Patient and Payer Advocates

12/28/2013

Another sad case of insurance denying a necessary procedure....

Surgery to remove a brain tumor two years ago has left a 12-year-old Texas girl with a heartbreaking condition that makes her gain...

12/19/2013

$158 million of "outpatient care was both never provided and unnecessary, prosecutors said while announcing the indictment."

A Houston doctor has been charged in a $158 million Medicare fraud case involving false claims for mental health treatment, officials said. From 2005 to 2012, Inglehart took part in a scheme to submit about $158 million in false claims for treatment at a Houston hospital for patients with severe men...

11/15/2013

If you receive care at a hospital, inpatient or outpatient, be aware of this:
The following generally DO NOT participate in ANY insurance networks (other than Medicare): Emergency Department physicians, Anesthesiologists (including CRNA's), Pathologists and Radiologists. The hospitals contract with physician groups to provide these services, so you have no choice but to use them, resulting in high out-of-network bills that you are stuck with. Also keep in mind that you will never personally see the Radiologist (interprets x-rays, etc and writes a report) or Pathologist (looks at tissue, etc and writes a report). The hospital will give you the standard, "And this form says that you understand that the doctors are not employees of the hospital and will bill you separately," when you are signing your paperwork. Ask if the above mentioned groups are in-network. The admission clerk will have no idea.

11/13/2013

Pay close attention to the #1 reason for "People falling into poverty due to"

And if the GOP had their way, we'd already be there.

11/01/2013

"University of Michigan professor and senior Brookings fellow Justin Wolfers on Thursday created a chart depicting the "winners and losers" under the Affordable Care Act, sourced to a Ryan Lizza article that used estimates from M.I.T. economist Jon Gruber, a former adviser to Mitt Romney."

University of Michigan professor and senior Brookings fellow Justin Wolfers on Thursday created a chart depicting the "winners and losers" under the Affordable Care Act, sourced to a Ryan Lizza article that used estimates from M.I.T. economist Jon Gruber, a former adviser to Mitt Romney. The chart d...

11/01/2013

Good news concerning Flexible Spending Accounts!

The Treasury announced that FSA participants now can carry over up to $500 of their unused FSA balances remaining at the end of a plan year.

10/23/2013

I just reviewed an outpatient bill for a Laparoscopic Hysterectomy for $43,752.38 Please "Like" if you think this amount is ridiculous.

10/23/2013

“We doctors have many new ways to prevent deaths from hypertension, diabetes, and heart disease — but only if patients can get into our offices and afford their medications.”

Nearly 45,000 annual deaths are associated with lack of health insurance, according to a new study published online today by the American Journal of ...

10/22/2013

Another reason medical care is expensive. Fraud hurts everyone.

Prosecutors say the scheme started in 2007 and Gibson submitted bogus claims to the Medicare and Texas Medicaid programs. Investigators say Gibson, who was sentenced to 52 months in prison, ordered medically unnecessary testing and physical therapy for Medicare and other patients.

09/23/2013

"My doctor looked at me and said, 'I don't have any idea how much anything costs,'" Taylor wrote.

Most of us wouldn't think to haggle with our doctor over the cost of an operation. But bargaining over medical prices does happen, and you can save big if you do it right.

09/23/2013

Calling all moms, dads, grandparents and the baby-obsessed! Tune into TODAY starting Monday for , a weeklong series about...

09/23/2013

Speaks for itself....

Like, Share, Join Us! Democratic National Christian Choice
THIS IS WHO THE GOP ARE PROTECTING! Lots of Republicans are saying that mass shootings have more to do with mental illness than with guns. So why are they fighting Obamacare, which includes the largest expansion of access to mental health care in U.S. history? - Source: Tales of a Real American Liberal