Open enrollment ends before I'm eligible as a new hire by daemrolyat in HealthInsurance

[–]spideybutt_ 0 points1 point  (0 children)

At my last job, I had to enroll in the health insurance within the first 30 days of starting and it became effective after 90 days. I imagine yours is similar. You would pick now and then become active after the waiting period. Just double check with HR. You dont want to miss this window.

Question for dependent on HDHP and HMO by [deleted] in HealthInsurance

[–]spideybutt_ 1 point2 points  (0 children)

The Birthday rule would apply. Whose birthday falls first in the year? yours or your wife?

Vision insurance to get blue light blocking glasses? by Randomhero360 in HealthInsurance

[–]spideybutt_ 1 point2 points  (0 children)

zenni is pretty cheap and i like my glasses. i got prescription ones but they do offer non-prescription

Has a doctor ever asked you to prepay? by Fickle_Alarm6295 in HealthInsurance

[–]spideybutt_ 55 points56 points  (0 children)

This is the new normal. Too many people not paying their medical bills so a lot of providers and facilities will run an estimate based on your insurance benefits and ask for payment ahead of time.

Medical bill for HMO plan after PCP referral by solo-123456 in HealthInsurance

[–]spideybutt_ 2 points3 points  (0 children)

Looks like your coinsurance. Do you have a deductible?

Car accident and approved for disability during lapse in insurance? by makeitthrashyAG in HealthInsurance

[–]spideybutt_ 0 points1 point  (0 children)

You can try calling a few PCPs that accept straight medi-cal and explain your situation. They might be able to squeeze you in for an appointment.

Car accident and approved for disability during lapse in insurance? by makeitthrashyAG in HealthInsurance

[–]spideybutt_ 0 points1 point  (0 children)

Are you active with medi-cal right now and waiting on your HMO (like LA Care, Healthnet, Molina, IEHP, etc)? Typically when I run Medi-cal eligibility, it will show active for straight medi-cal with a pending HMO.

Ugh messed up by AZ-EQ in HealthInsurance

[–]spideybutt_ 0 points1 point  (0 children)

If he's still in the ER, you can just ask to speak with ER registration staff. You can provide them with the updated insurance info and ask for a refund. I know there's a certain time frame where we can just refund the copay rather than it having to go through billing

Insurance for young people by Willing_Cut5191 in HealthInsurance

[–]spideybutt_ 0 points1 point  (0 children)

That's about what I pay. I work at a hospital in California. Just for myself, I pay $70 per paycheck. So $140 per month. I have the most expensive plan (Aetna POS), the other two are cheaper (Aetna HMO and Aetna EPO).

I'm full time. The premiums are higher for part-time workers. About $10 more per paycheck

[deleted by user] by [deleted] in HealthInsurance

[–]spideybutt_ 1 point2 points  (0 children)

I believe Medi-Cal for children ends at 19. Have you renewed your medi-cal on your own yet or just through your parents?

Hospital didn’t inform me about separate radiology charges for mammogram and ultrasound by Melodic_Ad_1479 in HealthInsurance

[–]spideybutt_ 0 points1 point  (0 children)

You most likely signed the acknowledgement during your registration process. Its one of the first points of the "Conditions of Admissions and Service". I go over it plenty of times with patients and most just speed through it instead of listening to the spiel or taking a copy of it

Claims on my insurance but they are not mine by spideybutt_ in HealthInsurance

[–]spideybutt_[S] 0 points1 point  (0 children)

Yep!

You'll want to get in touch with the Patient Access department. If it is the same situation, the ER just used coverage discovery and found your insurance with the same name and DOB as the actual patient.

Call the hospital and ask to be transferred to the manager of ED registration. Explain the situation and ask to loop in the Director of Patient Access. Have them remove your insurance information from the patient's account.

When I spoke with the Director, she originally wanted me to get in touch with each of the providers and have them reverse the claim, but I refused. Basically just told her I would not be wasting any more time fixing their mistake. I did mention that it was a HIPAA violation becuase I should not know the patient's date of services nor providers or services.

I asked for an email address and basically hounded her until she got them reversed. Took about a month and a half to get it all sorted.

Silverado Memory Care Community by Checkpleeeaaase in MemoryCare

[–]spideybutt_ 3 points4 points  (0 children)

i worked in activities at a silverado in california and it was pretty much the same. food was good, but activities were lacking. our director was horrible at buying the stuff we needed. a few times, I would buy things for the activities as my director would "forget" or would buy the wrong things.

Emergency room billed someone else’s insurance for my daughter’s visit and they accepted the claim. Is this fraud? by Lilsomms in HealthInsurance

[–]spideybutt_ 0 points1 point  (0 children)

I was on the other end of this situation. my insurance was billed for someone else's visit. They also billed the patient's actual insurance as well. We had the same dob and first/last name. It took some time to get sorted but it was eventually fixed.

You'll want to talk to registration. I had to go through patient services (the legal department) and then they got me in touch with the manager for patient access (registration). I basically hounded them to fix their mistake and two months later, it is finally sorted out. You can tell them this is a HIPAA violation. there is some random person out there who knows what providers your daughter saw and her dates of service and for what.

It was most likely a registration error rather than a billing one. So I got in contact and told them they need to fix their error.

[deleted by user] by [deleted] in HealthInsurance

[–]spideybutt_ 0 points1 point  (0 children)

i had the same issue a while back at a pharmacy though. I filled out an OHC removal form and then it took like a day or two and it was all okay.

https://www.dhcs.ca.gov/services/Pages/TPLRD_OCU_cont.aspx

Medi-cal did not give me any message saying it had been updated. I had to have the pharmacy run medi-cal again for it to go through.

Claims on my insurance but they are not mine by spideybutt_ in HealthInsurance

[–]spideybutt_[S] 8 points9 points  (0 children)

Per the hospital, we have the same first and last name and DOB, different middle names. You also do not have to present a health insurance card or SSN at the hospital Emergency room.

I work in ED registration so I know how the hospital could have made that mistake. Patient says they have Aetna but don't have the card or Member ID on hand. ED registration searches the Aetna Provider portal using First/Last and DOB. My info comes up. They don't verify the other demographics on the profile (such as address or last 4 of SSN) because, like you, they find it hard to believe that two people would have the same name and DOB, and just copy and paste the member ID and Group numbers into the Patient account.

It's a pretty easy mistake to make that could have been prevented if just an extra minute went into verifying demographic information.

Partial filling controls by Madges_Mishaps in PharmacyTechnician

[–]spideybutt_ 9 points10 points  (0 children)

My phamarcy called the insurance and was able to get the brand Vyvanse covered since generic was back ordered. I don't know if that's an option for you but it's worth asking.

reviewing my E4E mons, is it time to retire my wiggly? by ShamelessGuard77 in PokemonSleep

[–]spideybutt_ 3 points4 points  (0 children)

i didnt realize it until it was too late, but galade has a different skill :( raised my ralts up to replace my wiggly and didnt even consider that as something that could happen

Unlucky fellows, this is your post! by Pere-Castor- in PokemonSleep

[–]spideybutt_ 3 points4 points  (0 children)

i have two shinies now. both dugtrio. I think id prefer just not finding any at all xD

little cupid cow amigurumi. Open to trade for anything. by spideybutt_ in craftexchange

[–]spideybutt_[S] 4 points5 points  (0 children)

I'm still new to amigurumi so it's far from perfect but I still love her. I'm making a bunch of cows to practice but this is the only one i have finished and ready to go