This is a book I wrote when I worked in hospital billing. I couldn’t believe how many people did not know how their insurance worked. Do you?
It can be any insurance plan. Do you know how it works? Why you pay for a specific amount for your doctors visit and someone else pays another amount?
Contracts
Is the mystery word which we all need to know and how it works for you.
Your insurance program is contracted with a specific Physician, Hospital, Hospital, Laboratory, X-ray, etc. It depends upon the contracted rate which was established at the time the contract was signed.
Most physicians try to get onto as many medical plans they can. Sometimes the plan is full and the physician can’t get on a certain plan.
In case of an emergency, you could end up in a hospital which is not contracted with the hospital you were taken. Your (EOB) or explanation of Benefits with deny the charge and say, “Your hospital was not contracted with our insurance. Or words to that effect and will not be paid Then the bill needs to be appealed.
Appeal
In my book are sample letters of appeal letters. I have written hundreds of these in my time on the job force. Also, personal stories of nightmares I had trying to get my bill paid.
hank you for reading my article.
Copyright Linda Meckler
www.lindameckler-author-artist.
Linda Meckler copyright 2021