Medical Claims Consulting

Under the Patient Protection and Affordable Care Act, also nicknamed “Obamacare”‘s , most insurance plans  are required to cover all costs for preventive care, including colon cancer screenings at 100%.  Therefore, Jax thought his colonoscopy would be free. Of course he had some doubts, so he called his insurance company prior to having the colonoscopy [...]

The health care system in the United States can be confusing. In order to get the most out of your health care benefits, you need to understand the terms used by insurance companies, health plans and health care providers. This way, you can make better decisions and ultimately receive better care. Ambulatory Care – Health [...]

1) Use “in-network” providers. If you have health insurance you should be sure the physicians you see are in your insurance carrier’s network. If you are not sure whether the physician is in-network, call your insurance company to find out prior to your visiting the provider. 2) Ask for a discount If you do not [...]

Medical debt causes almost 2 million bankruptcies a year. If you do not have health insurance, you do have options to reduce and prevent high medical bills. Cash Discount: Many doctors, clinics, and hospitals will generally offer a 20-30% cash discount off your medical bills if you can pay them off in full. Negotiate a [...]

Here is an excerpt from an online guide on what health reform means for you: “Recently enacted legislation will radically transform the U.S. health care system. These changes will occur over time, however. The most significant changes (e.g., a requirement that most people obtain health insurance) will not become law until 2014. A tax on [...]

A pre-existing condition is a health problem that existed before you apply for a health insurance policy or enroll in a new health plan. It can range from something minor such as hay fever to a serious chronic condition like heart disease. Insurance companies are concerned about their financial bottom line—it’s more risky to insure [...]

Here is a wonderful, short video explaining the insurance terms:  deductible, co-pays, coinsurance & maximum out of pocket.

Do you know how much a visit to a primary care doctor costs? Or a trip to a specialist? How about the cost of your monthly prescription? The average patient has no idea. Many patients only have to pay a copay when visiting a doctor, specialist or picking up a prescription. Their insurance carrier pays [...]

If you have a new health insurance plan or insurance policy beginning on or after September 23, 2010, preventive care services are now offered with out your having to pay a copay, coinsurance or meet your deductible when seen by an in network provider?  If you have questions on whether or not your policy falls [...]

Be sure to use up your FSA money before you lose it. Here are 5 tips with ways to help you spend down your FSA dollars. 1. Review the list of eligible expenses. 2. Make sure you have the medications and supplies you need. If you regularly take an over-the-counter or prescription medication, be sure [...]