I love insurance; I hate insurance companies

UpDownAround · May 22, 2018 at 02:23 PM

Called to make sure something was approved and met out of pocket so it was covered at 100% before I went to provider. Took them 15 minutes to tell provider I needed to meet more deductible and the bill was going to be $1200. Took me another 30 minutes sitting out in the lobby to get it straightened out and leave with a bill for $0. So glad I have coverage but I wish it wasn't so painful to get them to admit that I do.

May 23, 2018 at 06:54 AM

Insurance companies rarely, if ever, look out for their patients. It's all about the $$$ with them. They'll look for any excuse to get out of paying for something. Then if you're not paying close attention, they'll get away with it.

Sorry you had to go through this. Insurance companies are a huge pain in the butt.

pirilin · May 23, 2018 at 09:14 AM

I don't see the hate in making 1200 bucks in 45 minutes. Do you make that much often?.

UpDownAround · May 23, 2018 at 12:45 PM

Quote:

Originally Posted by pirilin

I don't see the hate in making 1200 bucks in 45 minutes. Do you make that much often?.

I didn't make anything. It's a drop in the bucket compared to the premiums, copays and deductibles I have paid to hit the out of pocket limit (several thousand). Even if it is in my favor when you add everything up, they should not have told the provider it wasn't covered and then taken so long to tell me it was. At one point, I was concerned that I didn't understand the policy and that maybe it wasn't covered. I have no doubt that some people have refused services they could not afford when in reality they could have if the insurance company had provided better service. Giving out bad information about coverage can potentially have severe consequences for the insured.

May 23, 2018 at 01:55 PM

I had to struggle and fight with the insurance company over my late husband’s care. I had to threaten them several times with the insurance commissioner, which worked.

They should have been investigated. That’s exactly what they don’t want to happen because they do so many evil things they will be busted.

UpDownAround · May 23, 2018 at 02:40 PM

The first person was pretty adamant that it wasn't covered. The second person explained the confusion, but what he said caused it was not what the first person used as a reason. I did feel like I was being played and that saying it wasn't covered was just the default first response. I don't have anything concrete to base that suspicion on, so I am not planning to report them. It is possible I am wrong and it was an honest mistake, but something about the conversations just didn't feel right.

May 23, 2018 at 03:02 PM

Ah, I see. Well, keep it in mind in case they deny a claim and you get a bill. They tried to make me file several appeals, which I said fine I would do that, after I fill in the complaint form with the commissioner, I just need the name of the claim rep that denied the claim (there is never a name and you need that).

I swear, they did not make me appeal a single thing when I threatened them. It’s because they pull crap they shouldn’t be. They tried to claim things weren’t covered or were duplicative. Then they tried to say it was misunderstandings with insurance codes or authorizations or needing doctors letters (hoop hoop hoop).

It’s funny how they don’t really need any of that.

pirilin · May 24, 2018 at 08:20 PM

Quote:

Originally Posted by UpDownAround

I didn't make anything. It's a drop in the bucket compared to the premiums, copays and deductibles I have paid to hit the out of pocket limit (several thousand). Even if it is in my favor when you add everything up, they should not have told the provider it wasn't covered and then taken so long to tell me it was. At one point, I was concerned that I didn't understand the policy and that maybe it wasn't covered. I have no doubt that some people have refused services they could not afford when in reality they could have if the insurance company had provided better service. Giving out bad information about coverage can potentially have severe consequences for the insured.

I'm flattered I caught your attention. Really. Thank you!!!.
Anything else I can do for you?. C'mon, this is your chance to flush it all out.
Venting is healthy. Try it sometime. XOXO

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I love insurance; I hate insurance companies

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Anonymous35014 Guest Posts: n/a	May 23, 2018 at 06:54 AM #2 Insurance companies rarely, if ever, look out for their patients. It's all about the $$$ with them. They'll look for any excuse to get out of paying for something. Then if you're not paying close attention, they'll get away with it. Sorry you had to go through this. Insurance companies are a huge pain in the butt.
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pirilin SUPERMAN Member Since Feb 2016 Location: Metropolis Posts: 3,679 8 2,698 hugs given	May 23, 2018 at 09:14 AM #3 I don't see the hate in making 1200 bucks in 45 minutes. Do you make that much often?. __________________ ]Roses are red. Violets are blue.[ Look for the positive in the negative. PIRILON. If lemons fall from the sky, make lemonade. Unknown. Nothing stronger than habit. Victor Hugo. You are the slave of what you say, and the master of what you keep. Unknown.
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Anonymous45390 Guest Posts: n/a	May 23, 2018 at 01:55 PM #5 I had to struggle and fight with the insurance company over my late husband’s care. I had to threaten them several times with the insurance commissioner, which worked. They should have been investigated. That’s exactly what they don’t want to happen because they do so many evil things they will be busted.
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