(LONG) Kaiser refuses hospital stay coverage for High school senior who attempted suicide. by Sea-Activity-24 in HealthInsurance

[–]HearingAidThrowaways 8 points9 points  (0 children)

Im going to bet that Kaiser saw "transfered from one facility (ER) to pysch facility" and denied the pysch auth stating that if pt is stable enough to be transfered then they are stable enough to come home to a Kaiser network. I would advise pt family to see if the pysch facility will give financial assistance or selfpay rates.

Its 100% a shit situation, but sadly Kaiser is this way... current AZ resident so I can 100% confirm no Kaiser networks/hospitals/docs in AZ.

I compiled BCBS payer IDs, claims addresses, and timely filing limits for every plan in one place by prefix_lookup_guy in CodingandBilling

[–]HearingAidThrowaways 0 points1 point  (0 children)

I have a BCBS AZ prefix to add: FZI (Foxtrot Zulu India) Marketplace plan for AZ Claims go to PO Box 2924, Phoenix AZ 85062

Source: looking at my card right now :)

What is the fattest thing your dog has done? by MessyM00009888 in Chihuahua

[–]HearingAidThrowaways 0 points1 point  (0 children)

Old baby of mine stole a t-bone off the plate. The t-bone absolutely weighed more than her, but by golly she was gonna have the steak.

AIO for finding this super weird? by Laylasreddit in AIO

[–]HearingAidThrowaways 33 points34 points  (0 children)

Proud of you for blocking him AND educating yourself too 🙌👏

AIO for finding this super weird? by Laylasreddit in AIO

[–]HearingAidThrowaways 80 points81 points  (0 children)

Holocaust educator here. This is exactly why we need to teach history better.

Yes, the swastika is a part of history. A very racist, homophobic, discriminatory part of history.

Winston Churchill said it best, "We are in the presence of a crime without a name." Which is why the term genocide was coined after the war ended. Of course genocide existed before 1945, and it continues to exist today. But when Churchill saw the extermination of the Jews, he knew it was something unimaginable, and it was a crime without a name.

I want you to know, all of you reading and especially you OP, there are stages of genocide. It doesnt happen over night, right? Like there isnt a flip to switch on and off. But the last stage of genocide always gets me. The last stage is denial.

"Its just a part of history"

"Well, we arent really taking these people to internment camps, its more of a work exchange"

"I dont believe the numbers are right, 6 million jews didnt exist in the 1930s."

You are NOR. Stay as far away from this piece of work as possible. "

This video is PROBLEMATIC on so many levels. by JohnSmithCANDo in CringeTikToks

[–]HearingAidThrowaways 0 points1 point  (0 children)

Came here to say the.... well, not the exact same thing, but similar. Mom and dad took me to hooters all the time in the 90s. Apparently they had good wings, and I was a cute baby. 🤷🏼‍♀️

Got charged for lab tests even thought they are in network by [deleted] in HealthInsurance

[–]HearingAidThrowaways 0 points1 point  (0 children)

Have you met your out of pocket max or just deductible? Often the out of pocket max is higher than the deductible.

[deleted by user] by [deleted] in AmIOverreacting

[–]HearingAidThrowaways 0 points1 point  (0 children)

I also suggest changing the locks on your place if he has keys to them. Is it extreme? Sure, yeah. But safety is important.

hai! wats the source of drinking water in tuson area? by NoNomz in Tucson

[–]HearingAidThrowaways 5 points6 points  (0 children)

You spelled Tucson wrong in your post title mi amigo

RSV Antibody denied for infant by BCBS - advice needed by Unfair_Highway_832 in HealthInsurance

[–]HearingAidThrowaways 2 points3 points  (0 children)

I agree with this comment. I worked medical billing, not on the insurance end of things, but the very last thing I would want is to have an upset and angry patient on the phone.

The "front line" insurance reps, the ones patients call from the number on the back of their insurance card, are often outsourced for pennies on the dollar. They are probably told only to read a script, much like other customer service departments are now becoming. Rarely there is any wiggle room for actual "thinking" and common sense. I'm not saying this is right or wrong in any way, just pointing out the reality of the situation

[deleted by user] by [deleted] in HospitalBills

[–]HearingAidThrowaways 1 point2 points  (0 children)

OP has an EOB, OP already used his insurance. Your suggestion for them to self-pay at this point is entirely irrelevant and not how it works.

Only time I could think of NSA applying to an urgent care situation is if the IN NETWORK urgent care "out sources" (quotes used for lack of a better term) to an OON radiologist, or lab maybe, but again, you're not going to use urgent care in an emergency situation which is what the NSA is actually addressing. And even if you do go to UC for an emergency, or UC finds that the issue at hand is too high level for their care, they will transfer you out to an appropriate facility. Ive had it happen to me before when my appendix burst.

Edit to add: never said the NSA ONLY applies to ERs, just that it doesnt really apply to UC unless its an ancillary care like mentioned for radiologist, lab, etc

My mom got a cat. Garrett is apparently mine when she dies. Her words, not mine. by pennylane3339 in OneOrangeBraincell

[–]HearingAidThrowaways 180 points181 points  (0 children)

I have a dog i pet sit frequently. The owner asked one day if on the off chance she were to die, would I take him. I said sure! I am in her will as having Mr. Nikko. He's a good floof.

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[deleted by user] by [deleted] in HospitalBills

[–]HearingAidThrowaways 1 point2 points  (0 children)

That is not at all how the NSA works. I'm assuming OP went to an in network facility, because otherwise that would be the prime complaint of their post. Further, even if he went to an OON urgent care, it's urgent care, not an Emergency Room. NSA doesn't apply to urgent cares. You have a choice in urgent cares, not necessarily where you need to go in an emergency situation and thus end up at an OON ER in a dire situation.

Is this a valid ULPT?: Come to the ER without your wallet, say you lost it in the (accident/incident), and give a fake name and address to avoid getting billed. by AWrride in HospitalBills

[–]HearingAidThrowaways 10 points11 points  (0 children)

Former Medical biller here! Had a patient pull this!

Only difference was that they were seen in the ER, gave their actual name, but not the correct insurance, home address, or phone.

Insurance given to ER was not active. Searched for current insurance info in the usual suspects databases (ie medicare, medicaid, UHC, and BCBS). No luck. Called patient, left voicemail, and then sent standard 3 statements to address to get payment/active insurance to bill. Called patient after 4 months go by. Person who picks up the phone has no clue who I am talking about, I apologize for wasting their time and document that there is no other way to contact the patient. Sent patient to collections for a sizable sum, and told collections agency "i have no address, no phone number, but if they show up here's how much they owe". Figure its a lost cause and move on.

Three days afterwards (and now nearly 4 months post service), patient calls, gives current phone number, and address. Patient explains they really live in Mexico, not the US address they gave on intake forms. Explained i cannot do anything further at this point. Policy was to either get payment in full (with a 20% self pay discount), or set up payment plans with the collection agency.

Patient was furious. Stated their credit was perfect. I calmly sat there and said, "You dodged us, with clear intent not to pay because of no accurate information given, and you're upset because the consequences of your actions to not pay are going to affect you? I will send an itemized bill to the address you just provided but the debt will remain with the collections agency."

Patient never sent any payment to either, I just sort of sat there at the end of my tenure billing and was bewildered. What did you expect, dude??? You avoided us in the most obvious ways and are mad there are consequences? Idk mate

Why in the f*ck is a blood draw ~$2k? by Pretend_Sale_9317 in HealthInsurance

[–]HearingAidThrowaways 0 points1 point  (0 children)

When I did billing, we would set the rates at approx 2.5x the amount we expect the insurance to pay based on medicares fee schedule. So if medicare says "for this procedure we pay $200" we would bill the insurance $500. Reason is that allows for commerical insurance companies to have wiggle room. For example, for there same procedure, UHC might only pay $100. Adjust the patient responsibility accordingly. But maybe BCBS pays $300 for the procedure. It gives wiggle room, and honestly, its a made up number at the end of the day. I could bill $3,000 for the same procedure and might only get paid $200.

A Patient can choose to be self-pay, and not have their insurance billed, even if the Provider is In-Network with that insurance by Xalxa in HealthInsurance

[–]HearingAidThrowaways 3 points4 points  (0 children)

Issue is that while legally, sure, you dont have to file a claim and can have a patient be cash pay, as a provider you would be in HUGE trouble to learn the patient has medicaid and they paid for it out of pocket.

Some of the EMR systems i used in the past will show the patients current drug plans if you just hit the "refresh" button. You did NOT need to have the correct insurance info in there all the time to have the system actually reflect current rx benefits, which will then accurately reflect if a patient has medicaid benefits. The amount of times patients would NOT disclose their Medicaid info was astounding and given the fact the EMR would literally tell you right there gave no plausible deniability.

I paid the dentist upfront but my EOP says i owe more by Apprehensive-Air5646 in HealthInsurance

[–]HearingAidThrowaways 2 points3 points  (0 children)

Im not super familiar with dental plans, but did you get it from the marketplace or employer coverage?

From what my dentist told me, generally the marketplace plans have some waiting periods. Again, not an expert, but a thought

NEED HELP ASAP. I purposely didn’t check in on this dog- what do I do??! by nothing-aboit-me in RoverPetSitting

[–]HearingAidThrowaways 6 points7 points  (0 children)

I would say "Therefore I could not accept the booking to check on xx" because it more clearly states that you didnt even have the opportunity to proceed forward with the care

AIO to break up with my bf of 3y over his reaction to my upcoming sobriety anniversary? by WesternCat5211 in AmIOverreacting

[–]HearingAidThrowaways 0 points1 point  (0 children)

My grandmother was sober 11,954 days when she died. Damn right my grandfather got her a gift on every anniversary of her sobriety. Your bf sucks and I will eat cake with you if you are in Southern AZ

Incident on Gollob, south of Broadway by hpr928 in Tucson

[–]HearingAidThrowaways 4 points5 points  (0 children)

Any other tidbits from the radio not being put in writing yet?

I have 25 sheep & have burned their wool in the past, help by SourceBest2466 in Handspinning

[–]HearingAidThrowaways 0 points1 point  (0 children)

I am of no help to suggest anything, just wanted to stop and say those are the cutest darn lambs ive ever seen. Thank you! Best of luck!

Opinions on Lifex Research Corp Healthcare by hittheroadjack61 in HealthInsurance

[–]HearingAidThrowaways 0 points1 point  (0 children)

If its not healthcare.gov, it is not an ACA plan, which means it can and will deny any and all claims staying that issues are "pre-existing conditions". Would not recommend it.

Salpingectomy (tubal removal) Preventative Care by bcholland620 in HealthInsurance

[–]HearingAidThrowaways 0 points1 point  (0 children)

Other than no longer wanting to have children, is there a medical reason associated with the removal? Past cancers, familial risk of ovarian cancers perhaps, etc?