Medical Bill Advocate

Use Due Diligence to Negotiate Medical Bills

Associated health plans and self-insurance programs are increasingly part of the healthcare marketplace and they are leading a movement of comparative shopping for medical care and prescriptions . Over 90% of patients want to know what their costs will be for care prior to service. In January 2019 a federal requirement insists hospitals list their service prices on the hospitals website. Unfortunately, the prices are not the same across the board and there is not an industry standard service [...]

Read more...

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, [...]

Read more...

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 [...]

Read more...

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 [...]

Read more...

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 [...]

Read more...

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 [...]

Read more...

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 [...]

Read more...

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), [...]

Read more...

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 [...]

Read more...
"It is a Gift to Negotiate"

2 Clients with Over 1.5 Million in Denied Medical Bills are Paid

Last month, I shared a story about a woman, who had medical bills that had to be negotiated, totaling close to a million dollars and the bills were paid in full to the hospital from her insurance company. Now, I will tell a story of a woman, who had medical bills over $500,000, from out-of-state care. Between the 2 cases, with very different facts and billing complications, MedWise Insurance Advocacy saved 2 clients over 1.5 million dollars in less [...]

Read more...