if a provider does not have pre-authorization for services rendered, which are usually the following procedures, surgery when they’re, uh, doing a procedure and they have to put dye in you, MRI, CAT scan, and, and also involving many other services, your claim is going to be denied if you didn’t have pre-authorization. I recently […]
Who’s Responsible for Preauthorization for Your Medical Procedure? Read More »
In the complex landscape of healthcare and insurance, collaboration is key to overcoming challenges and achieving meaningful change. Medical insurance advocacy is no exception. Collaborative partnerships between medical insurance advocates, healthcare providers, policymakers, and other stakeholders are instrumental in strengthening advocacy efforts, improving patient outcomes, and shaping a more patient-centered healthcare system. This blog post
Strengthening Medical Insurance Advocacy through Partnerships Read More »
Believe it or not, some medical providers are still using outdated CPT or ICD nine codes. A C P T code is the procedure performed and the I C D nine codes are no longer in existence. Now they have these I C D 10 codes and the I C D is your diagnosis. The
Outdated CPT Codes May Cost You Thousands Read More »
Hospital codes, such as Current Procedural Terminology (CPT) codes and International Classification of Diseases (ICD) codes, play a pivotal role in accurately documenting medical procedures and diagnoses. However, using incorrect hospital codes can have significant consequences, including claim denials by insurance companies. This article explores why insurance companies may deny medical claims when incorrect hospital
Why Insurance Companies Deny Medical Claims Read More »
Have you ever been in a situation where your provider did not send the bill out to the insurance company on time? Insurance company usually demand that they receive the bills for services within 3, 4, 6, 9 or 12 months. So this client was directed and was billed over $75,000. When we discussed this
What If Your Provider Does Not Send Out the Bill on Time to the Insurance Company? Read More »
The healthcare journey can be complex, overwhelming, and emotionally challenging for individuals and families. Amidst the complexities of insurance, medical insurance advocates emerge as a beacon of hope, providing personalized support and compassionate guidance. This article delves into the human side of insurance and highlights the invaluable role of medical insurance advocates in offering personalized
The Human Side of Insurance Read More »
If it’s possible, I highly recommend that you keep track of claims that you have received and paid. It’s always best not to pay your medical provider until you receive the explanation of benefits. Sometimes providers duplicate the bills and occasionally they’re paid twice. I had a case recently where they were paid by the
How to Avoid Paying the Same Medical Bill Twice Read More »
Medical insurance is designed to provide individuals with financial protection and access to necessary healthcare services. However, one of the most significant challenges faced by patients is the denial of medical claims by insurance companies. The denial of medical claims occurs when insurance companies refuse to reimburse policyholders for medical services, medications, or treatments. This
The Denial of Medical Claims by Insurance Companies: A Critical Examination Read More »
I recently had a case where the provider did not have medical records for which they were billing the patient for. It was very difficult for them to not be able to find any medical records, even though they kept on billing my client over $25,000. So there was a lot of fighting back and
$25,000 Medical Claim Reduced to Zero With This Read More »
In the realm of medical practices, accurate coding is crucial for successful insurance claims. Incorrectly assigning medical codes can have far-reaching consequences, potentially resulting in denied insurance claims. This article explores the significant impact of using incorrect medical codes in medical practices and highlights the importance of precise coding for a smooth claims process. Understanding
How Incorrect Medical Codes Can Lead to Denied Insurance Claims Read More »
MedWise Insurance Advocacy
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