I am also available to help with this case. My website is medicalbillproblems.com

They can also find me in AdvoConnection

If the patients plan is self-insured, the guidelines for payment and coverage will come from his employer, not Anthem.
That a procedure is FDA approved, established standard of care and/or medically necessary does not guarantee coverage under an ERISA plan.

If this is the case, rather than barking at the wrong (and unhelpful) tree, the patient…[Read more]

It is my experience through 1000s of denials and appeals that I’ve worked, that the second level appeal is actually the level where clinicians and medical personnel are reviewing the case, vs, the first level. That’s why it’s so important to continue on with the second level appeal.

Thankfully this was overturned!! Congratulations on this…[Read more]

Unfortunately, as I tell my clients–as an advocate, I’m usually at the opposite end of the table when it comes to insurance companies! Unless health plans are willing to cover my clients for all their necessary medical needs—not sure those plans want to pay me!

I don’t know if this helps you or you are already aware of these CE sources: https://www.pacboard.org/project/ethics/

Just to play devil’s advocate…..by the time a story gets press attention that was not initiated by an advocate and an advocate wasn’t asked to quote on the story, buyer be ware. As our posts here demonstrate these are rarely straightforward situations and many reporters that don’t report in this space as their regular beat don’t fully appreciat…[Read more]

And I think we are not only patient advocates but patients (as well as our loved ones!) I try out every platform available to me as a “patient” if possible (budget-wise & time-wise) so that I have first-hand experience!

Thanks for reminding us about Picnic Health! I’ve been meaning to research & will put on my “to do” list this week!

I reached out to the reporter last week; however, he hasn’t responded yet. I’ll let you know if I hear back from him.

Thanks so much!

Jennifer

Good morning!

I would be happy to assist them since medical billing issues is my niche! If you are still looking for assistance then please feel free to send them my contact info below.

Thanks so much!

Sincerely,

Jennifer Kastner, CPC , CPMA, CEMC
Owner of Patient Advocacy Solutions…[Read more]

I have used them for my husband Steve and did agree for them to use Steve’s records for research. I have found them to be extremely professional and have in fact referred others with Alzheimer’s to check them out.

Thanks for the feedback, I am going to try it out. It is free if you permit them to use your anonymized data.

Thank you all for posting and sharing your ideas. This is such a great way for all of us to learn!

However – a reminder – while posting here helps all of us, it does nothing to help the man who needs help. He doesn’t have access to this forum.

If you feel as if you can contribute support or ideas, please find my post at the top of this page, and…[Read more]

Where does the person live? I am in South Florida (Fort Lauderdale area.

Nicole Broadhurst

Consult

Kathy,

I had one client who used them and I was given access to the platform. It seemed quite impressive. His only complaint was the price.

AnnMarie McIlwain
Patient Advocators

I have helped clients with SSDI also. I have also used a company, Allsup for complex patients or for one’s that have been denied. They which specialize in this disability They are very helpful and work hand in hand with the patient.

Hello Raye – Stacie Lampkin has courses on her site. She has a class that provides 1 CE for Ethics.