Insurance

[brother in brown]

Odviously unless you are a new hire, everyone has insurance at this point. Most doctor or hospital visits I have gone to for some reason have treated me even better in my opinion when they ask who I work for or give them my insurance information-weird but true on almost every visit to docs. Anyway...

So my wife takes our little girl to the doc for her yearly check up and you just have to Thank God these days for having a healthy kid. Anyway all as normal you put up the 10.00 co pay thing and go about your day. Time goes by and we get a bill for about 90% of the neg price. Which I find odd because we had to take her to the E.R. one night and were expecting some kind of a bill, to find out not even a co pay, insurance covered 100% of the bill. So I speak with the aetna people and they say they only cover these (cant think of what you call these yearly appointments with little kids) kind of appointments like every two years or something to that effect. Insurance can sure send people through a loop when coverage comes into play.

Maybe I should have taken my little girl to the E.R. for a check up and they have to cover thousands instead of a hundred and some change

 

[dannyboy]

Maybe I should have taken my little girl to the E.R. for a check up and they have to cover thousands instead of a hundred and some change

Lotsa people do, and just for that reason. Our insurance pays for wellness visits. Thing like to monitor you if you are overweight, high blood pressure, diabetic, etc etc. Basically, you go, they pay, regardless of what the reason.

You want to have some fun, have two insurances.

Went to the dermatologist with my daughter for a follow up visit.

Said they could not see her until the past due amount is paid.

I asked why they did not send a bill for the unpaid amount.

They responded that the accounting system could not send out a bill when you have a overpayment on your account. I asked how much was the bill? 35 bucks. How much was the credited overpayment? 597 bucks. My wifes insurance had double paid what mine already had three years ago.

So they are sitting on almost 600 bucks credit, and refuse to see my daughter until we pay them another 35?

In most states, that extra money by law has to be sent to the patient if the insurance company does not ask for it back. But not in the fine backward state of Tennessee.

d

 

[trplnkl]

Odviously unless you are a new hire, everyone has insurance at this point. Most doctor or hospital visits I have gone to for some reason have treated me even better in my opinion when they ask who I work for or give them my insurance information-weird but true on almost every visit to docs. Anyway...

So my wife takes our little girl to the doc for her yearly check up and you just have to Thank God these days for having a healthy kid. Anyway all as normal you put up the 10.00 co pay thing and go about your day. Time goes by and we get a bill for about 90% of the neg price. Which I find odd because we had to take her to the E.R. one night and were expecting some kind of a bill, to find out not even a co pay, insurance covered 100% of the bill. So I speak with the aetna people and they say they only cover these (cant think of what you call these yearly appointments with little kids) kind of appointments like every two years or something to that effect. Insurance can sure send people through a loop when coverage comes into play.

Maybe I should have taken my little girl to the E.R. for a check up and they have to cover thousands instead of a hundred and some change

Well Baby checkups?
I've got news for ya, they don't cover yearly or biennial check ups for you either. The want something to be suspected to be wrong with you, so how the doctors office files the claim makes a difference. Don't worry though, most doc's business offices know how to file it.
What gets me is that some lab tests are covered 100%, some not at all.

Also, some of the denials are done automatically just to see if you will let it go and pay for the procedures yourself. Sometimes you have argue with them to get them to pay.

 

[anonymous6]

Odviously unless you are a new hire, everyone has insurance at this point. Most doctor or hospital visits I have gone to for some reason have treated me even better in my opinion when they ask who I work for or give them my insurance information-weird but true on almost every visit to docs. Anyway...

So my wife takes our little girl to the doc for her yearly check up and you just have to Thank God these days for having a healthy kid. Anyway all as normal you put up the 10.00 co pay thing and go about your day. Time goes by and we get a bill for about 90% of the neg price. Which I find odd because we had to take her to the E.R. one night and were expecting some kind of a bill, to find out not even a co pay, insurance covered 100% of the bill. So I speak with the aetna people and they say they only cover these (cant think of what you call these yearly appointments with little kids) kind of appointments like every two years or something to that effect.



Insurance can sure send people through a loop when coverage comes into play.

Maybe I should have taken my little girl to the E.R. for a check up and they have to cover thousands instead of a hundred and some change

dispute it. they'll most likely revise the charges

 

[UpstateNYUPSer(Ret)]

dispute it. they'll most likely revise the charges

This is the point I was trying to make with d earlier.

 

[UPSGUY72]

The only copays I have are for prescriptions and even with that we get $600 a year to offset those expenses. I guess things must differ by your local and region.

 

[brother in brown]

Thanks for the replys...
That might be a good idea to despute it, tryed that once and had a good outcome with a different appointment out of network. Also might call her doc and see if the office ladies will change the charged description. Either way it's not a problem, just have a hard time sitting on the idea of the things that are covered and the silly things that they dont.

 

[pissedoffmanager]

The frequency of visits depends on the age of the child. When I worked for UPS they would pay for the visit every year from the ages of 1-3, even though he had 2 well baby visits every year, they only paid for one. Read the fine print in your insurance certificate, it should all be in there.

 

[barnyard]

We've found that the best way to avoid the disputes is to read the policy so that we know what is covered. It saves us a ton of hassles.

TB