Have you ever received a bill from your doctor and stopped breathing? Have you wondered why you are receiving a bill when you have medical insurance? Have you asked the question, why am I paying this astronomical monthly payment?

MEDICAL BILL:

When you receive a medical bill from any provider; example, doctor, hospital, lab or x-ray is it paid correctly? Has any payment from your medical insurance been paid to your bill?

When a payment has not been paid or very little and you call and speak to a representative from you medical insurance company and the doctor’s office, what is the next step?

If you’re medical provider is going to appeal your bill or claim, great. Just make sure they follow through in a timely manner. Some appeals are time sensitive.

If you’re medical provider says it is your responsibility to appeal your claim keep reading.

APPEALING YOUR MEDICAL BILL:

1. Write a letter and explain why you feel your claim was not paid correctly or was not paid.

2. Make sure you have your name, address, city, state, zip code and telephone number on your letter.

3. The name of the person insured on your insurance plan. (Guarantor)

4. The name of the person that was seen by a provider.

5. The date of service the medical care was obtained.

6. The place of service the medical care was obtained.

7. Attach a copy of your explanation of benefits (EOB) you received from your insurance company.

8. Attach any correspondence you received from your insurance company prior to receiving the final explanation of benefits.

9. Attach a copy of your medical insurance card.

10. Attach a copy of all your medical records pertaining to this date of service. Include x-rays, lab slips, anything that will present your case completely with one viewing.

SECRET:

Insurance Companies need your date of service and place of service. This is how they track all your medical care by each individual provider.

Example:

You were seen by your doctor that morning in her office. That afternoon you were admitted to a hospital. Now you have two different providers on the same day.

Try to make your presentation as professional as possible. The person that will be reviewing all your information will expect to see your entire case presentation in one sitting.

If the appeal board needs more information from you, they will probably send you a letter or phone you.

EXCEPT:

You will not win an appeal if your deductible or co pay was not met. Another denial is a non-covered service. With this denial your medical provider can help you make a decision before you go through the entire appeal process.

Sometimes this is not entirely true and an appeal would be perfect.

So I say go for it. Appeal your claim. Pour your emotions and passions out in your letter to the appeal board.

If you do not have a computer to type your letter hand write it. Just make your letter legible. Sometimes a hand written letter is more effective.

MEDICAL CARE FOR ALL PEOPLE.

I hope your enjoyed my article. Please check out my other articles. I love to hear from you.

Copyright 2006 Linda Meckler

Linda has worked in the medical insurance field for many years.

Currently she is the author of the adventure, “Ghost Kids Trilogy,” Christy, 12 and her Brother Brad, 16 move into an old house on top of a mountain and meet two Ghost Kids. Become involved with all the characters and all the adventure and mystery.

Then we have a mysterious, magical Blue Vase where Uncle Charlie the villain is trapped.

Take a walk with Christy and Brad down a dark hall hunting for Pirates” Treasure. You will think were you there right there with them. Love, Family Values and Charity burst off the pages.

Check out my website http://www.lmeckler.com

If you are wheelchair/bed confined or can’t sit on a toilet, you can stand and urinate. Check out my website

Share This

Whether you are self-employed or a small business owner, finding an affordable individual health insurance plan has gotten easy with online health insurance providers. By comparing quotes and coverage plans, individuals are able to choose a provider that best meets their needs. Before you pick the plan with the lowest monthly premium though, make sure that provider is best for your situation.

Picking A Plan

Individuals have three basic types of health insurance plans they can choose from. Managed care plans provide the most coverage with a low premium. However, you have to use network doctors. Fees-for-service plans gives you the flexibility of choosing your own doctor, but they don’t typically cover preventative care or check-ups. And finally, you can choose catastrophic insurance to cover major hospitalization, but not regular medical expenses.

Your medical and financial needs will determine which plan is best for you. Managed care plans are usually the most cost efficient. If you have excellent health and financial resources, then fees-for-service or catastrophic insurance could be an option for you.

Start Researching

Once you have an idea as to what type of plan and coverage you want, start gather quotes. You can do this quickly with online health insurance websites. After you have entered your personal information, you will receive several quotes. Take the time to also look at the coverage being offered and make sure they are comparable between plans.

Finding A Provider

Finding a good price is only one part of finding the best provider. You also need to be sure that you can contact them easily if you have a question. Many health insurance providers use their website to provide policy and network information. This is especially helpful if you need to pick a doctor from their network. You should also be able to contact them through email, phone, or in person.

Easy Application Process

The application process for your health insurance should also be easy. Most providers complete the application online or over the phone. You may also need a medical check-up, which is usually completed by a medic meeting you at your home or workplace.

To view our list of recommended companies online that provide health
insurance and can help you compare quotes, visit this page: Recommended Insurance Companies Online.

Carrie Reeder is the owner of eZerk, an
informational website with articles and information about various topics.

Share This

Try to imagine the new medical insurance plan from a detached position.

There is an excellent opportunity for seniors sharp enough to see it, and it is available to anyone willing to do a little math. The savings presented in Medicare part d are a little deceiving because at first glance it looks like 75%, when in fact that is only a portion of the overall savings in the formula. Here is a simple way to calculate how to take advantage of the new government medical insurance IF EXPENSES ARE OVER $2250 PER YEAR.

Four things need to be considered.

Start with annual prescription expenses. Figure out how much would be spent on prescriptions if there was no insurance at all. The full retail amount is important for this calculation.

Calculate which month of the year full retail costs reach the “Magic Mark” of $2250. This will expose when the medical insurance stops and full retail costs apply.

For plan costs, add up how much will be spent on the annual deductible and monthly premiums. (in the chosen medical insurance plan) Add $500 to this amount for the 25% not covered by Medicare part d.

Now add the full retail amount that will be spent for the remainder of the year to find the real expenses. Subtract savings ($1500) from expenses to calculate the real percentage of savings. Understand that 75% savings is impossible to reach.

Here’s How To Maximize Savings if Prescription Expenses Are More Than $2250

The “Magic Mark” for maximum savings is $2250 in medicare part d. USE IT! Once prescription costs go beyond that magic mark, the percentage of savings sinks like a rock. To avoid that problem and to take advantage of every angle, use another discount source for prescriptions.

Canadian medications are typically 30% - 40% less expensive, and using a Canadian Pharmacy to balance expenses is like an additional medical insurance policy. The recommendation is to buy enough prescriptions from Canada every three months to target the “Magic Mark” of $2250 with the government medical insurance. By spending exactly $2250 per year (Retail) through medicare part d and buying the balance of medications from Canada, the savings will work out as follows.

Approximately 50% - 60% savings will be had through the government medical insurance plan, and about 30% - 40% savings on the portion purchased from Canada. If there are some medications that can be bought from Canada to help target the “Magic Mark” of $2250 then figure out which Canadian Prescriptions offer the greatest savings and buy those medications from Canada throughout the year. Keep in mind some medications will not be covered under Medicare part d and those ones would be ideal to get from Canada.

One More Consideration

If expenses are beyond $5100 there can still be a significant savings by using this method. It depends on how much would be spent at full retail in the year and how far expenses go into the catastrophic end. Use a Canadian Pharmacy to supplement the Government Medical Insurance and avoid the dreaded un-insured portion… the “Doughnut Hole”

***Squeeze Every Dime Out of Medicare Part D***
How To Save More Without Paying Insurance Premiums
Click Here Now ==> Medicare Part D

Share This