HW Medical Billing Solutions, LLC

08/29/2026

Celebrate with us for Candace’s 1 year anniversary!

08/19/2026

08/14/2026

1. Metal Tiers (Bronze, Silver, Gold, Platinum): These tiers are primarily defined by how you and your plan share costs. Bronze plans generally have the lowest premiums but highest out-of-pocket costs, while Platinum plans reverse that relationship.

2. Plan Types (HMO, PPO, EPO): These tiers determine which doctors you can see and whether you need referrals for specialists.

3. Prescription Drug Formularies: Drugs are categorized into tiers that dictate your copay or coinsurance amount, ranging from low-cost generics (Tier 1) to expensive specialty medications (Tier 4/5).

When choosing a plan, it is crucial to consider your budget, health history, and anticipated medical needs. This infographic provides a framework, but always consult specific plan details, as exact costs and coverage can vary widely.

08/12/2026

As someone living with Major Depressive Disorder, I see myself in this image. Depression isn’t just an emotion; it’s a filter that changes how I experience everything, and sometimes it tries to convince me I'm alone in the struggle.

The "Limit These" list are my invisible hurdles. Forgetting to eat or sleep well, the way I pull away from the people who love me, the silence I sometimes retreat into—these are real things I fight daily.

But this graphic is also a gentle reminder that we have some control. It’s not about doing everything on the "Do
This Instead" list perfectly. It's about recognizing that making space to look after my body, practicing self-compassion, and making a tiny connection with a friend can give me the strength to keep going.

The most important thing I can tell you is this: Your mental health matters just as much as your physical health. Prioritizing it is essential. If you’re fighting this too, I’m in your corner. Let’s make those small shifts together.

*We have many small private practices we can recommend for your needs in KY.

08/06/2026

These three out-of-pocket costs determine how you and your health insurance company split medical expenses throughout the coverage year.
| Term | What It Is | When You Pay It | Example |

| Deductible | The fixed dollar amount you must pay out-of-pocket each year before insurance starts sharing costs.

At the beginning of the plan year until the cap is reached.

If your deductible is $1,500, you pay 100% of non-preventive care up to $1,500.

| Copay | A set flat fee for a specific routine service or prescription.

At the time of service (clinic visit, pharmacy counter).

A $30 fee for a primary care doctor visit or $15 for generic medication.

| Coinsurance | Your percentage share of the cost of a covered service after meeting your deductible.

After your deductible is met, until you reach your out-of-pocket maximum.

If your coinsurance is 20% and a scan costs $1,000, you pay $200 and insurance pays $800.

How They Work Together in a Plan Year

* Stage 1: Paying Your Deductible
At the start of the year, you pay 100% of the billable cost for most medical services until your total payments reach your annual deductible (e.g., $2,000). (Note: Preventive care like annual checkups is typically 100% covered without needing to meet your deductible).

* Stage 2: Sharing Costs via Coinsurance & Copays
Once your $2,000 deductible is satisfied, insurance kicks in. For major procedures, hospital stays, or lab work, you now pay only your coinsurance percentage (e.g., 20%). For standard visits or medications, you pay your designated copay.

* Stage 3: Hitting the Out-of-Pocket Maximum

Your plan includes an Out-of-Pocket Maximum (the absolute ceiling on what you can spend in a year). Once your combined payments for deductibles, coinsurance, and copays reach this limit (e.g., $6,000), insurance pays 100% of all covered medical services for the remainder of the calendar year.

08/04/2026

Celebrating a Milestone: 2 Years in Business!

Although I am a few days late in sharing this news, I am thrilled to share that HW Medical Billing Solutions officially turned two years old!

The past two years have been a remarkable journey filled with valuable learning experiences, challenges, continuous growth, and rewarding achievements.

I extend my sincere gratitude to everyone who has supported us along the way—our valued clients, partners, and colleagues. Your trust, collaboration, and insightful feedback have been instrumental in helping us learn, adapt, and refine our services.

Thank you for being a part of our story. Here’s to celebrating the last two years and to many more ahead! 🥂

07/31/2026

Navigating Timely Filing Limits

As a healthcare provider, you know that missing a claim filing deadline is one of the fastest ways to lose revenue. But keeping track of the specific TFLs for different payers can be a constant challenge.

This quick reference guide outlines the timely filing limits for six major top payers to help you stay compliant and avoid claim denials.

From Medicare’s 12-month window to Medicaid’s state-by-state 90-day variation, understanding these timelines is essential for a healthy revenue cycle.

Check out this snapshot and keep your claims moving!

07/31/2026

Department for Medicaid Services:

Key Message: The previously announced 4% reduction to Medicaid provider reimbursement rates has been reversed thanks to recent executive action taken by Governor Andy Beshear.



Immediate Impact: The planned rate cuts will not be implemented at this time, and provider reimbursement rates will stay at their current levels.



Long-Term Outlook: This reversal serves as a temporary solution. The Department is working alongside state leadership to find a sustainable, long-term funding solution.

07/22/2026