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<blockquote data-quote="BrownBrokeDown" data-source="post: 1350287" data-attributes="member: 46824"><p>This seems to be a problem. I have received variations of the same answer everytime I talked to them about the allergic reaction, BUT on other issues I don't always receive the same answer. After looking up the definition of anaphylaxis (lol), you need to check and see how the hospital coded it. The explanation I got this last time wasn't just for allergic reactions but everything. If they coded as emergency it is 100%, if not your screwed. The lady I spoke with used another example that I will include here since I have more time today. She said they get a lot of calls on chest pain ER visits only being paid 80%. What happens is it is a minor non-life threatening issue (heartburn, etc) and the ER codes it as non-emergency. Where, if it is actually something life threatening (heartattack, etc) it is 100%.</p><p> </p><p> </p><p> </p><p>I have been happy with everything else on this insurance, but this is starting to bug me. Basically we have to self diagnose and make sure our's or our families lives are threatened in order to get the 100% benefit.</p></blockquote><p></p>
[QUOTE="BrownBrokeDown, post: 1350287, member: 46824"] This seems to be a problem. I have received variations of the same answer everytime I talked to them about the allergic reaction, BUT on other issues I don't always receive the same answer. After looking up the definition of anaphylaxis (lol), you need to check and see how the hospital coded it. The explanation I got this last time wasn't just for allergic reactions but everything. If they coded as emergency it is 100%, if not your screwed. The lady I spoke with used another example that I will include here since I have more time today. She said they get a lot of calls on chest pain ER visits only being paid 80%. What happens is it is a minor non-life threatening issue (heartburn, etc) and the ER codes it as non-emergency. Where, if it is actually something life threatening (heartattack, etc) it is 100%. I have been happy with everything else on this insurance, but this is starting to bug me. Basically we have to self diagnose and make sure our's or our families lives are threatened in order to get the 100% benefit. [/QUOTE]
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