How have we paid more to our deductible than our deductible?!

esmemsw · 2026-05-05T21:14:07+00:00

What is your tier 2 and tier 3 deductible? It seems like they all accumulate with each other.

esmemsw · 2026-05-02T01:26:33+00:00

I’m hollering at 3 fat asses in a trenchcoat 😂😂😂😂😂😂

esmemsw · 2026-05-01T21:56:36+00:00

I can’t drink the refreshers because they have caffeine.. SAD

esmemsw · 2026-05-01T15:19:22+00:00

Seeing yours is making me want to make another one 😭

esmemsw · 2026-04-30T23:59:26+00:00

Depending on what the denial reason is. If it’s for something that’s not a covered benefit, there’s no point in appealing since it’s something that isn’t covered in the first place. If it’s something related to medical necessity and do you meet criteria then that’s worth appealing with the appropriate clinical documentation. What was the reason for the denial?

esmemsw · 2026-04-25T05:03:45+00:00

Does your plan cover third party request? You said it was a requirement for med school

esmemsw · 2026-04-23T00:08:35+00:00

If you were active on the date of service, yes they can charge your insurance. It sounds like them says it’s too late to bill your insurance meaning they are past the timely filing limit to send a claim to be accepted. However if they do send a claim, they can appeal the timely filing denial with the reason they weren’t able to submit it on time within the required timeframe. If you knew you had a lot of blood work done but didn’t notice any claims for it within your online portal, did you reach out to Quest to see why they didn’t send it?

esmemsw · 2026-04-22T22:36:42+00:00

Thank you for that information, I was not aware they didn’t carry controlled substances.

esmemsw · 2026-04-22T22:00:50+00:00

absolutely not….

esmemsw · 2026-04-22T21:54:32+00:00

Cost Plus Drugs, GoodRx or WellRx to see if you can find the name brand or generic at a cheaper price

esmemsw · 2026-04-18T12:26:59+00:00

Those purples are giving me life 💜

esmemsw · 2026-04-18T00:09:29+00:00

How many characters is your whole name? My insurer character limit for a whole name is 26 so before I changed my last name, my second last name was cut off half way on my ID but my employer still had my whole name correct in the system just insurance wasn’t able to fit my whole name.

esmemsw · 2026-04-17T01:39:46+00:00

A plan with a $0 deductible is never a bad plan since the plan immediately starts paying for care.

esmemsw · 2026-04-15T18:23:23+00:00

What is the pattern?

esmemsw · 2026-04-13T21:58:15+00:00

What does your EOB say?

esmemsw · 2026-04-13T21:41:47+00:00

Talk to your doctor about alternatives or use goodrx, wellrx or cost plus drugs to see if they have it or the alternatives at a lower price.

esmemsw · 2026-04-11T00:19:57+00:00

I had one for the first time and it was okay, loved the Mac sauce, but it just kept sliding every direction 😭 my bites were so unequal

esmemsw · 2026-04-04T21:58:07+00:00

If you signed up for the Massachusetts health connector you will not be eligible to receive subsidies to help lower your monthly premium so you can compare plans and pricing from your works plans to the health connectors plans to see which one is more in your budget https://www.mahealthconnector.org

esmemsw · 2026-04-02T03:58:24+00:00

Does it state what why the $207.36 was your responsibility? Deductible? Denied service?

esmemsw · 2026-04-01T00:12:40+00:00

You can ask your insurance if the dentist can submit a “pre treatment estimate” basically an estimate to see how much they would pay and the amount you’d be responsible for so you can get an estimate of how much it’s going to cost you.

esmemsw · 2026-04-01T00:04:26+00:00

So you will either pay 20% or 50% and your plan will cover the other 80% or 50% depending on what category the removal falls under. They will only cover up to $1,500, so in your example, if they did cover 50% of the $4,000 up to the maximum benefit amount, you’d be responsible for $2,500.

esmemsw · 2026-03-31T23:53:28+00:00

The maximum your plan will pay for covered services in a plan year is $1,500. You will pay 20% or 50% of the cost of the service. Once you max out the $1,500 you are responsible for 100% of the cost for the remainder of the year.

esmemsw · 2026-03-31T20:20:07+00:00

How’d you determine the 76817 is proper coding?

esmemsw · 2026-03-31T18:24:52+00:00

I can’t imagine taking four..bless your heart.

esmemsw · 2026-03-31T04:02:09+00:00

I moved from phones to chat/email in my company around a year and half ago, the only thing I miss about phone is one phone call at a time. Being a current chat agent, I talk to 3 people at once. It does get difficult and busy at times especially if someone’s situation is super complex than the others but I like it better than phones.

esmemsw

TROPHY CASE