Pathfinder's Blog Posts

…Not a guarantee of payment. Huh?

Your doctor recommends a test or procedure. You’re a wise consumer. You ask your doctor or hospital to pre-authorize coverage, or maybe you even get the codes they will use to bill and call your insurer yourself. You get a pre-authorization reference number or a letter, but somewhere in the documents is a statement that …

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Don’t you talk back to me! (Or, why this *isn’t* always advice worth taking!)

I think it was often the look on my face. I can’t really remember ever “talking back” to an adult, but it’s hard to imagine any kid not wanting to at some point. I suspect there must have been something on my face that indicated I wanted to “talk back” that caused my grandmother or …

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The Good, The Bad, and The Ugly About Dr. Google

(Hint: It’s not personal.) There is no question that the internet has been the most important tool to ever empower patients with knowledge and information to make informed choices about their health and healthcare. Some have even given it a nickname of sorts, “Doctor Google.” It’s the first place many of us go when we …

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Appeal Your Insurance Denial Successfully!

You’ve reviewed the letter from your insurance company that says they’re not going to pay for a service you or a loved one has already had. When the rage has cooled and you re-read the letter, it states the reasons they denied payment, which may or may not make sense to you. Terms like “Didn’t …

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Should you appeal your insurance denial?

  Carla’s* mother had been hospitalized for a week for a hip replacement, and discharged to a skilled nursing facility for rehab. Three weeks after her admission, she received a notice that her mother’s Medicare plan was denying payment for her care because she wasn’t participating in therapy.  Dave* had foot surgery that required the …

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Making Hard Medical Decisions

Back in the glory days of black and white television, Dr. Welby walked into a hospital room, provided a diagnosis, and told his patient what to do. As patients insisted on more of a role in decisions that affect them, often we now find ourselves in the position of our physicians providing options and asking …

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