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Health Plan Administration/Expert Profile

Linda Woolsteen

U.S.

Available

Expertise

I can help you with questions about health insurance. If you feel your insurance company is mistreating you. Are they telling you they are checking eligibity, pre-existing, etc. Or you just don`t understand how your insurance works or don`t understand what a PPO is.. I can help you.

Past/Present Clients

One company I worked for I was the underwriter for the Academy of Medicine of Cleveland and the Ohio Bar Association. I was also a supervisor of our customer service department.

What do you like about this subject?

Health Insurance costs a lot of money. With over 25 yrs experience in this field, I enjoy helping others navigate through this confusing environment. We all have to have it and If I can help someone using my knowledge it is very worthwhile to me.

What do you still hope to achieve/learn in this field?

There is money in Claims and it can either be in your pocket or theirs! Let me do an audit of your claims for you & see if they were processed correctly. I will read your policy and see if they paid/billed claims correctly. I an expert with appeals, predeterminations. 330.721.6767 or Chandegar@yahoo.com. State background checked.

Something interesting about this subject that others may not know:

Precertification DOES NOT guarantee benefits. No benefits are ever guaranteed. Also, if you are giving money to your provider to meet your deductible.. that money does not go to your deductible by you paying your provider. The only way your deductible gets met is by claims being submitted to your insurance company and if applicable; them applying the claim toward your deductible.

Something controversial or provocative about this subject

I have wrote to our state senator asking for a bill to be passed. For what? Do you know that there are many cases in which money floats back & forth between your Insurance Company & your doctor/hospital and neither of them actually want it! I have proposed it be sent to YOU! when this happens.

Average Ratings

Recent Reviews from Users

User	Date	K	C	P	Comments
Beth	12/31/10	10	10	10
Cheryl Goble	12/20/10	5	10	10	Linda did advise me to make charts .....
sandy	04/18/10	8	10	10	appreciate your response. Thanks
bill	02/20/10	10	10	10
babu	01/09/10	10	10	10	hai linda thanks for the response

Recent Answers from Linda Woolsteen

2011-02-23 Health Insurance Lab Test Cost Denied:

Hi, I am assuming you have a PPO Plan and not a HMO like Kaiser. Ultimately, it is your responsibility to find out beforehand if the provider you are going to use is in your network. The providers

2010-12-31 Recieve innetwork benifets for out of network doctor:

Hi, The facility itself would either be in or out of network and would have nothing to do with the physician sending her for the MRI. Also, most of the time the ancillary physicians are out of network

2010-12-30 Recieve innetwork benifets for out of network doctor:

Hi, I would write on the top in big, bold, letters, "PREDETERMINATION" so it goes to the correct department first of all and doesn't sit around on an examiners desk which does not have the authority

2010-10-08 misinformation:

Hi, Sorry for the delay. Additions of newborns was actually done by another department at our company (Administration) so I wanted to review a policy first before trying to answer you to freshen up on

2010-08-21 Michigan coverage of BCBSFL/Medicare:

Hi, Some of the PPO networks now are national meaning you are able to find providers (doctors, hospitals, etc.) in various states that participate in your plan to be able to get the discounts. If

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