C
Cut-Throat
Guest
nm
OP
OP
Cut-Throat
Guest
Re: The 'Big Wrench' Health Ins.
I'll give you a link, but you have to know that this stuff happens on a regular basis. We fight every year with insurance companies, and end up paying out of pocket, for stuff that should be covered. This is not new news at all. It's just getting worse as costs escalate!
Heres your link http://yahoo.businessweek.com/magazine/content/06_21/b3985105.htm
Nords said:
I'll give you a link, but you have to know that this stuff happens on a regular basis. We fight every year with insurance companies, and end up paying out of pocket, for stuff that should be covered. This is not new news at all. It's just getting worse as costs escalate!
Heres your link http://yahoo.businessweek.com/magazine/content/06_21/b3985105.htm
MasterBlaster
Thinks s/he gets paid by the post
- Joined
- Jun 23, 2005
- Messages
- 4,391
Re: The 'Big Wrench' Health Ins.
Well the writer of the article went out of his network to get top-of-the-line care from a "leading expert", didn't get pre-authorization, and only when the bills arrived did he start making calls.
I don't know the writer or anything about the writers insurance plan. However, I don't see him as a victim at all. I see someone who wanted better than he (or his company) paid for and worked the system to pay for what he probably should have himself paid alot more for.
If you want the very best medical care then you better find and pay for the very best insurance.
People don't see the hypocrisy in what they ask for. They want the very best care but then they only want to pay a small amount. We can't have it both ways.
Well the writer of the article went out of his network to get top-of-the-line care from a "leading expert", didn't get pre-authorization, and only when the bills arrived did he start making calls.
I don't know the writer or anything about the writers insurance plan. However, I don't see him as a victim at all. I see someone who wanted better than he (or his company) paid for and worked the system to pay for what he probably should have himself paid alot more for.
If you want the very best medical care then you better find and pay for the very best insurance.
People don't see the hypocrisy in what they ask for. They want the very best care but then they only want to pay a small amount. We can't have it both ways.
OP
OP
Cut-Throat
Guest
Re: The 'Big Wrench' Health Ins.
MB - I can see you never been sick!
When you 'Go outside of your area' it's because you have to.
YOu sound just like the insurance company with all the excuses! - Like I said - Don't get sick and everything will be alright!
MB - I can see you never been sick!
When you 'Go outside of your area' it's because you have to.
YOu sound just like the insurance company with all the excuses! - Like I said - Don't get sick and everything will be alright!
MasterBlaster
Thinks s/he gets paid by the post
- Joined
- Jun 23, 2005
- Messages
- 4,391
Re: The 'Big Wrench' Health Ins.
I haven't been sick so I probably should be more compassionate.
However I stand by my statement that this Blue Ribbon healthcare is NOT consistant with low insurance prices and/or universal coverage. In fact the opposite is true.
This increasing medical consumption trend cannot go on and on. The Single-payer model that you and others have avocated would not have provided a world-class expert to treat the writers son. You'd get some guy who was assigned who may or may not know enough to treat the condition. Furthermore you'd have to wait 6 months or a year to have the surgery done.
I haven't been sick so I probably should be more compassionate.
However I stand by my statement that this Blue Ribbon healthcare is NOT consistant with low insurance prices and/or universal coverage. In fact the opposite is true.
This increasing medical consumption trend cannot go on and on. The Single-payer model that you and others have avocated would not have provided a world-class expert to treat the writers son. You'd get some guy who was assigned who may or may not know enough to treat the condition. Furthermore you'd have to wait 6 months or a year to have the surgery done.
Re: The 'Big Wrench' Health Ins.
Workmans comp. is another huge battle. Suppose to make you whole and you don't sue in return. They will do everything in their power to not pay. Including fraud. I should write a book about it when I retire. I am not the victim, my wife was. Long and bloody battle that we won.
Workmans comp. is another huge battle. Suppose to make you whole and you don't sue in return. They will do everything in their power to not pay. Including fraud. I should write a book about it when I retire. I am not the victim, my wife was. Long and bloody battle that we won.
perinova
Full time employment: Posting here.
- Joined
- Apr 18, 2006
- Messages
- 531
Re: The 'Big Wrench' Health Ins.
cut-throat
I am 100% with you there.
premium = 1 arm and a leg
service = zero (even though you are a customer)
they always try to find an excuse not to pay. got many problems with that in the past.
They will denie reimbursement as a policy.
Why?
Simply because most people give in right then and the ins. co. goes free. Lots of people don't want to bother or don't know how or just don'thave the time.
Another round of people will give up after the 1st attempt.
Another round after the 2nd.
Etc.
you receive a bill from the doctor that the ins. didn't pay
you call the ins. co. who sends you to the Dr (mistake, something wasn't done...)
you call the doctor who sends you back to the insurance company (same deal)
(both of them lying)
this will last 2-3 times with a bill reminder each time
what to do: call the ins. co put them on hold a mnute. call the Dr and do a 3-way-call. now everything gets resolved since they can't lie to you any more. You can then assign the action items.
(true story: try the 3-way call it worked for me)
(Insurance companies will fight any regulation every step of the way. Lobbying your congressman with your premiums.)
cut-throat
I am 100% with you there.
premium = 1 arm and a leg
service = zero (even though you are a customer)
they always try to find an excuse not to pay. got many problems with that in the past.
They will denie reimbursement as a policy.
Why?
Simply because most people give in right then and the ins. co. goes free. Lots of people don't want to bother or don't know how or just don'thave the time.
Another round of people will give up after the 1st attempt.
Another round after the 2nd.
Etc.
you receive a bill from the doctor that the ins. didn't pay
you call the ins. co. who sends you to the Dr (mistake, something wasn't done...)
you call the doctor who sends you back to the insurance company (same deal)
(both of them lying)
this will last 2-3 times with a bill reminder each time
what to do: call the ins. co put them on hold a mnute. call the Dr and do a 3-way-call. now everything gets resolved since they can't lie to you any more. You can then assign the action items.
(true story: try the 3-way call it worked for me)
(Insurance companies will fight any regulation every step of the way. Lobbying your congressman with your premiums.)
maddythebeagle
Thinks s/he gets paid by the post
- Joined
- Jun 15, 2005
- Messages
- 2,450
Re: The 'Big Wrench' Health Ins.
hmm. I am surprised that they were even able to get cosmetic surgery to be covered? Seems like folks have a disconect with an HMO vs. a PPO or blue cross/blue shield plan. If you know that you have some specialized need, why mess around in an HMO? MB hit the nail on the head, the guy wanted to pay less.
hmm. I am surprised that they were even able to get cosmetic surgery to be covered? Seems like folks have a disconect with an HMO vs. a PPO or blue cross/blue shield plan. If you know that you have some specialized need, why mess around in an HMO? MB hit the nail on the head, the guy wanted to pay less.
