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Old 07-26-2013, 10:05 AM   #21
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Originally Posted by noelm
EXACTLY, if you are the doctor then you should also check out with AMA about their lobbying in Washington.

Offnote, I read an article about somebody in Washington that signed/supported the bill that patient can not sue the doctor for xyz. After 10 or so years, he wanted to sue the doctor for the same XYZ that happened with him. It turned out that he can not because the bill that he signed/supported.
I burst into laughter after that. so glad that S0B suffered what others suffer on day-to-day basis.
Payback! Insurance companies, although receiving payment from individuals, don't really act in the best interest of the individual. They act to protect the interests of the pool. The ACA did get a few wins against them with pre existing conditions, no maximums, and guaranteed minimum coverages. That's a plus for consumers. So, what seems idiotic to an individual probably has meaning when considering the system in its entirety. What can't be resolved between parties can go to the courts.

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Old 07-26-2013, 11:03 AM   #22
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Originally Posted by Gatordoc50 View Post
Payback! Insurance companies, although receiving payment from individuals, don't really act in the best interest of the individual. They act to protect the interests of the pool.
I would say they act in the best interest of their executives and stakeholders, and then perhaps throw a bone to their pool of clients.

Just my 2 cents......

Don't look back. You're not going in that direction.
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Old 07-26-2013, 11:16 AM   #23
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Refuse to pay and find a new doctor. They will write it off and you wont have to deal with these clowns again.
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Old 07-26-2013, 11:17 AM   #24
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I had something similar happen as well. The doctor ordered blood work to screen for the function of my adrenal glands. When submitted she submitted a diagnosis code rather than a screening code. I didn't find this out until I wanted to switch my health care plan to a cheaper plan and went thru medical underwriting . I was denied. Reason: Adrenal Failure!!!!

It took me going to a specialist (endocrinologist) who ran the same test and determined my adrenals were fine. I obtain a letter from her in writing documenting that fact. I also had to right a letter to the primary care doctor requesting she resubmit the "right" code and to write me a letter admitting she made a mistake. I submitted both to the underwriting department and appealed their decision to deny me the right to move to another plan.
All this took time, probably months to get straight.

I'd like to suggest, whatever you do, do it in writing. Phone calls don't create the paper trail you may need.

This experience taught me to scrutinize the codes the doctor or doctors office submits and to watch for "diagnosis codes" rather than screening codes.

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