AboutTricia Expertise Has your medical insurance company denied your claim and refuses to pay? Have
you received a pre-authorization and still your insurance company
refuses to pay? How can you get your insurance company to reverse a
denied claim? How do you get a provider to waive your copayment if you
are financially unable to pay? Can a provider sue you for a unpaid bill and
will they? Can a provider send me to a collection agency for a medical bill?
If my insurance company does not pay, am I responsible? If you have these questions or others on why your insurance company is not paying your bills, I can help. I can give you "tricks of the trade" to get your insurance company to pay.
I have limited knowledge on Medicare and Medicaid and that is not my expertise. Each state is very different regarding Medicare and Medicaid so you need to review their website when you have questions. So please no Medicare or Medicaid questions!!
Experience In the medical field for over 20 years spending majority of time in the collections aspect.
Question My mother switched last Dec. to Secure Horizon's Complete Plan 1 and we have had nothing but problems. We were unaware too that her plan is an HMO. Everytime we try and call Secure Horizon's, we get more confused. Our major problem right now is that she's a remission cancer patient and she's been seeing her oncologist and every bill they submit to Secure Horizon, it gets denied and we don't know what to do. My mother lives in Peoria, IL and is there anyone that can sit with her and help her understand what we need to do get the claims paid?
Answer Hi Carolyn!
Sometimes AARP has local centers that can help Medicare patients.
Check their site to see if they have something or perhaps call them.
Also senior citizen sites in her area may help out.
Medicare in general is tough to figure out.........what you need to do is go through each EOB (explanation of benefits) and see why they denied the service and respond to their denial. Do it one by one and it won't be so confusing. Sometimes the Dr office will help.
Most insurance companies always deny a few times before paying.......a game they play to float their money.
