Table of Contents Navigating the complexities of health insurance, an Explanation of Benefits (EOB) is a common sight. However, what if this ordinary document reveals… Read More »Beware: The Phantom Healthcare Billing Scam Could Cost You
Table of Contents A significant legal conflict is unfolding in Califonia that could reshape the health insurance scene and patient care. The California Hospital Association… Read More »Lawsuit: Slow Insurance Approvals Delay Patient Care in California
Table of Contents In a significant development for cancer patients in Michigan, the state’s chief insurance overseer has ruled definitively that health plans must cover… Read More »Insurance Ruling: Health Plans Can No Longer Deny Valid Cancer Treatments Based on Tricky Wording
Table of Contents Every year, individuals across America find themselves trapped in battles against health insurance denials, which can delay critical treatments and burden them… Read More »Your Health Insurance Denial Wasn’t Just Unfair, It May Have Been Illegal
Table of Contents Recently, a pivotal ruling from the 4th Circuit Court of Appeals mandated that state health insurance plans in North Carolina and West… Read More »Healthcare Victory: Appeals Court Rules for Transgender Health Care Coverage in State Insurance Plans
Table of Contents SUMMARY: The Affordable Care Act prohibits health insurers from denying coverage or charging more due to pre-existing conditions, but beware of non-ACA-compliant… Read More »Pre-existing Conditions and Insurance: A Guide to Understanding Your Coverage Options
Table of Contents SUMMARY: Insurance companies may not cover a medication due to factors like lack of proven efficacy, but there are alternatives such as… Read More »Can an Insurance Company Refuse to Cover a Medication? What to Know and Do
Table of Contents SUMMARY: Medical necessity is decided by healthcare providers and insurance companies, using a set of reviews against set criteria, and denials can… Read More »Who Determines Medical Necessity? Decoding Health Care Decisions
Table of Contents SUMMARY: Generally, new health insurance won’t retroactively cover old medical bills; however, some Medicaid plans may be an exception. If a different… Read More »Will My New Insurance Cover an Old Medical Bill? Unpacking the Truth
Table of Contents SUMMARY: If your insurance doesn’t cover a doctor-ordered test, you can file an appeal using a structured process or negotiate with your… Read More »Doctor Ordered Test Not Covered by Insurance? Here Are Your Options
Table of Contents SUMMARY: Medical necessity documentation is critical when a treatment, medication, or device must be proven essential for a patient’s health issue and… Read More »What Are the Criteria for Documentation of Medical Necessity Explained
Table of Contents SUMMARY: When your insurance changes, your prescriptions may not be covered, but you can challenge this by appealing the denial, ideally using… Read More »What Happens to My Prescriptions When My Insurance Changes: A Complete Guide
Table of Contents If you’re experiencing pain or discomfort that isn’t getting better, your doctor may recommend an MRI to help diagnose the issue. However,… Read More »How to Get Your MRI Approved by Insurance
Table of Contents As a registered nurse with over 15 years of experience, I know how important health insurance is for covering those oh-so-pricey medical… Read More »Top 5 Reasons Your Health Insurance Claim Might Be Denied (And How to Fight Back!)
Table of Contents Health insurance appeals might come across as a complex and daunting task, but diligently following up on your appeal is key to securing… Read More »How to Follow Up on Your Health Insurance Appeal
Navigating the complex world of health insurance claims can be overwhelming, especially when you’re dealing with the stress of a medical issue. When you or… Read More »What’s the Difference Between Rejected Claims and Denied Claims?
You’ve been standing near the pharmacy counter for what seems like forever, patiently waiting for the pharmacist to fill the script from your doctor. Finally,… Read More »How Do I Write a Letter of Appeal for Medication?
Getting the healthcare you need should be a straightforward process. You pay your premiums, and your insurance company covers your expenses when you require medical… Read More »How to Fight Health Insurance Denial
Have you ever found yourself dealing with a health issue, but your insurance company is standing in the way of getting the care you need? … Read More »How Do I Write an Effective Insurance Appeal Letter?