In network and billed for $1,400: “Cracking the Code” looks at balance billing

Filed Under: Costs, Health plans, Patients

In network and billed for $1,400: “Cracking the Code” looks at balance billing

“Steve Fair woke up at 2 a.m. in his room at the Sheraton New Orleans to find that his uvula – the tissue that hangs from the back of one’s palate – had swollen to the size of a Hershey’s Kiss. Worried it might block his airway, he and his wife rushed down to the […]

Understanding the guts of the insurance system: Ron Peck

Filed Under: Costs

Understanding the guts of the insurance system: Ron Peck

Summary: Understanding the guts of the system — arcana  such as plan documents, stop-loss, self-insurance, ERISA commitments, balance billing, subrogation and generally chasing down the money — may not seem like fun stuff. But it actually is, when you get to talk about these things with Ron Peck, senior vice president and general counsel at […]

10 steps for appealing a claim or bill: Part 2 of our series on billing

Filed Under: Costs, Health plans, Patients

10 steps for appealing a claim or bill: Part 2 of our series on billing

So you got a huge bill, and you’re sure there’s been a mistake, either in the bill or the insurer’s processing of a claim. You want to appeal, because it’s a lot of money. Here’s a step-by-step course of action. We cannot guarantee that you will win, but at least you will have tried. Read first, […]

Balance billing: What it is, and what you can do

Filed Under: Costs, Health plans, Patients

Balance billing: What it is, and what you can do

Balance billing. It’s a scary term, in consumer and insurance circles: That’s what happens to a consumer if the hospital or doctor (also known as the provider) and the insurance company (also known as the payer) fail to agree, even under PPO terms, and the balance that they’ve agreed upon doesn’t satisfy one or the […]