Health Insurance Claim Denials: Fighting Back

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Wow, you have certainly been through the mill on this one and it sounds like everyone who has their ultrasound through your doctor's office for pregnancy is treated the same way. There has to be a better way both to have the procedure at least partially covered as well as informing the patient right up front what costs are ahead of them. There needs to be a better method of communication. The person with whom you start the billing conversation should take ownership of the issue and be the point of contact until the issue is resolved to the satisfaction of the patient rather than sending the patient all over the place to try to resolve on their own. Great article. I am sorry you had to go through all of this.
www.bhmpc.com

Linda Ringquist of FL 11:42AM November 15, 2012

I understand your position regarding that you feel that your doctor should have offered you a choice between a standard U/S and the more complex one, but I took a medical law class a few years at Barry University, and learned this.
The presumtion under medical law is that when you present yourself before a doctor or hospital, it is presumed that you desire the best treatment that medicine has to offer, unless you indicate otherwise at the begining of the medical relationship. If the patient desires to save money, the patient has the responsibility to state so, if not, the doctor has the responsibility to provide the BEST medical care that he or she knows how to deliver.
As a patient, it sucks not to know this responsibility, but it is infact, the way the law, or least legal principle, works.

Sean of FL 4:10PM May 20, 2012

Great article,
It is very important for everyone to have health insurance.If you don't have insurance and you have to go to hospital, you'll have to pay over $20,000.That happened to a friend of mine.I know a site that offer the cheapest possible price for health insurance, free quotes and a lot of benefits.
http://GetHealthInsurances.info

Carol James of MT 5:25AM May 28, 2010

I came up with this in a google search. I am currently in two different appeals with close to $70K (perhaps more) of costs from Aetna. In my opinion they are looking at the financial health of their company rather than the health of my family.

Undisclosed of CA 4:45PM April 15, 2010

Aetna is like organized crime! When a patient really needs a procedure no go!
THese guys need to be scrutinized and boycotted

Joyce of OH 1:47PM March 16, 2010

Our national association of over 80 advocates across the United States are specialized in assisting consumers in getting a true & accurate fair & reasonable medical bill. We have been assisting consumers for over 15 years and have grown tremendously this past year alone. With the downfall of the economy, and all the media attention we have received consumers are educated on the services our advocates provide and turning to us to reduce their medical bills. If you think about it, reducing the erroneous charges on a doctor/hospital bill for an insured consumer helps both the consumer on receiving a true & accurate bill and reimbursing the insurance for over payments made that they fail to see, in the long run would help in the major increase of insurance premiums. Also with regards to assisting Corporate America, assisting a Self Insured Corporation, TPA and Insurance Companies; our advocates would again stop the erroneous charges before the insurance pays, TPA's send for payment and would reduce the annual payout for Self Insured Corporation so they would be able to continue offering insurance. Just wanted to give my opinion in regards to the Healthcare Reform and let people know that if we can stop all the above, it will make a difference. Check out our website.

Candy Butcher of VA 1:59PM October 19, 2009

what specific procedurees have been denied, and for what reason. Are insurance companies maximizing their profits at patient expense, or are they truly concerned abnout the welfare of the patient?

john naranjo of CA 5:48PM September 21, 2009

I loved reading everyone's "NIGHTMARE STORIES" I have more on my website www.keymedicalbillconsultants.com.
If you need help fighting the system I am your medical billing specialist. The comment that was made about hiring a health claim professional "they are pitbulls" really sums it up!
My best to all! You don't have to fight the system alone!

Frances of NJ 10:38PM September 20, 2009

This article is a great example of why we need to understand and take control of our health insurance. There are many things that one can do to reduce their health care costs. But, most importantly, they need to be active in their health care and take an active role in ensuring their insurance pays for their care.
www.yourmedicalbills.com provides many different tips that anyone can use to help control their costs.
You can also hire a claims assistance professional to take control of your medical bills. These individuals are like pit bulls when dealing with your insurance companies. They can let you focus on your health while they focus on your medical bills.

Jeff of FL 2:11PM September 15, 2009

There is real HELP on the way, H1N1Warrior.com.
To help your neighbor is truly a way to help ourselves.
It's time to put your faith where your life is.
The H1N1 virus will bring us together, and then we will have the power to cast it out.
May GOD bless your choice.

Xavier of NV 11:13PM September 09, 2009