Why does your doctor bill one amount, but your insurance pays something completely different? In this episode of the Take Care podcast, Melody Mulaik breaks down one of the most confusing parts of healthcare billing and explains why the number on your bill is rarely the number your physician receives.

Using a real listener question, this episode walks through how insurance contracts work, how in-network and out-of-network status is decided, and why Medicare rates play such a big role in what doctors are paid. Melody also explains the real costs physicians carry behind the scenes and why the gap between charges and payments exists in the U.S. healthcare system.

If you’ve ever looked at an Explanation of Benefits and thought, “This makes no sense,” this episode is for you.

In this episode, Melody discusses:

• 00:00 – Why insurance doesn’t pay what your doctor charges
• 00:27 – How doctors negotiate with insurance companies
• 00:56 – In-network vs. out-of-network explained
• 01:21 – How insurance companies decide what they pay
• 01:55 – What Medicare rates really mean
• 02:40 – Medicare allowed amounts and patient responsibility
• 02:55 – Why insurance might pay more or less than Medicare
• 03:17 – Percentage-of-charge contracts (and why they’re rare now)
• 03:43 – Why charges still look so high
• 04:09 – The real costs of running a medical practice
• 04:29 – Why billing and reimbursement are separated in U.S. healthcare
• 04:51 – How this affects what patients ultimately owe

Take Your Healthcare Advocacy Further

Navigating the healthcare system doesn't have to be a solo journey. For deeper dives into the topics we discuss on the show, plus exclusive "insider" tips delivered straight to your feed, subscribe to Take Care Newsletter.

• Subscribe to the Take Care Newsletter
• Connect With Melody on LinkedIn
• Got a Healthcare Question? Ask Melody Now.

You went to the doctor, paid your copay… and then a separate lab bill showed up. Why does this happen?

In this episode of Take Care, Melody Mulaik explains why lab work is often billed separately from your doctor’s visit, how insurance companies classify lab services, and why those charges may apply to your deductible instead of your copay.

You’ll learn the difference between preventive and diagnostic lab tests, what questions to ask before getting bloodwork done, and how to check your insurance so you only pay what you truly owe.

This episode helps you make sense of unexpected lab bills and avoid paying more than you need to.

In this episode, Melody discusses:

• 00:00 – Why lab bills often arrive separately from your doctor visit
• 00:41 – Doctor visits vs lab services: why they’re considered different
• 01:37 – How lab companies and outside processing work
• 02:08 – How insurance plans “bucket” lab services
• 03:01 – Copays, deductibles, and how labs are billed
• 03:41 – Preventive labs vs diagnostic labs explained
• 04:28 – When labs during an annual visit become diagnostic
• 05:03 – Asking if your lab is in-network
• 05:53 – Finding out where your labs are sent
• 06:14 – Mixed preventive and diagnostic labs in one visit
• 06:49 – Asking for cost estimates before bloodwork
• 07:29 – Why you should always verify lab bills with your insurance
• 08:00 – Final reminders on validating what you actually owe

Take Your Healthcare Advocacy Further

Navigating the healthcare system doesn't have to be a solo journey. For deeper dives into the topics we discuss on the show, plus exclusive "insider" tips delivered straight to your feed, subscribe to Take Care Newsletter.

• Subscribe to the Take Care Newsletter
• Connect With Melody on LinkedIn
• Got a Healthcare Question? Ask Melody Now.

Filling a prescription seems simple until you’re faced with multiple options, insurance rules, and cost differences that aren’t always explained.

In this episode of Take Care, host Melody Mulaik answers a listener’s question: Where should I get my prescriptions filled? Melody walks through the pros and cons of local pharmacies versus mail-order prescriptions and explains how to decide based on urgency, cost, insurance coverage, and personal preference.

This episode helps you understand that there’s no one-size-fits-all answer and that you’re allowed to mix and change options as your needs evolve.

In this episode, Melody discusses:

• [00:30] Why this question is more complex than it sounds
• [01:00] In-person pharmacies: grocery store vs freestanding locations
• [01:35] The advantage of same-day and 24-hour pharmacies
• [02:00] Why access to a pharmacist matters, especially for new medications
• [02:45] Mail-order prescriptions and why they’re usually 90-day supplies
• [03:10] Cost savings and convenience of mail-order medications
• [03:45] Insurance considerations and mail-order contracts
• [04:30] Why you don’t have to choose just one option
• [05:00] How to decide what works best for your situation

Take Your Healthcare Advocacy Further

Navigating the healthcare system doesn't have to be a solo journey. For deeper dives into the topics we discuss on the show, plus exclusive "insider" tips delivered straight to your feed, subscribe to Take Care Newsletter.

• Subscribe to the Take Care Newsletter
• Connect With Melody on LinkedIn
• Got a Healthcare Question? Ask Melody Now.

Finding out your doctor can no longer see you is a jarring experience that can leave you feeling dismissed and anxious about your health.

In this episode of Take Care, host Melody Mulaik demystifies the process of "physician dismissal." You’ll learn why this happens, what legal protections you have against patient abandonment, and most importantly, the immediate steps you need to take to ensure your care isn't interrupted.

In this episode, Melody discusses:

• [00:45] The Hard Truth: Can a doctor really "fire" a patient?
• [01:10] Understanding Patient Abandonment: Why they can’t just stop caring for you without notice.
• [02:00] The Notice Period: What to look for in your formal written communication.
• [03:00] The Action Plan: Securing medical records and ensuring you have access to prescriptions.
• [04:00] Finding Your New Provider: Resources, insurance tips, and referral advice.
• [04:45] Your Rights: When and how to contact your state medical board.

Take Your Healthcare Advocacy Further

Navigating the healthcare system doesn't have to be a solo journey. For deeper dives into the topics we discuss on the show, plus exclusive "insider" tips delivered straight to your feed, subscribe to Take Care Newsletter.

• Subscribe to the Take Care Newsletter
• Connect With Melody on LinkedIn
• Got a Healthcare Question? Ask Melody Now.

Have you ever signed a HIPAA form at the doctor’s office and wondered what you were actually agreeing to? In this episode, Melody Mulaik breaks down the Health Insurance Portability and Accountability Act (HIPAA) to demonstrate that it’s more than just paperwork; it’s a powerful tool for patient empowerment.

From your right to access your own records to how you can dictate who sees your information, Melody explains how to navigate these protections to ensure your healthcare remains accurate, private, and within your control.

In this episode, Melody discusses:

• [00:00] What is HIPAA and why does it matter to you?
• [01:12] Your right to access and own copies of your medical and billing records
• [01:58] How to request changes or amendments to inaccurate medical information
• [02:40] Understanding the Notice of Privacy Practices (NPP)
• [03:45] Requesting restrictions on how your information is shared
• [04:44] Dictating your communication preferences and confidential contacts
• [05:33] Withdrawing permission and managing third-party access
• [06:30] Final recap of patient rights under HIPAA

Want to Ask Melody? Visit: https://melodymulaik.com/ASK Don’t forget to subscribe so you won’t miss an episode. If you've ever signed a privacy form at the doctor's office and wondered what you were actually agreeing to or, if you've ever found an error in your medical records and didn't know you could fix it, this episode is a must-listen.

Take Your Healthcare Advocacy Further

Navigating the healthcare system doesn't have to be a solo journey. For deeper dives into the topics we discuss on the show, plus exclusive "insider" tips delivered straight to your feed, subscribe to Take Care Newsletter.

• Subscribe to the Take Care Newsletter
• Connect With Melody on LinkedIn
• Got a Healthcare Question? Ask Melody Now.

Melody Mulaik and Ashley Hunter demystify the world of telehealth and telemedicine. From diagnosing a sinus infection from your couch to managing a specialist's care in a different state, virtual visits have transformed how we access healthcare.

But with new technology comes new questions: Is my insurance going to pay for this? Is that TikTok ad for medication legitimate?

Melody and Ashley break down the "how-to" of virtual care, provide a framework for vetting online services, and share tips for helping older family members navigate digital appointments.

Featured Topics:

• Understanding the live, virtual interaction between patients and providers for diagnosis and prescriptions.
• How to research the legitimacy, transparency, and provider availability of digital healthcare websites.
• Navigating the complexities of 2026 coverage and how state laws impact online medical care.

In this episode, Melody and Ashley discuss:

• [00:09] Telehealth allows providers to diagnose and prescribe via live video on computers or phones.
• [02:22] COVID-19 accelerated telehealth adoption and insurance coverage by roughly 20 years.
• [03:32] Virtual visits offer faster appointments for rural residents and caregivers of elderly parents.
• [05:58] While coverage continues in 2026, state laws and specific insurance plans still vary.
• [10:48] Consumers should prioritize transparency and consult local pharmacists to verify online medical services.

Want to Ask Melody? Visit: https://melodymulaik.com/ASK

Don’t forget to subscribe so you won’t miss an episode.

Take Your Healthcare Advocacy Further

Navigating the healthcare system doesn't have to be a solo journey. For deeper dives into the topics we discuss on the show, plus exclusive "insider" tips delivered straight to your feed, subscribe to Take Care Newsletter.

• Subscribe to the Take Care Newsletter
• Connect With Melody on LinkedIn
• Got a Healthcare Question? Ask Melody Now.

Navigating the mountain of medical correspondence and bills is one of the most stressful parts of receiving care. Melody Mulaik breaks down the top five most confusing medical billing issues and gives you a clear, actionable plan to validate every charge, so you only pay what you truly owe.

Learn the critical difference between the communication that says "This is not a bill" and the final statement that requests payment. Most importantly, Melody provides the one non-negotiable step you must take with your insurance company before making that payment.

Featured Topics:

• Validating Your Bill: The essential first step is to log in to your insurance company's website to review the Explanation of Benefits (EOB) and confirm your patient's responsibility before paying any medical bill.
• Handling Unsubmitted Claims: If you receive a bill but the claim isn't showing up on your insurance company's website, call the provider's billing office and ask them to resubmit the bill.
• The Timely Filing Rule: If you get a bill months after a procedure, check your EOB to see if the insurance company denied the claim due to the provider missing the "timely filing" deadline; if they did, you are not obligated to pay it.

In this episode, Melody discusses:

• [00:00] The stress of medical correspondence and why providers communicate with you.
• [01:06] What to do with the initial "This is not a bill" statement.
• [01:54] The non-negotiable step to take once you receive a bill—checking your insurance claim.
• [04:36] Action plan: What to do if your provider failed to submit the bill to your insurance.
• [07:11] Why do you receive multiple bills for a single ER visit?
• [10:43] The "Timely Filing" rule: Do you have to pay a bill received months later?.
• [13:08] Detailed breakdown: How to read your Explanation of Benefits (EOB) to find your exact responsibility.

Want to Ask Melody? Visit: https://melodymulaik.com/ASK Don’t forget to subscribe so you won’t miss an episode. If you've ever tried to get an urgent appointment with your doctor and were told they have no availability, this episode is a must-listen.

Take Your Healthcare Advocacy Further

Navigating the healthcare system doesn't have to be a solo journey. For deeper dives into the topics we discuss on the show, plus exclusive "insider" tips delivered straight to your feed, subscribe to Take Care Newsletter.

• Subscribe to the Take Care Newsletter
• Connect With Melody on LinkedIn
• Got a Healthcare Question? Ask Melody Now.

Navigating your health requires more than just showing up; it requires a strategy. Melody Mulaik breaks down the complexities into five actionable steps, so you can stop feeling powerless and start getting the high-quality, timely care you deserve.

Are you struggling to find a specialist without a three-month wait? Does your doctor rush you and type on a computer instead of listening? Are you sick and need care today? Melody provides insider strategies for all these common pain points.

Featured Topics:

• Strategically Find Your Doctor. Go beyond proximity and personal traits by seeking respected physicians who are board-certified or double-board-certified in their specialty.
• Get a Faster Appointment. Use the online scheduling portal, ask about flexibility in location, or utilize the waitlist to secure an appointment with a busy specialist quickly.
• Demand to Be Heard. Do not leave the exam room until all your questions are answered, and politely ask the staff to have the physician return if they try to rush out.

What You’ll Learn:

• [00:00] How to stop guessing and strategically find the absolute best doctor for you and your family.
• [05:58] Four key ways to get that critical appointment fast, even if you are initially told the wait is months long.
• [11:47] What to say to ensure your doctor stops rushing and listens to all your comments and questions.
• [16:55] How to schedule your appointments to significantly avoid frustrating delays and long waiting times.
• [20:00] Four simple options for getting the medical care you need immediately when your physician is unavailable today.

Want to Ask Melody? Visit: https://melodymulaik.com/ASK Don’t forget to subscribe so you won’t miss an episode. If you've ever tried to get an urgent appointment with your doctor and were told they have no availability, this episode is a must-listen

Take Your Healthcare Advocacy Further

Navigating the healthcare system doesn't have to be a solo journey. For deeper dives into the topics we discuss on the show, plus exclusive "insider" tips delivered straight to your feed, subscribe to Take Care Newsletter.

• Subscribe to the Take Care Newsletter
• Connect With Melody on LinkedIn
• Got a Healthcare Question? Ask Melody Now.