who have lost everything because of an illness. Having to choose between paying rent, buying food or paying for medical care is stressful. The Kaiser Family Foundation reports that in 2016, half of all insurance policy-holders face a deductible of at least $1,000. This is the amount someone has to pay before their insurance starts paying and for some it is even higher. Almost [...]

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National Organizations that Pay for Medical Care

National Organizations that Provide Assistance Paying for Medical Care and Procedures Department of Health and Human Services (DHHS) [hhs.gov] The Department of Health and Human Services (DHHS) has information on assistance in paying for medical care for low-income families. Go to “Families & Children.” Government Benefits [benefits.gov] The official government benefits website. This is a free, confidential tool that locates government benefits. Health Resources and Services Administration [mchb.hrsa.gov] The Health Resources and Services Administration (HRSA) of the DHHS website, Maternal and Child Health Bureau (MCHB), [...]

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Federal and State Programs that Help Pay Medical Bills

Medical care and prescription drugs are expensive.  If someone is struggling paying for medical care or prescription drugs, these state and federal programs may be able to help: HealthCare.gov this site helps find insurance options, compare care, learn about prevention, and understand the Affordable Care Act. State human/social service agencies offer direct aid and referrals to other organizations. These organizations and the people who work for them are invaluable. So many agencies have online forums and resources that help streamline the [...]

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