Health Plan Administration/Expert Profile


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Gail Nowacky

U.S.
Available
Expertise

An expert in health plan disputes, medical benefit administration and medical bill review. I can answer questions regarding health plans, claims, denials, appeals, coverage and incorrect balance billing by healthcare providers.

Experience in the area

25 years working for or with almost every major insurer or reinsurer that provides health insurance.

Organizations

ACAP, MBAA, several local business groups and chambers of commerce.

Publications

Many industry periodicals

Education/Credentials

Associate Life & Health Claims

Average Ratings

Recent Answers from Gail Nowacky

2011-08-06 cost of surgery:

I can surely help you research this. If you would be kind enough to email me directly, I would prefer communicating that way as this will take some conversations together to go over your condition, what

2011-07-13 letter stating no longer on insurance:

Have you submitted a termination notice to HP yet? If not, I suggest that you let them know you are terminating on 7/31. They will go over the termination procedures with you. When you are terminated,

2011-05-27 out of network lab charges:

Provider contracts require a physician to use in network labs. If your GYN used a non participating lab, you need to hold him/her accountable.     You can appeal this with Aetna and you can also file a

2009-03-05 health insurnce coverage once divorced:

You must meet the eligibility requirements of his health plan to be covered and if you don't meet them then you are not eligible and the plan won't pay for your medical expenses. Did your husband or you

2007-06-12 PPO adjustment:

Ask that doctor for a copy of the "law" he is quoting. Your are probably dealing with an outside billing company. Talk to the doctor himself. Send the doctor a certified letter asking him for clarification

 

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