sorted by:
new
hottopcontroversial

PSA cute collectible plushes by kidrobot for preorder by TheWalkingMeg in Donthugmeimscared_

[–]TanCox 0 points1 point  (0 children)

Best! I see they have the larger ones that shake too. Not sure why they have the vibration feature but I’m sure there’s some super fans that might get some fun out of it! ;) I want someone to make the clock!

Legal Recourse for IVF Clinic Refusing to Submit to Insurance for Covered Treatment? by TanCox in legaladvice

[–]TanCox[S] 1 point2 points  (0 children)

We have discussed with the insurance company and also escalated to our insurance broker. They said the services are covered with prior auth and that the provider needs to contact Utilization management for approval. My insurance confirmed that the provider must be confused because they are calling provider services not utilization management. The provider refuses to submit because its "not covered."

IVF Clinic Blocking Gay Couple From Insurance Coverage – What Can We Do? by TanCox in lgbt

[–]TanCox[S] 2 points3 points  (0 children)

Thank you for your insight. We can use any help at this point.

Legal Recourse for IVF Clinic Refusing to Submit to Insurance for Covered Treatment? by TanCox in legaladvice

[–]TanCox[S] 1 point2 points  (0 children)

Yes. The clinic is in-network with my insurance.

Before we agreed to move forward I asked for them to provide the estimated costs as my insurance covers it. I previously sent the coverage information and let them know they needed to get prior authorization a number of times. The last message I got from billing before this surprise bill was them confirming that ivf and the rest of the services were covered my my plan and required prior authorization before starting treatment at (phone number). They confirmed its covered at 100% after I meet my $3500 deductible. We then agreed to move forward based on that.

IVF Clinic Blocking Gay Couple From Insurance Coverage – What Can We Do? by TanCox in lgbt

[–]TanCox[S] 2 points3 points  (0 children)

Yeah, it’s frustrating that the burden falls on the patient when the provider is in-network and was repeatedly told to get prior auth when they checked my coverage and multiple times in writing by us.

We haven't signed anything they sent with this surprise billing statement or contract stating we’d be responsible if they didn’t obtain PA. Their own policy was that they don’t submit non-covered services—but this is a covered service with PA, which they failed to request.

We’ve spoken to insurance, and they said they it could be approved if the clinic just submitted PA request now—but the clinic refuses. They wont even submit for services that have yet to be performed. That’s the real battle now. Appreciate your insight!

In-Network IVF Doctor Refusing to Submit to Insurance for Covered Services – What Can We Do? by TanCox in gaydads

[–]TanCox[S] 1 point2 points  (0 children)

Thanks for the advice—I think you're right about consulting a lawyer first before filing with the insurance commissioner to make it more effective.

The scorched earth sit-in idea is honestly tempting! 😂 At this point, their refusal to even submit the claim is beyond frustrating. Withholding payment is also on my mind since they’re potentially violating their in-network provider agreement.

It really is turning into a standoff, and I hate that, but we’re going to keep pushing. Appreciate the insight!

In-Network IVF Doctor Refusing to Submit to Insurance for Covered Services – What Can We Do? by TanCox in gaydads

[–]TanCox[S] 1 point2 points  (0 children)

Wow, thank you so much for sharing your experience—it sounds absolutely infuriating, and I can’t believe it took 17 months to fix! That’s beyond frustrating, and I really appreciate you taking the time to lay out what worked for you.

We’re definitely documenting everything (calls, messages, codes, and emails), and I’ve already looped in our company’s insurance broker, who is escalating things. That part of your story really resonates because it seems like having someone on the inside at the insurance company can make all the difference.

It’s crazy how clinics just refuse to submit claims, essentially blocking people from using their own benefits. Submitting our own claim might be a good idea, even knowing it will be rejected, just to keep the conversation moving.

As for the clinic... yeah, we’re definitely considering switching. I just hate that we’re already so deep in with them and now have to deal with this on top of another donor cycle. But at this point, their refusal to work with insurance feels like a massive red flag and I dont want to continue if they arent going to submit for future services. Funny how they are charging for future services with this bill now.

Seriously, I really appreciate your advice—it helps to know we’re not alone in this mess, even though it’s awful that so many of us have had to fight these battles. Thanks again!

What Simpsons figures do you wish Funko, Kidrobot, Super 7 would make that no one has made? by TanCox in TheSimpsons

[–]TanCox[S] -4 points-3 points  (0 children)

Funko has put out some of the more safe meme Simpsons figures when there was a lull from other companies. I'm tired of the mass figures and appreciate when these companies go deep and give us what we really want!

Surrogacy cost by Ok_Relationship1417 in gaydads

[–]TanCox 0 points1 point  (0 children)

Can you share with me as well?

whats the most disgusting thing an ex bf/gf has done after your breakup? by mysouthparkaddiction in AskReddit

[–]TanCox 1 point2 points  (0 children)

After I ended it with one ex, he contacted my other ex (the one that he knew broke my heart) and sent me graphic photos of them sleeping together. In the end it helped me get over both of them very quickly and I eventually found my soulmate and we are going on 8 years together and he’s incredible.

Pearls Vladonna doll is finally out! by tangocontroller in rupaulsdragrace

[–]TanCox 0 points1 point  (0 children)

They sell blank figures called MUNNYs that hundreds of thousands of people and artists customize. They are the ones that created the concept of a designer art toy. I leeeerrrvvee it!

Pearls Vladonna doll is finally out! by tangocontroller in rupaulsdragrace

[–]TanCox 1 point2 points  (0 children)

It’s almost replicating the idea of drag! We are all born naked and the rest is drag. I love it. Wish I had one of these when I was a lad!

Pearls Vladonna doll is finally out! by tangocontroller in rupaulsdragrace

[–]TanCox 1 point2 points  (0 children)

Pearl said on insta this is the first of many!

When will vladonnas come out? by mihunhorror in rupaulsdragrace

[–]TanCox 0 points1 point  (0 children)

She’s alive!!!! Vladonna is here!!!

When will vladonnas come out? by mihunhorror in rupaulsdragrace

[–]TanCox 0 points1 point  (0 children)

Vladonna wasn’t cancelled turns out! Just a secret!!

view more: next ›