(931) 437-2147 info@deniedclaimshelp.com

Need Help…?

…with denied health insurance claims?

Medical Claim Form
Precertification Forms

…with denied precertification for medical treatment?

…determining what you actually owe a medical provider?

Medical Claim Form

Staggering Statistics…

Medical Bill

$262 billing in medical claims are intially denied

(Source: Change Healthcare)

Out of all the denied claims, 65% of them are never reworked

(Source: Change Healthcare)

30% of claims are either denied, lost or ignored

(Source: Centers for Medicare and Medicaid Services)

These are some examples of the clients I have helped and a brief description of their health insurance fiasco:

Brenda K.’s spouse was in the final stages of cancer. They had satisfied both their deductible and out of pocket maximum, therefore, insurance was paying 100% of the allowed amount until she gets a bill for approximately $450 from a doctor. After reviewing the explanation of benefits, the conclusion was the insurance processed the claim as out of network because the doctor was out of network with this insurance carrier although this service was rendered at an emergency room. After I filed an appeal the insurance company payed the claim at 100% of the allowed amount. Brenda did not owe the provider anything.

Maxine B. had traditional Medicare and a supplement. After an extended stay in a skilled nursing facility she passed away. The skilled nursing facility started sending the executor of the estate statements with her balance in the thousands of dollars which she did not owe. I was able to resolve the billing issue and the estate was not responsible for the bills.

Cliff M. was supporting his family by driving a gravel truck until he lost the feeling in his hands and could not steer the truck safely. The orthopedic surgeon recommends surgery to repair cervical discs but his health insurance (precertification department) denies the procedure. Cliff contacted me to help with the mountain of problems between not able to work to support his family, he can’t have the surgery due to the precertification was denied and his employer is wanting to know when is he having surgery? I was able to get the denied precert overturned and he was able to have the surgery which insurance paid for and get back to work.

Carol C. received bills for approximately $15,000 after surgery and treatment on her left knee.  Carol has original Medicare and a supplement.  After speaking with Medicare I was able to resolve the issues and her bill was paid by insurance.  The issue was an open Worker’s Compensation claim with Medicare that needed to be resolved before claims were processed for payment.

Mission Statement

Helping individuals with denied health insurance claims, denied precerts, billed for out of network services when you think your health insurance should have paid. Helping the patient review Explanation of Benefits with clarification and ensure the amount you are paying a provider is correct.

Medical Claim Form

All health insurance policies have an appeals process. An appeal can be challenging, though. In fact, Ruth A. Carnes, an appeal nurse at Mercy Medical Center in Baltimore, says “for people with no medical background, [appeals] can be very overwhelming.”

Pursuing a health insurance appeal takes effort and time, too. But it’s probably worth it. According to Jennifer Obenchain, case management director at the Patient Advocate Foundation in Hampton, Va., 65% of appeals are successful.

(Source: Forbes article 07/23/2019)



  • Most medical providers send out estimated statements which can often be incorrect. I can assist you figuring out how much you truly owe the medical provider.
  • I can help in requesting a refund from a medical provider or setting up a payment plan for you and your provider.
  • After working as a medical coder, billing all insurances and working recovery for over 18 years I have learned the insurance language and helped many patients resolve their insurance issues. I would be happy to assist you with your insurance concerns.
  • I strongly encourage keeping all explanation of benefits, billing statements, receipts and all correspondence with the medical provider and insurance company.

Due to the nature of this information all employees of Patient Advocate Consulting, LLC willing comply with all HIPPA laws.

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Phone: (931) 437-2147  Email: info@deniedclaimshelp.com