Experience with out-of-network?

[mykidslovedogs]

Originally Posted by Nords

See, this is where I'd refer you back to the part where I said:

Nords, you and I probably butt heads because we both like to get the last word, right? Anyways, how would you suggest that I help the client properly without explaining to him/her what they need to do in order for me to be able to help them?

[Nords]

Originally Posted by mykidslovedogs

Nords, you and I probably butt heads because we both like to get the last word, right? Anyways, how would you suggest that I help the client properly without explaining to him/her what they need to do in order for me to be able to help them?

OK, so quoting the regs didn't work-- now let's make it the customer's problem.

Not gonna play that game. I'm pretty sure you have better insight into thinking up the solutions anyway, instead of explaining the problems.

[mykidslovedogs]

Nords, I give up! You are right! The service would be much better if a government agency were in charge of helping out with claims.

Heck, I've always gotten GREAT service from the IRS. Who needs brokers, anyway? A federal health insurance agency could do a much better job of mediating claims issues.

[TargaDave]

Originally Posted by Martha

Not surprisingly, our Minnesota BCBS plan covers care at Mayo.

You might want to read these links about Mayo:

http://www.mayoclinic.org/billing-rst/

http://www.kaisernetwork.org/daily_r...fm?DR_ID=30220

Martha, Helpful links.

Guess We'll have to put some work into this. Our income is too high for the "uninsured plan" discussed. DW has only one more checkup before getting the all-clear, but you never know if-when something might come back. It would be nice to get hooked up with a plan that includes Mayo on the provider list (just in case).

Thanks for the input(s)

[youbet]

Originally Posted by crazy connie

So, it appears they are waiting instead of forcing a write off. Good business decision.

I wonder what they are waiting for? Is your friend young enough that his financial picture may change and he may be able to pay the bill?

[crazy connie]

Originally Posted by youbet

I wonder what they are waiting for? Is your friend young enough that his financial picture may change and he may be able to pay the bill?

No, he is not a youngster. He is 57 and retired AirForce. He works for the phone company as a splicer and may be facing a disability in 2007 due to joint degeneration in spine and legs. Decent blue collar wage, less than 100K home equity, modest military pension and will not have a phone company pension due to age when hired. So very doubtful he will live long enough to pay off the bill. If they levied a garnishment he would quit work and live off pension which can not be garnished. That is why they are patient in my opinion.

[stargazer08]

In 2005, I took my oldest daugher to Mayo in MN twice. I had United Health Care that year through work. It was out of network. I had to meet my out of pocket for out of network and then pay 35% of the charges. I don't believe anything was over the usual and customary charges...she only had doctor visit charges and quite a bit of blood work and some overnight monitoring of her heart. I think in the end, it cost me around 2-3G for the piece of mind the specialist gave me about her condition. The endrocrinologist in my Illinois hometown couldn't provide me with enough information on what her problem was and what the cause was. At Mayo, they were able to pinpoint the disconnect in the particular endocrine cycle, explain it thoroughly to me and confirm she was on the correct medication. She has to take meds the rest of her life which is why I wanted a second opinion from what I consider a top facility. Of course, in 2006 to present, I have BCBS and Mayo is in their network! The real pisser of this entire thing was when we tried to purchase her private health insurance when she graduated from college and would no longer be covered under my plan. I had a friend in the insurance business ask several carriers if they would provide coverage for a 22 yr old with her diagnosis... the answer was NO. Thankfully, after graduating from college, she found a job that provides health ins and the problem is solved...for now.