Attorney David Holt is very familiar with the health insurance appeals processes for all health insurance companies operating in Minnesota. The testimonials below speak for themselves.
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I couldn’t thank David enough for all the hard work he has done for me. I had over $116,000.00 in out of network bills in which about $50,000.00 of it would have been out of my pocket due. David was by my side through an appeal. I also had many smaller bills that had gone to collections and he worked to get them off my credit report as well as working out affordable payments with them to pay off lessor amounts on these bills.Eunice
David represented me in a healthcare appeal. I was very happy with his work - he resolved the case! He was able to find records from my previous employer and submit them as evidence. He was professional and responded to my emails and calls right away. My family and I consider David a friend. I recommend David to others.Minyi
I worked with David on an employer sponsored healthcare payment dispute. He was hired to work with the insurance company to resolve this dispute, and did so in a timely manner. He was very knowledgeable and transparent through every step of the process. I will highly recommend David in the future!Dan
I need help paying for a $2300 medical bill. What do I do?
Sorry to hear about this and know that you are not alone. You can be your own advocate, here’s my advice:
1. Ask for discounts and fill out hardship applications
There are many discounts that are available and the only opportunity to hear about them is to take the initiative and inquire.
Charity care and discount programs provide some sort of discount to patients. Ask if there is a discount you qualify for given your financial situation. You will likely need to ask and prod to find these discounts because they are not readily advertised. You may also need to fill out an application to verify your income. If you are waiting for an application, request that a hold be placed on your account.
2. Negotiate, Negotiate, Negotiate
The magic words are “I am willing to pay something, but unable to pay the full amount.” This communicates to the healthcare provider that you are cooperative and want to find a solution to the outstanding medical bill.
Do not be afraid to make a discounted offer to close the account. I recommend an offer around 60% of the original medical bill. This number is based on the fact that when your medical bill goes to collections, the healthcare provider has to pay the collection company 20-30% of the amount collected. The more cash you can offer up front, the better the discount. For example, offer ~$1000 now for this $2300 bill and hold strong.
On the other hand, request a payment plan and push the payment terms out as far as possible. Make sure that interest is NOT running on your outstanding balance.
This is by no means easy, but I am confident that you can do it! Best of luck!
How difficult is is to win a health insurance appeal? What is the best approach to take?
From experience, it is quite difficult to win a health insurance appeal, but that should not prevent you from appealing in a situation like this with so much at stake.
Also, you asked about the best approach to take. I agree with the previous answer to try to resolve the matter by opening a strong line of communication with the insurance company. To be blunt though, you should file the appeal to get the process started now. You may qualify for an “expedited” appeal given your circumstances. Call and ask your insurance company about this.
Finally, if the result of the insurance company appeal does not satisfy you, then you should appeal to an external independent agency. In most states, these appeals are handled by the Department of Health and Human Services (HHS.) The information link to file that appeal is below:
If your external appeal is not handled by the federal government, then appeal to the appropriate external review agency based on your State (also shown in the link.)
Hope this helps!
I have medical bills on my credit report that was closed and unpaid. Can I get them removed?
I see this question very often, although for medical bills with errors. If there were no errors and the debts are valid, the short answer is no. You do have the right to add an explanation to the credit report.
If the medical bills had errors, then there is other recourse. First know that you are not alone; nearly 43 million Americans have medical debt on their credit reports, according to data from the Consumer Financial Protection Bureau. Medical bills are notoriously plagued with errors.
The “big-three” credit reporting agencies (Equifax, Experian and TransUnion) have a place on their websites that allow you to contest entries in your records with them. I recommend you go to each website and file a written contest of the entries on your records with them that you believe are in error.
The agencies have 30 days to respond to your request and either provide proof of the debt or remove the entry from your record. If they claim to have proof, you can then contact the company making the entry to resolve the issue. Negative entries remain on your record for seven years; positive entries remain for ten years.
Remember, the system is a mess and you are not alone. Keep organized records, stay persistent and I am confident you can get this resolved!
You got this!
I neglected to file a claim on time and now I have medical bills in collections. Is there anything I can do?
This is frustrating and I hear about it way too much in my practice. The short answer is that there is a lot you can do.
For starters, initiate an appeal with your insurance company clearly outlining the situation. Disregard if the appeal deadline or claim deadlines have passed, because insurance companies can make exceptions for exceptional circumstances.
Also, reach out to the hospital and determine WHY they did not bill and submit a claim to your insurance company. Tell them to bill your insurance company for the procedure and “call the collection debt back” while they resolve your complaint. Explain that their efforts will help them get paid, since you had an in-force insurance policy during your treatment. Do note that you will still likely need to pay some costs out of pocket depending per the terms of your insurance plan.
As a last resort, if the first two methods fail, tell the collections agent to provide valid proof of the debt (they are required to do this) and fight the validity of the debt using the same arguments as above.
Wouldn’t it be great if healthcare providers communicated effectively with insurance companies?
Best of luck!
Can a doctors office remove a charge for a visit after they already ran it through my insurance?
Short answer is yes to your original question.
I think your real question is: “Can a doctors office charge me for services they did not perform?” The answer to that question is absolutely not. I recommend you request an “itemized bill” from your doctors office and, if necessary, your medical records, to determine what services were actually performed. Then work from there to determine a reasonable payment amount. Hope that helps!
What health insurance companies cover alternative medicine or nurse/health coaching?
Great question! The short answer is very few…
From my experience, Aetna appears to have the best coverage in this area (I have no affiliation with them, this is from review health insurance contracts for my job.)
But, I recommend speaking with a healthcare broker in your area to see what your options are.
More resources here:
Aetna Coverage of Complementary/Alternative Medicine:
National Research and good Resource on What is “Medically Necessary”
Hope this helps! I welcome the day that the American Healthcare system focuses on wellness, and not just treatment. 🙂