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Author: Scott Glovsky
Publisher:
ISBN: 9780692568828
Category :
Languages : en
Pages : 156
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Book Description
Health insurance companies claim to act in their customers' best interests, but quite often fail to deliver on that promise. In this step-by-step guide, health insurance attorney Scott Glovsky examines the lawyer's role in helping a client navigate a health insurance denial, from understanding consumer rights, the appeals process, independent medical review, through the intricacies of an insurance bad faith lawsuit, and how the Affordable Care Act has impacted health care law. Drawing from decades of experience from large firms and from his own private practice, Scott uses his unique client-centered approach to shed light on this important and often misunderstood practice area.
Author: Scott Glovsky
Publisher:
ISBN: 9780692568828
Category :
Languages : en
Pages : 156
Get Book Here
Book Description
Health insurance companies claim to act in their customers' best interests, but quite often fail to deliver on that promise. In this step-by-step guide, health insurance attorney Scott Glovsky examines the lawyer's role in helping a client navigate a health insurance denial, from understanding consumer rights, the appeals process, independent medical review, through the intricacies of an insurance bad faith lawsuit, and how the Affordable Care Act has impacted health care law. Drawing from decades of experience from large firms and from his own private practice, Scott uses his unique client-centered approach to shed light on this important and often misunderstood practice area.
Author: Tammy Tipton
Publisher: Hcpro Incorporated
ISBN: 9781615690053
Category : LAW
Languages : en
Pages : 168
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Book Description
Combat denied claims and get paid what you deserve Don't take no for an answer! You can turn denied insurance claims on their head and recover millions of dollars in lost revenue - revenue that your organization deserves. Be informed of your legal rights and use them to your advantage when submitting denied claims. Here's your biggest ally in fighting denied claims: The Appeals Toolkit: Turn healthcare insurance denials into dollars provides extensive information on appeal strategies and methods to incorporate into your processes to avoid being denied in the first place. Sample letters found in this comprehensive resource. no need to look anywhere else! The Appeals Toolkit includes 25 tested, proven, and effective sample appeal letters from which you can model your own claims. These letters demonstrate the inclusion of legal citations and how to effectively demand a thorough response from a carrier. You'll have access to appealing the following denials: Incorrect payment Incorrect contractual adjustments Medical necessity Utilization review Preauthorizations Underpayments And more! As an added bonus, you will receive chapters dealing with appealing claim denials for Medicare and the Employee Retirement Income Security Act (ERISA) Accompanying CD allows you to customize Use the book version of the Appeals Toolkit for quick reference, or use the accompanying CD-ROM to download the letters and customize them to your specific situation. You can simply search the denial area you need, then copy, paste and edit to suit your needs.
Author: Jay M. Feinman
Publisher: Penguin
ISBN: 1101196289
Category : Business & Economics
Languages : en
Pages : 241
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Book Description
An expose of insurance injustice and a plan for consumers and lawmakers to fight it Over the last two decades, insurance has become less of a safety net and more of a spider's web: sticky and complicated, designed to ensnare as much as to aid. Insurance companies now often try to delay payment of justified claims, deny payment altogether, and defend these actions by forcing claimants to enter litigation. Jay M. Feinman, a legal scholar and insurance expert, explains how these trends developed, how the government ought to fix the system, and what the rest of us can do to protect ourselves. He shows that the denial of valid claims is not occasional or accidental or the fault of a few bad employees. It's the result of an increasing and systematic focus on maximizing profits by major companies such as Allstate and State Farm. Citing dozens of stories of victims who were unfairly denied payment, Feinman explains how people can be more cautious when shopping for policies and what to do when pursuing a disputed claim. He also lays out a plan for the legal reforms needed to prevent future abuses. This exposé will help drive the discussion of this increasingly hot- button issue.
Author: Robert A. Peterson (Jr.)
Publisher:
ISBN: 9780932622501
Category : Health insurance
Languages : en
Pages : 118
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Book Description
Author: Marshall Allen
Publisher: Penguin
ISBN: 0593190009
Category : Health & Fitness
Languages : en
Pages : 289
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Book Description
From award-winning ProPublica reporter Marshall Allen, a primer for anyone who wants to fight the predatory health care system--and win. Every year, millions of Americans are overcharged and underserved while the health care industry makes record profits. We know something is wrong, but the layers of bureaucracy designed to discourage complaints make pushing back seem impossible. At least, this is what the health care power players want you to think. Never Pay the First Bill is the guerilla guide to health care the American people and employers need. Drawing on 15 years of investigating the health care industry, reporter Marshall Allen shows how companies and individuals have managed to force medical providers to play fair, and shows how you can, too. He reveals the industry's pressure points and how companies and individuals have fought overbilling, price gouging, insurance denials, and more to get the care they deserve. Laying out a practical plan for protecting yourself against the system's predatory practices, Allen offers the inspiration you need and tried-and-true strategies such as: Analyze and contest your medical bills, so you don't pay more than you should Obtain the billing codes for a procedure in advance Write in an appropriate treatment clause before signing financial documents Get your way by suing in small claims court Few politicians and CEOs have been willing to stand up to the medical industry. It is up to the American people to equip ourselves to fight back for the sake of our families--and everyone else.
Author: Jennifer C. Jaff
Publisher: Advoc. for Patients w. Chronic Ill.
ISBN: 0977749207
Category : Chronic diseases
Languages : en
Pages : 213
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Book Description
Author:
Publisher:
ISBN:
Category : Appellate procedure
Languages : en
Pages : 6
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Book Description
Author: Adria Goldman Gross Fipc
Publisher: Outskirts Press
ISBN: 9781478760566
Category : Business & Economics
Languages : en
Pages : 130
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Book Description
Consumer protection advocate Ralph Nader praised Solved! Curing Your Medical Insurance Problems: "Who hasn't been bewildered and outraged by lengthy, inscrutable medical bills and the tricky ways of the health insurers? ....Learn what to watch out for in this volume by authors who know the inside ways of sellers who try to take you to the cleaners." Some say, "You get what you pay for." If only this were true! Too often, consumers find themselves paying much more than they expected, getting much less than they bargained for. Medical care is no exception. In their book, the authors show readers how to spot over-charges by providers, under-reimbursements by insurers, and inappropriate denials by insurers and government employees. Furthermore, they presented steps to take to prevent being victimized by "the system." And what is the system? In America, it is a hybrid of private healthcare providers, massive insurance companies, and governments at the state and national levels. Unlike Britain with its single-payer National Health System, this public-private mixed-breed creates the need for patient advocate professionals, who take up the cudgels on behalf of the medically disadvantaged and the financially strapped.
Author:
Publisher:
ISBN: 9781580410960
Category : Health insurance
Languages : en
Pages : 0
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Book Description
Provides sample appeal letters for the speech-language pathologist to use when appealing a denied insurance claim.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309439124
Category : Social Science
Languages : en
Pages : 171
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Book Description
Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.
