How to read a bill or explanation of benefits: Know the tricks

Filed Under: Costs, Health plans, Patients

How to read a bill or explanation of benefits: Know the tricks

The insurance company’s “explanation of benefits” explains nothing. In fact it often confuses matters more. Also: People believe their insurance companies are paying more than they really are, because quite often the explanation of benefits leads to that conclusion. When I founded this company, in fact, a major impetus was the fact that no one […]

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, […]

How much will that cost/did that cost? Part 1 of a series on billing

How much will that cost/did that cost? Part 1 of a series on billing

How much will that cost? Why did that cost so much? People are getting used to asking this in the health care marketplace. Many of us grew up with the $10 co-pay, but that’s rapidly becoming a thing of the past. With rising deductibles, more out-of-network providers, more uninsured people and more out-of-pocket spending, it’s increasingly a […]

Waste and fraud in Medicare

Filed Under: Costs, Providers, Regulators

Waste and fraud in Medicare

It’s an article of faith that one of the biggest sources of  health-care cost abuses is Medicare. The government pays bills for the elderly under this system, and it’s widely regarded as fraud-ridden and inefficient. So it was no particular surprise to read the other day that Medicare recovery audit contractors have returned $237.8 million […]