RE: Rant: Soo, I had to call my health Ins. Company

RE: Rant: Soo, I had to call my health Ins. Company (Full Version)

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NuevaVida -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 8:15:57 AM)
quote: ORIGINAL: bluepanda It's a very good point, but I want to make clear that I'm not saying that everyone who thinks differently than I do is stupid. I'm not even saying that everyone who opposes a national health care system is wrong, much less stupid. Actually you said people who can not grasp that there's a world beyond American borders is stupid. Since pretty much everyone knows there are countries beyond the U.S. borders, I did see there was frustration and sarcasm in what you said, but it seemed a generic insult to all, so I commented on it. No harm, though. Thanks for addressing it. Our system is definitely flawed. And I understand that emotions are at stake when the people we love are ill and not cared for appropriately. But I'm also a believer that hurling insults in either direction does nothing to resolve the problem. In fact, it takes focus away from it, allowing it to continue to grow. quote: And I'm very sorry about your uncle. I lost someone close a few months ago too. I hope you and your family are doing as well with that as is possible. Thank you. I'm sorry for your loss, as well. The last two years saw cancer wipe out 5 people in my family, as well as a dear friend. Loss allows us to appreciate life. We are doing well and closer to each other than ever. I appreciate your kind thoughts, and wish the best to you and your loved one. Off to work I go...so I can afford my $550 COBRA payments! (Gotta love it [8D] )

PanthersMom -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 8:21:53 AM)
my mother had surgery to fix hemmeroids. her insurance company refused to pay for the procedure her doctor had deemed medically necessary, calling it "cosmetic" surgery. now, mind you, the person who rejected this claim does not have a medical degree, but insisted on telling my mother this was a cosmetic procedure. my mother threatened to sit on a xerox machine and provide proof of her surgery being something other than a cosmetic procedure. her claim was paid without further argument. mom doesn't get snippity too often, but when she does, she's effective! [;)] PM

CalifChick -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 10:37:25 AM)
If a claim gets denied or paid at a lesser amount due to cosmetic reasons or not medically necessary, ask what diagnosis it was billed with. Often, if "pain" or something like that is the primary diagnosis, it will pay. You can also appeal with the idea that your doctor deemed it medically necessary and you took action (to have the procedure) based on that. You can also ask for the name and medical credentials of the person who reviewed your claim and made a medical decision (not medically necessary) on it. In many states they are required to provide that. Most of what I've read here has a good chance of being overturned on appeal. Cali

smilingjaguar -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 11:38:47 AM)
FR File an appeal and become a pain in the rear. I've had experiences with less reputable companies where they reject everything the first time knowing most won't appeal. It also helps to get your company benefits manager involved. Something's fishy. Oh yeah, do complain about her as well...politics have no place in your benefits determination.

thetammyjo -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 2:01:21 PM)
It so sucks when your insurance company changes.. that happened to me though luckily it didn't have any big expenses to pay for during that time. You know what sucks more? Not having health insurance these days. Fox had to spend 25% of his saving (yes, 25%!) on an emergency root canal he had last week.

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