Transparency is a modern buzzword gaining traction in many areas of public life. It’s been a part of the healthcare arena since at least 2010 and seems to have kicked into high gear starting in 2020. Yet even today, consumers struggle to find out what health services will cost upfront, and healthcare providers and insurers continue to strive to keep that information secret and hidden from patients until the bill comes after the fact. Read More

Medicare Advantage policyholders have their claims denied at an outrageous rate, according to the federal government’s own reporting. On the bright side (sort of), claimants who appeal their denials are by and large successful in eventually getting their claims approved. If you’ve had your legitimate Medicare Advantage insurance claim denied, there are steps you can take to get the coverage you need and are entitled to, and you might also have a right to monetary damages based on your insurer’s violation of the law. Read More

We’ve previously discussed some of the many reasons insurance companies give for turning down claims. Insurance companies are often wrong when they make these determinations, but how do you go about convincing them of their mistake? You have a right under state and federal law to appeal a health insurance claim denial, but you must follow certain steps in a certain order under defined time frames. We talk about those steps below. Read More

Surgeries and other treatments and procedures can cost thousands of dollars, so it’s no surprise that health insurance companies only want to cover procedures that are deemed medically necessary. So-called elective surgeries, procedures that people choose to enhance their looks or for other reasons unrelated to treating a medical condition, are not covered. Read More