Appealing a denial, or how to turn ‘no’ into ‘yes’: Part 3 of our series on billing

Appealing a denial, or how to turn ‘no’ into ‘yes’: Part 3 of our series on billing

So your insurance company denied a treatment or a medication, in advance, and you want help. This is part of our series on billing advice (see below for other entries.) Here are a few steps. Understand the reason for the denial. Ask that it be clearly stated, in writing, and that the appeal process for […]

Are insurance companies playing hard to get with Obamacare?

Are insurance companies playing hard to get with Obamacare?

Summary: “We’ve been hearing stories about problems with the ACA (Obamacare) insurance exchanges lately,” Dr. David Belk writes over at The Huffington Post, in a piece that should be read with the words “narrow network” in mind. “Now patients are buying the insurance, only to find that doctors refuse to see them. Why should these […]

How much does a doctor’s office visit cost? A California doc explains

Filed Under: Costs, Health plans, Patients

How much does a doctor’s office visit cost? A California doc explains

Summary: “Doctors, along with all other heath care providers, virtually always bill insurance companies far more than what we would expect in payments. Why? The simple answer is that we usually don’t know what to expect,” writes Dr. David Belk, a California internist who researches health costs. “Insurance companies will always pay what ever a […]

With health insurance, the deck is stacked: The Huffington Post

With health insurance, the deck is stacked: The Huffington Post

Summary: “We buy health insurance for the promise that the insurance companies will protect us from enormous medical bills. But what happens when they don’t keep that promise?” Dr. David Belk writes over at The Huffington Post. “We all know that medical costs are a nightmare for the uninsured. Hospitals and other health care providers […]

Health insurers actually don’t want to insure people:  David Belk

Health insurers actually don’t want to insure people:  David Belk

Summary: “Health insurance can be confusing. Take the Affordable Care Act…. Health insurance companies spent a lot of money lobbying to make sure they’d profit from the eventual system,” David Belk writes over at the Huffington Post. “They were so successful, in fact, that a frequent criticism of Obamacare is that it’s just a ‘giveaway […]

Pharmacy raises price of generic drug 3,000%: Problem and solution

Pharmacy raises price of generic drug 3,000%: Problem and solution

Summary: “You probably remember hearing the news a few weeks ago about a greedy hedge fund manager who acquired the rights to sell a life-saving medication just so he could raise the price of it by about 5,000%,” Dr. David Belk writes over at Huffington Post. “That was a pretty evil thing to do, and it […]

Having Insurance Doesn’t Always Pay: The case of the $1,700 mammogram

Having Insurance Doesn’t Always Pay: The case of the $1,700 mammogram

This post appeared originally in MedPage Today, where I wrote it as part of our pricing transparency partnership with MedPage Today. Re-posted with permission.   Summary: “I live in metro NY and received a bill for $2200 (approx) for a mammo/Ultrasound, of which approximately $767 was covered by insurance. I was balance billed $1,712,” the email […]

Culture Change is Here: People are Price-Shopping for Health Care. Our CEO’s ‘Disruptive Women’ Post

Culture Change is Here: People are Price-Shopping for Health Care. Our CEO’s  ‘Disruptive Women’ Post

Summary: Culture change is here. People are upset about rising health care prices and rising out-of-pocket expenses. In fact, they’re so upset that they’re acting like consumers, by shopping around for their health care, and by sharing information, and by complaining about their outrage. And that’s a good thing. Our CEO, Jeanne Pinder, was recently named […]

How Health Insurance Companies Keep Your Premiums High: Guest post

Filed Under: Costs, Health plans, Patients

How Health Insurance Companies Keep Your Premiums High: Guest post

  GUEST POST SUMMARY: Many insurance plans make you go to an approved doctor at an approved hospital for approved procedures and take approved drugs. Even doctors often don’t have much say in this. We hand all this control to insurance companies and they use it, they say, to control their own costs. Is that all […]

The price of pills: Here’s what pharmacies are paying for drugs (guest post)

Filed Under: Costs, Patients, Providers

The price of pills: Here’s what pharmacies are paying for drugs (guest post)

SUMMARY: A terrific resource for prescription buying: a site that gives the average price pharmacies pay for every preparation of every drug they purchase in the U.S. We bring this to you courtesy of Dr. David Belk, a California internal medicine doc who has a deep interest in health-care pricing, and who wrote this blog […]