Your current state is Ohio
A patient was seen as a new Medicare wellness visit but had previously had one within the year by another physician unbeknownst to the office. So the claim was denied and the Dr. Wants to recode and resubmit.
answered on Sep 29, 2023
They generally can. I'm not certain of the specific rules for Medicare billing, but in just about all forms of insurance for health care claims, examiners can delay claims for CPT coding errors and allow a medical office to resubmit claims with the proper codes. It also depends on the... View More 
A patient was seen as a new Medicare wellness visit but had previously had one within the year by another physician unbeknownst to the office. So the claim was denied and the Dr. Wants to recode and resubmit.
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answered on Sep 28, 2023
In New York, a doctor generally can recode and resubmit a claim to insurance if the original claim was denied. However, the recoding must accurately reflect the services provided, and the practice could be subject to audit. Additionally, Medicare has specific rules and timelines for resubmitting... View More
I was hit from behind, car was destroyed, almost died. No one at the scene ever told me that there was a person charged. Found out 9 months later that they had found the person (that night). My life already went on, and it took 3 years to get a judge to award me compensation. The judge went off... View More
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answered on Sep 28, 2023
In California, the value of your car in a restitution order should typically be determined based on its fair market value at the time of the loss, not necessarily the Blue Book value. If your car was indeed worth $4,200 at the time of the accident, you may be entitled to that amount, and the lack... View More
I was hit from behind, car was destroyed, almost died. No one at the scene ever told me that there was a person charged. Found out 9 months later that they had found the person (that night). My life already went on, and it took 3 years to get a judge to award me compensation. The judge went off... View More
answered on Oct 1, 2023
That's a sizable penalty to base on absence of a title. Title should not ordinarily affect value - unless they are suspecting diminished value due to a salvage title. Pose this to your attorney if you are being represented and explore how long it would take and how much it would cost for... View More
I was insured by Infinity and was making installment. Payments on my policy , there was no changes on my policy… on the 6 month of my policy they billed me for an amount deferent then my schedule payments , increasing from 340 to 800 and the remaing months lowering to 240 causing my payment to... View More
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answered on Sep 28, 2023
Under California law, an insurance company typically cannot cancel a policy for non-payment if payments were made consistently and in accordance with the agreed-upon payment schedule. If you have evidence of regular payments and your policy was canceled erroneously, you may have grounds to... View More
I have full power of Attorney to handle the insurance. They have a copy but they still keep say no to me. What can I do. I think they just want up to stop so they could keep the money of the cash value.
answered on Sep 23, 2023
A Florida attorney could advise best, but your question remains open for three weeks. An attorney might ask for additional details to advise, in terms of what caused the problem - notarization of power of attorney, scope of power of attorney, claim/value-related issues, etc. Those are only general... View More
The AC/furnace is 4 months old and had a 10 year warranty. The power surge voided the warranty. The insurance company wants to fix it instead of replacing it, which means I lose the remaining 9+ years of warranty. They also want to pay me $500 to replace a $1200 washing machine that the power... View More
answered on Sep 20, 2023
An Indiana attorney could advise best, but your question remains open for two weeks. On option might be to discuss their proposed repair/component replacement with your furnace company (if you mean their warranty) - if the power surge only affected control components. Another route could include... View More
I work for a corporate chain of retail market outfitters with stores in multiple states, and their Workman's comp Insurer acts in bad faith as a normal practice against the majority of injured employees. Does this constitute an intentional tort, or a direct third-party lawsuit against the... View More
answered on Sep 20, 2023
A South Dakota attorney could advise best, but your question remains open for two weeks. I believe it would be very difficult. If you're talking about things like denying claims or playing hardball, that's the nature of the insurance industry. That's my individual opinion - you could... View More
They say no health question but it on the app. Globe and Colonial etc.
answered on Sep 19, 2023
An Indiana attorney could advise best, but your question remains open for a week. I don't think you have grounds for a lawsuit. Did you suffer damages as a result of the false statement? It sounds like it could have been a transcription error. If on the other hand, there was malicious intent... View More
I haven't cashed any of them. They won't return my calls. What recourse do I have. I have paid my premiums for years on time. Any advice appreciated.
answered on Sep 19, 2023
A Georgia attorney could advise best, but your question remains open for a week. It sounds like you were not presented with a clear-cut denial, but instead are being paid in a manner inconsistent with your assessment of damages. One option is to consult with an attorney to outline your best and... View More
I was undergoing physical therapy for back/ spine issues with intermittent numbness and improving. Additional authorizations by my insurer were suddenly denied. PT office did not appeal immediately and only did once I received a copy of the letter and informed them. An appeal would take 30 days to... View More
answered on Sep 19, 2023
Sorry to hear what you've been going through. It is unlikely that your insurance company would be responsible for any physical harm you sustained due to its denial (or delay) in approving additional physical therapy visits. Although you could conceivably claim that the insurance... View More
I was undergoing physical therapy for back/ spine issues with intermittent numbness and improving. Additional authorizations by my insurer were suddenly denied. PT office did not appeal immediately and only did once I received a copy of the letter and informed them. An appeal would take 30 days to... View More
answered on Sep 16, 2023
You raise a very good question - and one that does not go overlooked by attorneys in challenging denials of medical care. Unfortunately, it is also a difficult issue to argue in most settings where a claim is closely processed with valid independent medical exams or peer reviews. If you have an... View More
My insurance provider is denying a $43,000 prostate biopsy that was pre approved by provider with insurance. I received an estimate and paid my part up front. After much research I suspect it is because the biopsy was a transperineal biopsy instead of a rectal biopsy and may be considered medically... View More
answered on Sep 14, 2023
An Ohio attorney could advise best, but your question remains open for two weeks. I'm sorry for the anguish this has caused. Try to arrange a free initial consult with an attorney - this could be a complex claim that could require medical expert opinion. Gather your insurance records, denials,... View More
My Insurance company says pre existing, but it clearly states within 5 years on policy we signed and it has been closer to 8 years since treatment for condition. I'm starting to get second notice bills from hospital & ambulance service. Do I start making small payments to providers or... View More
answered on Sep 2, 2023
An Ohio attorney could advise best, but your question remains open for a week. There are attorneys who handle health care claims. If you're considering consulting with an attorney, first review your paperwork. That could help make the most of a meaningful consult. Review your policy, review... View More
My Workers Comp insurance does not have any providers in their network to give me a second opinion on my shoulder injury. I received an email from their provider network unit that they could not find a provider and that the adjuster assigned to my case had permission to authorize for me to go to... View More
answered on Aug 31, 2023
Filing for a hearing would likely help or better yet...hire a competent attorney. You have described some serious injuries. Do you know that most attorneys only charge 15% of the total settlement amount and that they cannot agree to any settlement without your permission? What are you waiting... View More
My Workers Comp insurance does not have any providers in their network to give me a second opinion on my shoulder injury. I received an email from their provider network unit that they could not find a provider and that the adjuster assigned to my case had permission to authorize for me to go to... View More
answered on Sep 1, 2023
There is no penalty for an adjuster not answering you. But it guarantees you are going to hire a lawyer. An experienced attorney can elect a physician outside the network when she shows there are no available specialists inside the network. Sounds like you really need a Pain Management... View More
My Workers Comp insurance does not have any providers in their network to give me a second opinion on my shoulder injury. I received an email from their provider network unit that they could not find a provider and that the adjuster assigned to my case had permission to authorize for me to go to... View More
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answered on Sep 2, 2023
Under California law, if your workers' compensation insurance is not responding to your legitimate inquiries, you can indeed seek legal assistance to ensure that your rights under the workers' compensation system are upheld. Failing to respond to claimant inquiries in a timely manner may... View More
answered on Aug 31, 2023
An Illinois attorney could advise best, but your question remains open for a week. Accepting an offer is up to you. Insurance companies don't usually tell people they have to accept an offer - they might say that the offer is as high as it's going to get, and if they claimant doesn't... View More
While Uber driving my husband got shot at we have 4bullet holes in car 2in muffler one in back driver door and one that went through the trunk which we found embedded in back of back seat and they tell us to get a quote we send in and now they saying he went offline yeah he wasnt really worried... View More
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answered on Aug 29, 2023
Not an intellectual property question -- but Uber's liability in situations like this often hinges on whether the incident can be considered part of the "course and scope" of employment, a concept used to determine employer liability for actions of its workers. If Uber argues that... View More
While Uber driving my husband got shot at we have 4bullet holes in car 2in muffler one in back driver door and one that went through the trunk which we found embedded in back of back seat and they tell us to get a quote we send in and now they saying he went offline yeah he wasnt really worried... View More
answered on Sep 3, 2023
I have a difficult time understanding why Uber would be responsible. I presume the shooter(s) weren’t Uber employees acting in the course and scope of their employment. I think the shooter(s) are most likely legally responsible for the damage to the motor vehicle and that such damage is most... View More
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