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Fighting Health Insurance Denials
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Book Synopsis Fighting Health Insurance Denials by : Scott Glovsky
Download or read book Fighting Health Insurance Denials written by Scott Glovsky and published by . This book was released on 2016-01-15 with total page 156 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health insurance companies claim to act in their customers' best interests, but quite often fail to deliver on that promise. In this step-by-step guide, health insurance attorney Scott Glovsky examines the lawyer's role in helping a client navigate a health insurance denial, from understanding consumer rights, the appeals process, independent medical review, through the intricacies of an insurance bad faith lawsuit, and how the Affordable Care Act has impacted health care law. Drawing from decades of experience from large firms and from his own private practice, Scott uses his unique client-centered approach to shed light on this important and often misunderstood practice area.
Book Synopsis Delay, Deny, Defend by : Jay M. Feinman
Download or read book Delay, Deny, Defend written by Jay M. Feinman and published by Penguin. This book was released on 2010-03-18 with total page 247 pages. Available in PDF, EPUB and Kindle. Book excerpt: An expose of insurance injustice and a plan for consumers and lawmakers to fight it Over the last two decades, insurance has become less of a safety net and more of a spider's web: sticky and complicated, designed to ensnare as much as to aid. Insurance companies now often try to delay payment of justified claims, deny payment altogether, and defend these actions by forcing claimants to enter litigation. Jay M. Feinman, a legal scholar and insurance expert, explains how these trends developed, how the government ought to fix the system, and what the rest of us can do to protect ourselves. He shows that the denial of valid claims is not occasional or accidental or the fault of a few bad employees. It's the result of an increasing and systematic focus on maximizing profits by major companies such as Allstate and State Farm. Citing dozens of stories of victims who were unfairly denied payment, Feinman explains how people can be more cautious when shopping for policies and what to do when pursuing a disputed claim. He also lays out a plan for the legal reforms needed to prevent future abuses. This exposé will help drive the discussion of this increasingly hot- button issue.
Book Synopsis Never Pay the First Bill by : Marshall Allen
Download or read book Never Pay the First Bill written by Marshall Allen and published by Penguin. This book was released on 2021-06-22 with total page 289 pages. Available in PDF, EPUB and Kindle. Book excerpt: From award-winning ProPublica reporter Marshall Allen, a primer for anyone who wants to fight the predatory health care system--and win. Every year, millions of Americans are overcharged and underserved while the health care industry makes record profits. We know something is wrong, but the layers of bureaucracy designed to discourage complaints make pushing back seem impossible. At least, this is what the health care power players want you to think. Never Pay the First Bill is the guerilla guide to health care the American people and employers need. Drawing on 15 years of investigating the health care industry, reporter Marshall Allen shows how companies and individuals have managed to force medical providers to play fair, and shows how you can, too. He reveals the industry's pressure points and how companies and individuals have fought overbilling, price gouging, insurance denials, and more to get the care they deserve. Laying out a practical plan for protecting yourself against the system's predatory practices, Allen offers the inspiration you need and tried-and-true strategies such as: Analyze and contest your medical bills, so you don't pay more than you should Obtain the billing codes for a procedure in advance Write in an appropriate treatment clause before signing financial documents Get your way by suing in small claims court Few politicians and CEOs have been willing to stand up to the medical industry. It is up to the American people to equip ourselves to fight back for the sake of our families--and everyone else.
Book Synopsis Know Your Rights by : Jennifer C. Jaff
Download or read book Know Your Rights written by Jennifer C. Jaff and published by Advoc. for Patients w. Chronic Ill.. This book was released on 2005-05 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Solved! Curing Your Medical Insurance Problems by : Adria Goldman Gross Fipc
Download or read book Solved! Curing Your Medical Insurance Problems written by Adria Goldman Gross Fipc and published by Outskirts Press. This book was released on 2015-10-24 with total page 130 pages. Available in PDF, EPUB and Kindle. Book excerpt: Consumer protection advocate Ralph Nader praised Solved! Curing Your Medical Insurance Problems: "Who hasn't been bewildered and outraged by lengthy, inscrutable medical bills and the tricky ways of the health insurers? ....Learn what to watch out for in this volume by authors who know the inside ways of sellers who try to take you to the cleaners." Some say, "You get what you pay for." If only this were true! Too often, consumers find themselves paying much more than they expected, getting much less than they bargained for. Medical care is no exception. In their book, the authors show readers how to spot over-charges by providers, under-reimbursements by insurers, and inappropriate denials by insurers and government employees. Furthermore, they presented steps to take to prevent being victimized by "the system." And what is the system? In America, it is a hybrid of private healthcare providers, massive insurance companies, and governments at the state and national levels. Unlike Britain with its single-payer National Health System, this public-private mixed-breed creates the need for patient advocate professionals, who take up the cudgels on behalf of the medically disadvantaged and the financially strapped.
Book Synopsis The Affordable Care Act by : Tamara Thompson
Download or read book The Affordable Care Act written by Tamara Thompson and published by Greenhaven Publishing LLC. This book was released on 2014-12-02 with total page 130 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :0309439124 Total Pages :171 pages Book Rating :4.3/5 (94 download)
Book Synopsis Ending Discrimination Against People with Mental and Substance Use Disorders by : National Academies of Sciences, Engineering, and Medicine
Download or read book Ending Discrimination Against People with Mental and Substance Use Disorders written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2016-09-03 with total page 171 pages. Available in PDF, EPUB and Kindle. Book excerpt: Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.
Book Synopsis Healthcare Unhinged: The Making of an Advocate by : Liz Helms
Download or read book Healthcare Unhinged: The Making of an Advocate written by Liz Helms and published by Page Publishing Inc. This book was released on 2016-05-23 with total page 136 pages. Available in PDF, EPUB and Kindle. Book excerpt: Helms takes us through her unfiltered, uplifting story of chronic pain and severe depression to becoming a nationally recognized coalition builder and health care advocate as she battled to change a system that had failed millions. With stark honesty, she describes her personal struggle for appropriate care and the redemption she found challenging some of America’s most powerful, for-profit corporations on behalf of patient fairness and access to affordable, appropriate standards of quality care for all. “The power of one” an often over-used cliché, but the soul’s message of Unhinged; one woman joined by many to face down one dragon at a time; one voice joined by a chorus to alter forever, the conversation. Helms plots a roadmap for anyone who, even while questioning their own value or power, can move mountains unimagined by owning their voice, their sense of justice and their purpose. Armed with truth, directed purpose and willful respect, Helms proves that the ‘Lion’s den’ is but a myth, waiting to be challenged and exposed as such on behalf of all concerned.
Book Synopsis An American Sickness by : Elisabeth Rosenthal
Download or read book An American Sickness written by Elisabeth Rosenthal and published by Penguin. This book was released on 2017-04-11 with total page 434 pages. Available in PDF, EPUB and Kindle. Book excerpt: A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.
Book Synopsis For-Profit Enterprise in Health Care by : Institute of Medicine
Download or read book For-Profit Enterprise in Health Care written by Institute of Medicine and published by National Academies Press. This book was released on 1986-01-01 with total page 580 pages. Available in PDF, EPUB and Kindle. Book excerpt: "[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.
Download or read book Deadly Spin written by Wendell Potter and published by Bloomsbury Publishing USA. This book was released on 2010-11-09 with total page 289 pages. Available in PDF, EPUB and Kindle. Book excerpt: That's how Wendell Potter introduced himself to a Senate committee in June 2009. He proceed to explain how insurance companies make promises they have no intention of keeping, how they flout regulations designed to protect consumers, and how they make it nearly impossible to understand information that the public needs. Potter quit his high-paid job as head of public relations at a major insurance corporation because he could no longer abide the routine practices of the insurance industry, policies that amounted to a death sentence for thousands of Americans every year. In Deadly Spin, Potter takes readers behind the scenes of the insurance industry to show how a huge chunk of our absurd healthcare expenditures actually bankrolls a propaganda campaign and lobbying effort focused on protecting one thing: profits. With the unique vantage of both a whistleblower and a high-powered former insider, Potter moves beyond the healthcare crisis to show how public relations works, and how it has come to play a massive, often insidious role in our political process-and our lives. This important and timely book tells Potter's remarkable personal story, but its larger goal is to explain how people like Potter, before his change of heart, can get the public to think and act in ways that benefit big corporations-and the Wall Street money managers who own them.
Book Synopsis Catastrophic Care by : David Goldhill
Download or read book Catastrophic Care written by David Goldhill and published by Vintage. This book was released on 2013-01-08 with total page 386 pages. Available in PDF, EPUB and Kindle. Book excerpt: A visionary investigation that will change the way we think about health care: how and why it is failing, why expanding coverage will actually make things worse, and how our health care can be transformed into a transparent, affordable, successful system. In 2007, David Goldhill’s father died from infections acquired in a hospital, one of more than two hundred thousand avoidable deaths per year caused by medical error. The bill was enormous—and Medicare paid it. These circumstances left Goldhill angry and determined to understand how world-class technology and personnel could coexist with such carelessness—and how a business that failed so miserably could be paid in full. Catastrophic Care is the eye-opening result. Blending personal anecdotes and extensive research, Goldhill presents us with cogent, biting analysis that challenges the basic preconceptions that have shaped our thinking for decades. Contrasting the Island of health care with the Mainland of our economy, he demonstrates that high costs, excess medicine, terrible service, and medical error are the inevitable consequences of our insurance-based system. He explains why policy efforts to fix these problems have invariably produced perverse results, and how the new Affordable Care Act is more likely to deepen than to solve these issues. Goldhill steps outside the incremental and wonkish debates to question the conventional wisdom blinding us to more fundamental issues. He proposes a comprehensive new way, where the customer (the patient) is first—a system focused on health and maintaining it, a system strong and vibrant enough for our future. If you think health care is interesting only to institutes and politicians, think again: Catastrophic Care is surprising, engaging, and brimming with insights born of questions nobody has thought to ask. Above all it is a book of new ideas that can transform the way we understand a subject we often take for granted.
Book Synopsis Insurance Bad Faith Litigation by : William M Shernoff
Download or read book Insurance Bad Faith Litigation written by William M Shernoff and published by . This book was released on 1997-03-06 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume provides a complete treatment of tort liability of insurers for wrongful conduct. Topics covered include: the liability insurer's duty of good faith and fair dealing in connection with defence and settlement of third-party actions against the insured; the insurer's duty of good faith and fair dealing in handling claims by insurers under first-party policies; the insurer's liability for violation of statutory claims duties; punitive and compensatory damages; pre-trial practice considerations, discussion of the substantive law, and sample form pleadings and jury instructions, with explanatory comments. This work is updated twice annually.
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :0309459575 Total Pages :483 pages Book Rating :4.3/5 (94 download)
Book Synopsis Pain Management and the Opioid Epidemic by : National Academies of Sciences, Engineering, and Medicine
Download or read book Pain Management and the Opioid Epidemic written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-09-28 with total page 483 pages. Available in PDF, EPUB and Kindle. Book excerpt: Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
Book Synopsis ERISA Basics by : American Bar Association. National Institute
Download or read book ERISA Basics written by American Bar Association. National Institute and published by . This book was released on 2011 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Casino Healthcare written by Dan Munro and published by . This book was released on 2016-03-25 with total page 208 pages. Available in PDF, EPUB and Kindle. Book excerpt: Author Michael Lewis was recently interviewed by Steve Kroft on 60 Minutes and a quote from that interview was the inspiration and influence for Casino Healthcare."If it wasn't complicated, it wouldn't be allowed to happen. The complexity disguises what's happening. If it's so complicated that you can't understand it - then you can't question it." What he was referencing, of course, was high-speed trading on Wall Street, but the quote could just as easily be applied to healthcare. In fact, it's tailor-made.The statistics prove just how much of a casino the U.S. healthcare system has become.* As a country, we now spend over $10,000 per year - for each person - just on healthcare.* Measured as an economic unit, U.S. Healthcare is now the size of Germany. * Preventable medical errors are now the 3rd leading cause of death in the U.S. (behind cancer and heart disease). * Medical debt is the leading cause of personal bankruptcies in the U.S.* Hospital pricing is determined by a cabal - in secret - and beyond legal challenge.* The Pharmaceutical industry - with profit margins that often eclipse tech giants like Apple and Google - paid out a whopping $15 billion in fines over the last six years - just for off-label drug marketing.* American healthcare was recently ranked dead last when compared to 10 other countries.The system has become so complex and opaque that most Americans have simply given up on understanding how it works. Whole families are crushed in this casino trying to pay for unanticipated medical expenses, many of which are immediate, unavoidable and life threatening. The huge expense might be defensible if the system delivered exceptional quality, but it doesn't. When the World Health Organization last ranked health systems, the U.S. came in at #37 - just ahead of #38 (Slovenia) and behind #36 (Costa Rica).Casino Healthcare is not a theoretical policy book for the elite, but a book that penetrates the blanket of fog surrounding a major - and growing - household expense. With the research and style of an investigative journalist, the book is easy to understand and accessible by every American. The U.S. healthcare system was never designed from whole cloth with a strategic vision or intent, but instead it has evolved through the decades with a host of legislative "patches" and temporary fixes. The reason for this is simple. When a casino is generating profits of this magnitude it's critical to keep the casino humming and almost impossible to close it. Rick Scott - now the Governor of Florida - captured the enormous scale of this challenge with this simple two-sentence quote:"How many businesses do you know that want to cut their revenue in half? That's why the healthcare system won't change the healthcare system." Americans have a right to be angry with how the U.S. healthcare system has been hijacked for revenue and profits. One analyst recently categorized it as "legalized extortion on a national scale." In the same way that Michael Lewis exposed the complexity of high-speed trading on Wall Street, Casino Healthcare will expose the U.S. healthcare system for what it really is - a giant casino of epic proportions where the risks are both personal and nothing less than the health of an entire nation.
Download or read book Medicare Essentials written by Tanya Feke and published by . This book was released on 2015-03-28 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt: The best-selling Medicare guide is now available with 2015 updates! Written by Tanya Feke MD, a board-certified family physician, Medicare Essentials tells you everything you really need to know about this government program. With experience both caring for patients and working with administrators, she has learned tricks that can save you money and improve your healthcare experience. This book shares the most up-to-date Medicare information with 2015 cost analyses, a review of Medicare's latest preventive screening offerings, and a discussion of Medicare's controversial 2-Midnight Rule. Simple worksheets guide you through the Medicare maze to help you on your way. Let Dr. Feke be your advocate and explain the fine print.
