Dealing with denial of cashless settlement and huge deductions in health insurance claims



a group of people in a room: COVID-19 treatment: Dealing with denial of cashless settlement and huge deductions in health insurance claims


© Venkatasubramanian K
COVID-19 treatment: Dealing with denial of cashless settlement and huge deductions in health insurance claims

In the past few months, we’ve heard several stories of people with health insurance policies facing claim rejections, not getting cashless treatments, or having to pay hospital bills out of pocket for COVID-19 hospitalizations. There could be many reasons that insurers give for rejecting claims. Some situations are avoidable. You must ensure that a COVID diagnosis or treatment does not burn a hole into your hard-earned savings.

This article discusses some such key issues, along with actions you could take to avoid or reduce the financial burden of an already taxing health situation.

Claims declined for mild symptom cases: Health Insurance policies cover hospitalization treatments that are considered ‘necessary’ – where there is active treatment carried out in a hospital, under any local or international medical protocol. The claim could be declined

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Pandemic-related job cuts have led 14.6M in U.S. to lose insurance

Up to 7.7 million U.S. workers lost jobs with employer-sponsored health insurance during the coronavirus pandemic, and 6.9 million of their dependents also lost coverage, a new study finds.

Workers in manufacturing, retail, accommodation and food services were especially hard-hit by job losses, but unequally impacted by losses in insurance coverage.

Manufacturing accounted for 12% of unemployed workers in June. But because the sector has one of the highest rates of employer-sponsored coverage at 66%, it accounted for a bigger loss of jobs with insurance — 18% — and 19% of potential coverage loss when dependents are included.

Nearly 3.3 million workers in accommodation and food services had lost their jobs as of June — 30% of the industry’s workforce. But only 25% of workers in the sector had employer-sponsored insurance before the pandemic. Seven percent lost jobs with employer-provided coverage.

The situation was similar in the retail sector. Retail

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How we can help the unemployed keep their health insurance

Keith Prisco is a stagehand at the United Center in Chicago and a proud union member of IATSE Local 2. Like tens of millions of Americans, he receives health insurance through his employer for himself and his family. The security of this coverage is even more important for Keith after he was diagnosed with leukemia four years ago. But when COVID-19 put a screeching halt on live events, that meant Keith was out of work — jeopardizing his health care coverage in the middle of a pandemic.

As COVID-19 continues to threaten the health and safety of Americans, millions of workers have found themselves under threat of losing their jobs, their health coverage, and their financial savings — all through no fault of their own.

It is unconscionable that unemployed or furloughed workers could also lose health coverage during a public health crisis, yet there are an estimated 10 to

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Health insurance changes leave many surprised with lack of cover

As a paramedic, Natalie Glaser has a highly stressful job, with long hours and shift work.

She went to her GP, complaining of an upset stomach.

“I was really scared as well, and I still am scared,” she told PM.

But when the doctor advised her to get a colonoscopy straight away, her anxiety grew further.

“My GP asked me if I’d like to go to the private hospital system or the public, and I took out my HCF cover because I said I’m sure I’m covered for this procedure,” she recalled.

“When I pulled it out and it said I wasn’t covered for it, I was quite confused.”

Natalie Glaser said she lost the majority of her coverage when HCF reviewed her policy and moved her down to a lower-cost, more basic level of coverage.

“I lost 18 out of 25 procedures — that’s about 72 per cent of

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Tips for Navigating Medical Care Without Health Insurance

Millions of people in the U.S. live without health insurance, a circumstance that can cause people to weigh the need to see a doctor against the cost. Unfortunately, many people will put off or do without medical care because they can’t afford it, a decision that could jeopardize their health.

(Getty Images)

While the Affordable Care Act has boosted the number of Americans with insurance, millions remain uninsured. In 2018, 27.5 million people – more than 8% of the U.S. population – were uninsured, according to the U.S. Census Bureau. Private health insurance covered 67% of Americans. Those without health coverage face the dilemma: Where can I go for medical care without insurance?

The Coverage Gap

In addition to the people who are uninsured, millions are underinsured, according to a survey by the Commonwealth Fund. Among people with health insurance, 29% were underinsured in 2018, compared to 23% in 2014,

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We Like Our Health Insurance And Working From Home

Jan Dubauskas is the Vice President of Healthinsurance.com.

We have experienced a lot of change throughout the course of the pandemic that has required us to reconsider our priorities and become nimble in the way we work and how we reach out to our clients. Many were skeptical that these changes would lead to similar productivity. However, as we prioritize our health during the pandemic, working from home has become important, and many (24%, according to CNBC) have adapted so well that they want to keep doing it.

When we first started working from home, the primary concern for many was to set up an office, retain camaraderie, and continue meeting with clients. During the spring, as I watched as annual springtime conferences got canceled or sent to an online format, I keenly felt the void previously filled by those intense social interactions. It seemed that with a bit

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Numbers Soar for Texas Kids Without Health Insurance / Public News Service

Seven Texas counties – Harris, Dallas, Tarrant, Hidalgo, Bexar, Travis and El Paso – were among the top 20 counties in the nation with the highest number of uninsured children, according to a report by the Georgetown University Center for Children and Families. (Semevent/Pixabay)

October 13, 2020

AUSTIN, Texas — Advocates for children are calling on Texas lawmakers to take action in the next legislative session, after a new report shows the state has the highest number of children in the nation without health insurance.

Texas had an estimated 995,000 uninsured children in 2019, an increase of 243,000 from three years earlier. Data in the annual report from the Georgetown University Center for Children and Families was collected in 2019, during a relatively strong economic period.

Patrick Bresette, executive director at the Children’s Defense Fund-Texas, said he was startled by the dramatic increase – especially because the data was collected

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Americans need to separate health insurance from our jobs

If we want to radically improve insurance and health care in our country to ensure that every American receives the care they need, we have to be bold. And that begins with divorcing insurance from where we work.



a close up of a person sitting on a chair: Getty Images


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Not only would that improve the choices of consumers, but it would also help lower costs and provide more options for people who aren’t covered in the current system. That would empower individuals to choose their health plans according to their needs.

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As of March 2019, the U.S. Census estimates that 91% of the population had health insurance. Nearly one third receive coverage from government health insurance, whether Medicare, Medicaid or state employees. Left out are approximately 29.9 million Americans without health insurance — public, private or otherwise.

The number of uninsured is an important metric because it is the target group for

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China’s public health insurance agency says it can’t afford to provide Covid-19 vaccine for free



a person holding a wine glass: A man works in a Sinovac Biotech laboratory in Beijing. An experimental Covid-19 vaccine developed by the company is one of four Chinese candidates in the final stage of human trials. Photo: Reuters


A man works in a Sinovac Biotech laboratory in Beijing. An experimental Covid-19 vaccine developed by the company is one of four Chinese candidates in the final stage of human trials. Photo: Reuters

With four Chinese vaccine candidates in the final stage of human trials, it is still not clear whether Beijing plans to provide Covid-19 shots for free after the public health insurance agency said it would not pay for them.

Some advanced economies, including the United States, Australia and Japan, have said any Covid-19 vaccines they buy – provided they have been proven safe and effective – will be made available to their citizens for free.

But China’s National Healthcare Security Administration on Friday said the medical insurance system could not afford the “high cost” of vaccinating the population. It made the remarks in a public reply to a request for free vaccinations from an unidentified deputy of

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MoHAP launches ‘Post Office’ initiative to improve health insurance claims process

DUBAI — The Ministry of Health and Prevention (MoHAP) has launched the “Post Office” initiative as part of the National Unified Medical Records “Riayati”, a linkage system between hospitals and clinics and health care providers.

From improving treatment services and reducing healthcare costs in the UAE, to achieving a smart and integrated health system that serves the beneficiaries of health services and strengthening the control over the insurance system to reduce the misuse of financial resources, the new service helps provide better management of the central information related to the electronic insurance claims and their tracking

The post office service is covering the workflow of all claims between healthcare facilities and insurance companies, such as the verification of eligibility and insurance coverage and e-payments, including claims submission and tracking refusals. All the mentioned services are available for use by the authorized users in the healthcare facilities without having to rely

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