Do I need a lawyer for Medicare benefits?
An attorney who is an expert at Medicare law can look at your situation and advise you as to whether you should be seeking additional coverage or benefts.
What does a Medicaid lawyer do?
A Medicaid lawyer is a legal professional who specializes in the complex laws of the Medicaid program. A Medicaid lawyer assists eligible people who have been denied coverage in obtaining their legal rights to Medicaid benefits. Medicaid lawyers intervene on a client’s behalf by filing an appeal to review a denial of benefits.
When should I contact a Medicare attorney?
If you feel you are entitled to Medicare and are not getting it, or there is a service that you feel should be covered that is not, contact a Medicare attorney. An attorney who is an expert at Medicare law can look at your situation and advise you as to whether you should be seeking additional coverage or benefts.
Do you need a health & health care lawyer?
If you, as a patient, have issues related to Medicare & medicaid, medical bills, access to care, medical record confidentiality, consent to medical treatment, a health & health care law attorney can help.
What is medical malpractice?
What are some examples of negligence by an anesthesiologist?
What are the damages for a patient who has passed away?
Can a hospital be held liable for medical malpractice?
Can a doctor be found negligent for failing to order a test?
Can MRIs cause serious injuries?
Is medical malpractice a reward?
See more
About this website
What is Medicare Part A responsible for?
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Can you get denied for Medicare Part B?
If a Part A or Part B claim is denied or not handled the way you think it should be, you can appeal the decision. You may request a formal Redetermination of the initial decision.
Who pay if Medicare denies?
The denial says they will not pay. If you think they should pay, you can challenge their decision not to pay. This is called “appealing a denial.” If you appeal a denial, Medicare may decide to pay some or all of the charge after all.
What do I do if Medicare won't pay?
An appeal is the action you can take if you disagree with a coverage or payment decision by Medicare or your Medicare plan. For example, you can appeal if Medicare or your plan denies: A request for a health care service, supply, item, or drug you think Medicare should cover.
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Examples of medical malpractice can include any injury, damage, or loss caused by medical negligence. Most medical malpractice cases involve a patient making a claim against a doctor, hospital, or other medical professionals.
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What to do if you are not entitled to Medicare?
If you feel you are entitled to Medicare and are not getting it, or there is a service that you feel should be covered that is not, contact a Medicare attorney. An attorney who is an expert at Medicare law can look at your situation and advise you as to whether you should be seeking additional coverage or benefts.
What is Medicare insurance?
What Is Medicare? Medicare insurance is a public, government-run and funded insurance plan that provides health coverage for Americans 65 and older. Those with End-Stage Renal Disease are also eligible for Medicare, as are people with certain disabilities even if they are not yet 65.
What is Medicare Advantage?
Medicare Part C, or Medicare advantage, is designed to provide private insurance that covers any gap between what your regular Medicare covers and what you need covered. You will have to pay for Medicare Part C. Medicare Part D provides prescription drug coverage.
How many parts are there in Medicare?
There are four main parts to the Medicare Plan:
What is Medicare for seniors?
Medicare is the federal health insurance program for people who are age 65 or older. Almost all seniors are enrolled in Medicare, which pays for outpatient visits, hospital stays, prescription drugs, and much more. There are four different parts of Medicare, and each part covers a different aspect of health care.
What is Medicare Part C?
Medicare Part C is the least-used type of Medicare coverage. It is a type of health plan offered by a private company that contracts with Medicare to provide Part A and Part B benefits. If you have Medicare Part C, often called a Medicare Advantage Plan, most Medicare services are covered through the plan instead of Medicare Parts A and B. ...
Can you get Medicaid for long term care?
If you or a loved one needs long-term care in a nursing home or assisted living facility, you may want to consider Medicaid instead. Medicaid is a federal needs-based program administered by the states that provides coverage for people who need long-term care.
Can an attorney help with Medicare?
An attorney can help defend you against these claims and reach an ideal conclusion for your circumstances. If you would like to learn more about Medicare or if you need the assistance of an attorney to help you navigate the Medicare process, contact Alperin Law today to schedule your consultation.
Does Medicare cover nursing home care?
Medicare Part A covers inpatient hospital stays (including emergency room visits), care in a skilled nursing facility, hospice care, and some home health care. However, Part A will not cover care in a skilled nursing facility for a long-term resident. If you or a loved one needs long-term care in a nursing home or assisted living facility, ...
Why is it important that a response is prepared by a qualified legal representative?
It is important that this response is prepared by a qualified legal representative to ensure that all the pertinent evidence is submitted and explained in order to achieve a favorable determination.
How many stages are there to appeal a Medicare claim?
After a claim has been denied or reimbursement has been requested, there are five stages to appeal an initial decision by Medicare:
Does CMS audit claims?
CMS has recently increased its audit process, utilizing private contractors to perform review of previously paid claims and to determine whether reimbursement was proper. In the event the auditor determines that a claim was improperly paid based upon coding errors or lack of medical necessity, a request for reimbursement will be submitted to the provider who has a limited time to properly respond.
What is a medicaid lawyer?
A Medicaid lawyer is a legal professional who specializes in the complex laws of the Medicaid program. A Medicaid lawyer assists eligible people who have been denied coverage in obtaining their legal rights to Medicaid benefits.
Who is eligible for medicaid?
Medicaid is the federal program that provides healthcare benefits to a wide variety of people including uninsured individuals with low income, pregnant women, certain children and disabled individuals, and senior citizens who need nursing home care. However, in order to receive Medicaid benefits individuals must meet financial eligibility ...
Do you have to meet financial eligibility requirements for medicaid?
However, in order to receive Medicaid benefits individuals must meet financial eligibility requirements. Medicaid benefits and eligibility requirements are even more complex because each state manages its own Medicaid program while the federal government sets Medicaid policies and contributes money to the state Medicaid fund.
Do you need a lawyer for medicaid?
Medicaid recipients are not the only people who need the services of a Medicaid lawyer. Oftentimes the legal guardian of a child or the caregiver for an elder must act on their behalf to obtain Medicaid benefits or handle other Medicaid problems.
Can a lawyer file an appeal for medicaid?
A Medicaid lawyer may also file an appeal if a Medicaid application is stalled in the system and has not been reviewed in a timely fashion. A Medicaid recipient may have trouble with the care and services received from a health organization authorized to provide Medicaid services.
Is Medicaid a bureaucracy?
Medicaid is a bureaucracy that is a partnership between the federal and state governments with services provided by huge healthcare corporations. It’s easy to understand how mistakes, delays and denials can occur.
What is medical malpractice?
Medical malpractice occurs when a healthcare professional provides treatment that deviates from accepted standards of care within the medical community, thereby causing injury to a patient. If a doctor, surgeon, hospital, or another party was medically negligent, they may be liable for any ensuing losses.
What are some examples of negligence by an anesthesiologist?
Some examples of negligence by an anesthesiologist include: Administering the wrong type of dose of anesthesia. Administering anesthesia too late.
What are the damages for a patient who has passed away?
An injured patient or the family of a patient who has passed may be awarded damages for the harm caused by a negligent medical professional, hospital, or other party. These damages are intended to compensate the victim for losses they’ve suffered, and may include: Medical expenses: - Medical expenses may cover hospital stays, doctor visits, physical therapy, prescription drugs, assistive devices, and other past and future costs associated with your injury. - Lost Wages and Loss of Earning Capacity: If you’re forced to take time away from work to recover from your injury, you may be eligible to collect compensation for lost wages. If you’re unable to earn the same amount of money as you did prior to your injury, you may be awarded compensation for diminished earning capacity. - Pain and Suffering: Pain and suffering damages are designed to compensate the victim for physical pain caused by their injury, as well as emotional distress (e.g., anxiety, fear, depression, and other mental suffering). - Loss of Consortium: Surviving family members may be awarded compensation for the loss of aid, companionship, and other benefits of a family relationship. - Other Damages: You may be awarded other various damages including loss of life’s enjoyment, disfigurement, and punitive damages (intended to punish severe negligence or recklessness).
Can a hospital be held liable for medical malpractice?
Failure to meet these and other standards may be grounds for a medical malpractice lawsuit. In addition, hospitals can be held vicariously liable if an employee or staff member causes injury to a patient, provided the employee was acting within the scope of their employment at the time the negligent act took place.
Can a doctor be found negligent for failing to order a test?
Failing to order tests: A doctor can be found negligent for failing to order standard tests after observing certain symptoms. Failing to interpret test results correctly: Medical professionals are responsible for interpreting test results correctly.
Can MRIs cause serious injuries?
Medical devices such as MRIs are used routinely to diagnose, treat, and prevent illnesses. However, they can be misused and result in serious injuries or even death. In addition, manufacturers can be liable for manufacturing defects, design defects, and inadequate warnings.
Is medical malpractice a reward?
Unfortunately, that trust isn’t always rewarded. In some instances, the actions (or lack thereof) of a healthcare professional may rise to the level of malpractice.
What is medical malpractice?
Medical malpractice occurs when a healthcare professional provides treatment that deviates from accepted standards of care within the medical community, thereby causing injury to a patient. If a doctor, surgeon, hospital, or another party was medically negligent, they may be liable for any ensuing losses.
What are some examples of negligence by an anesthesiologist?
Some examples of negligence by an anesthesiologist include: Administering the wrong type of dose of anesthesia. Administering anesthesia too late.
What are the damages for a patient who has passed away?
An injured patient or the family of a patient who has passed may be awarded damages for the harm caused by a negligent medical professional, hospital, or other party. These damages are intended to compensate the victim for losses they’ve suffered, and may include: Medical expenses: - Medical expenses may cover hospital stays, doctor visits, physical therapy, prescription drugs, assistive devices, and other past and future costs associated with your injury. - Lost Wages and Loss of Earning Capacity: If you’re forced to take time away from work to recover from your injury, you may be eligible to collect compensation for lost wages. If you’re unable to earn the same amount of money as you did prior to your injury, you may be awarded compensation for diminished earning capacity. - Pain and Suffering: Pain and suffering damages are designed to compensate the victim for physical pain caused by their injury, as well as emotional distress (e.g., anxiety, fear, depression, and other mental suffering). - Loss of Consortium: Surviving family members may be awarded compensation for the loss of aid, companionship, and other benefits of a family relationship. - Other Damages: You may be awarded other various damages including loss of life’s enjoyment, disfigurement, and punitive damages (intended to punish severe negligence or recklessness).
Can a hospital be held liable for medical malpractice?
Failure to meet these and other standards may be grounds for a medical malpractice lawsuit. In addition, hospitals can be held vicariously liable if an employee or staff member causes injury to a patient, provided the employee was acting within the scope of their employment at the time the negligent act took place.
Can a doctor be found negligent for failing to order a test?
Failing to order tests: A doctor can be found negligent for failing to order standard tests after observing certain symptoms. Failing to interpret test results correctly: Medical professionals are responsible for interpreting test results correctly.
Can MRIs cause serious injuries?
Medical devices such as MRIs are used routinely to diagnose, treat, and prevent illnesses. However, they can be misused and result in serious injuries or even death. In addition, manufacturers can be liable for manufacturing defects, design defects, and inadequate warnings.
Is medical malpractice a reward?
Unfortunately, that trust isn’t always rewarded. In some instances, the actions (or lack thereof) of a healthcare professional may rise to the level of malpractice.
