Category: Health Plans

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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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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Trump expects voters to fall for the same health care trick twice

As a presidential candidate four years ago, Donald Trump not only railed against the Affordable Care Act; he also made bold promises about the magnificence of his alternative plan. The Republican’s alternative to “Obamacare” would offer everything Americans they could dream of, including better coverage at a lower price. All voters had to do was elect him.

In reality, of course, Trump didn’t know and didn’t care about how to deliver on these promises. He was peddling post-policy nonsense, counting on the electorate to not know the difference.

As a president, when it came time to follow through, Trump was lost without a map, amazed to discover the complexities of an issue he never he even tried to understand. The Republican endorsed plans that did the opposite of what he told voters he’d do, and when it came time to engage in actual negotiations, Trump struggled to keep up —

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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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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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York County schools plan to bring back more grades in early November

More grades could return to schools in November under a plan presented Monday evening to the York County School Board.

Last week, preschoolers, kindergartners and first graders returned as part of a two-day-a-week hybrid model. District leaders released a plan in September to bring back students up through third grade by Oct. 19. Some students with disabilities — and English language learners — also returned in September.

Superintendent Victor Shandor told the school board they’re on target to meet that goal and tentatively hope to have all elementary grades back on Nov. 5. Sixth and ninth graders could return Nov. 9, assuming conditions allow.

“This is a draft — it is target dates,” Shandor said. None of this is in stone.”

Administrators described the return of pre-K through first grade on Oct. 5 as a success that will hopefully translate to older grades.

“I would consider it definitely a success

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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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Health care law on line at court, but is it likely to fall?

WASHINGTON (AP) — To hear Democrats tell it, a Supreme Court with President Donald Trump’s nominee Amy Coney Barrett could quickly get rid of the law that gives more than 20 million Americans health insurance coverage.

But that’s not the inevitable outcome of a challenge the court will hear Nov. 10, just one week after the election.

Yes, the Trump administration is asking the high court to throw out the Obama-era healthcare law, and if she is confirmed quickly Barrett could be on the Supreme Court when the court hears the case.

But even if the justices agree that the law’s mandate to buy health insurance is unconstitutional because Congress repealed the penalties for not complying, they could still leave the rest of the law alone. That would be consistent with other rulings in which the court excised a problematic provision from a law that was otherwise allowed to remain

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