Sunday, May 29

Day: September 12, 2021


Getting Health Insurance in an Emergency

This is an attempt to drive people to urgent care centers or doctor's offices which are less expensive and can save the insured money. Exceptions exist for referrals from a physician to the ER for non ER services, non ER services provided to children under age 14, instances when an urgent care clinic is more than 15 miles away and when care is administered on Sundays and major holidays.Necessary ER VisitsThere is a lot of grey area here but the Affordable Care Act defines an emergency as anything that "a prudent layperson, possessing an average knowledge of medicine and health" would believe to be emergent and in need of immediate attention.That leaves it to the patient to self-diagnose and then decide which is the most prudent place to go. Of course, it does not help that ER staff and doc...

Free Medicare Advantage Plans – The Real Story

Are there really free Medicare Advantage Plans?Everybody like free. But what if free isn't really free at all? We all know the meaning of free: that which has no cost. But what about Medicare Advantage Plans? Is a plan with a $0 premium free?To get to the bottom of these questions we need to review how a Medicare Advantage Plan works. Private insurance companies offer plans as another way to receive your Medicare benefits. Plans must include all Part A and Part B benefits and often include Part D drug benefits as well.You must also continue to pay your Medicare Part B premium no matter what the monthly premium; even if it's $0 per month. And here lies the answer to the question.Would you refer to Medicare as free? When the Part B premium gets deducted from your Social Security income (as a...
Personal Property

Renters’ Insurance Recommendation

When renting an apartment, whether you are a first time renter or an experienced renter, it is important to purchase renters' insurance! It is one product that I definitely recommend getting when leasing an apartment. Renters' insurance is generally not required to get when living in an apartment, but it is necessary and extremely smart to get it anyways.We all think that incidents like theft, fire, flood, etc will never happen to us, but they could. Renters' insurance is there to protect your belongings that you bring into the apartment. Your landlord will not be responsible for damages to your property. The landlord has their own insurance to protect their buildings and the furniture or whatever they provide in the apartment. They will not protect your belongings, which is important to k...
Medical Billing

Billing Practices That Can Be Costly Part II

In part II of this article we will further discuss costly medical billing practices. In some cases, these have led to the loss of medical licenses for false reports include billing unnecessary services, double billing, upcoding or altering CPT codes, unbundling and false diagnoses.Unbundling is when you charge separately for a visit or a procedure that is normally part of another procedure or visit. Double billing is when you bill for the same procedure multiple times on different dates.Upcoding refers to using a higher procedural code than what was performed.This includes billing for services that the patient did not receive or using codes that are at a higher level of what really took place during the visit or procedure. Some examples of that are where a practice submitted bills for of...