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  You are here:  AllExperts > Industry > Health Plan > Medicare, Medicaid, Insurance, HMO problems

Expert Profile: Tricia

Expertise:  Has your medical insurance company denied your claim and refuses to pay? Have you received a pre-authorization and still your insurance company refuses to pay? How can you get your insurance company to reverse a denied claim? How do you get a provider to waive your copayment if you are financially unable to pay? Can a provider sue you for a unpaid bill and will they? Can a provider send me to a collection agency for a medical bill? If my insurance company does not pay, am I responsible? If you have these questions or others on why your insurance company is not paying your bills, I can help. I can give you "tricks of the trade" to get your insurance company to pay. I have limited knowledge on Medicare and Medicaid and that is not my expertise. Each state is very different regarding Medicare and Medicaid so you need to review their website when you have questions. So please no Medicare or Medicaid questions!!

Experience in the area
In the medical field for over 20 years spending majority of time in the collections aspect.

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Recent Answers from Tricia
2009-07-01  Out of network benefits for prenatal care. Hi Tiffany! If your out of network benefits is 70/30 then you probably will receive a bill for your portion as the bills get paid. The only way not to is if the hospital is accepting your out of...
2009-06-30  Michigan - Can a chiropractor charge a 100% markup if not paying with cash? Hi Helen! Most providers/Dr's have a set price (UCR) for those with insurance and then a prepay price if someone does not have any type of insurance. The prepay is much lower allowing those without...
2009-06-18  insurance won't pay Hi Bo! Depends on the explanation of benefits that you got from your insurance carrier when they denied. Look to see if they say you are responsible.......if you can not find the eob then call them...
2009-06-15  Secure Horizon/Medicare billing questions Hi Carolyn! Sometimes AARP has local centers that can help Medicare patients. Check their site to see if they have something or perhaps call them. Also senior citizen sites in her area may help out...
2009-06-12  Surgeon/Insurance Billing Problem Hi Angie! I would first call Aetna yourself because usually under an HMO plan the provider/Dr is required to get authorization prior to any service and if they do not then the patient is not liable...
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