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Funny Humana Health Insurance Story.

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Funny Humana Health Insurance Story.

Old 07-16-2012, 03:17 PM
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Default Funny Humana Health Insurance Story.

I pay for our health care out of pocket for the 4 of us (wife, 2 kids and me) -- littlest one goes in for her wellness visit. Bloodwork, etc. ALL WORK is on the "list" of approved tests to be part of wellness visit.

All is paid for (no deductible with wellness visits, as you may or may not know) EXCEPT $16 for part of the lab work. They insist I owe them $16.

I call LabCorp. They tell me tough crap pay it or it'll go to collections and we won't give you anymore tests/care. Humana tells me tough luck, the lab billed the wrong code, cal the lab and they say the doctor billed the wrong code, the doctor's office says they did everything right and that the lab billed the wrong code -- and this goes around and around.

The keep sending letters. Normally after the first letter I send a certified letter and tell them to hug my nuts.

FOR SOME REASON -- I decide I'm going to call them again. I call Humana, explain the whole thing - lady puts me on hold, calls the lab and the doctor, confirms that one of them screwed up the coding and put in one of the blood tests as diagnostic instead of wellness... and all is fixed.

Just wonder how many people "just pay it" when it's only $16...? Then the next time when it's $160, and then the next time when it's $1600... and so on?

End Rant.
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Old 07-16-2012, 03:23 PM
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I just received a $400.00+ bill from the colonoscopy, thought the number looked familiar, it was a duplicate of a bill I already paid.
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Old 07-16-2012, 03:25 PM
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My payments are way more than $16. I have to check every one. Co-pays are always $30. Allot of the time the wrong codes are put in and its up to you to get corrected or just pay the bill. Great system we have for people who have insurance.
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Old 07-16-2012, 04:43 PM
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I had a facility bill my insurance company 100 dollars for a procedure they never did. I called the insurance company about it they told me yea this happens all the time. It will cost more money to re-collect the 100 dollars than it's worth.
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Old 07-16-2012, 04:54 PM
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Originally Posted by baker2605 View Post
I had a facility bill my insurance company 100 dollars for a procedure they never did. I called the insurance company about it they told me yea this happens all the time. It will cost more money to re-collect the 100 dollars than it's worth.
That happened to me too! I was reviewing the codes on an EOB and called the insurance company to let them know that it never happened. -- They didn't care.

At the end of the day, they really don't care -- they just pass the cost along to us, the suckers. LOL.
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Old 07-16-2012, 06:36 PM
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Just got off the phone with Cigna....little one went to her specialist....needed an X-ray...the dr office X-ray machine was broken so they sent us across the hall. They are trying to tell me now that she went for an outpatient procedure which is not covered, to the tune of $240. Had the X-ray machine in the dr office been working, it would have been covered.

Time to appeal yet another claim....I'm getting good at writing letters.
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Old 07-16-2012, 09:05 PM
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Originally Posted by OldPete View Post
I pay for our health care out of pocket for the 4 of us (wife, 2 kids and me) -- littlest one goes in for her wellness visit. Bloodwork, etc. ALL WORK is on the "list" of approved tests to be part of wellness visit.

All is paid for (no deductible with wellness visits, as you may or may not know) EXCEPT $16 for part of the lab work. They insist I owe them $16.

I call LabCorp. They tell me tough crap pay it or it'll go to collections and we won't give you anymore tests/care. Humana tells me tough luck, the lab billed the wrong code, cal the lab and they say the doctor billed the wrong code, the doctor's office says they did everything right and that the lab billed the wrong code -- and this goes around and around.

The keep sending letters. Normally after the first letter I send a certified letter and tell them to hug my nuts.

FOR SOME REASON -- I decide I'm going to call them again. I call Humana, explain the whole thing - lady puts me on hold, calls the lab and the doctor, confirms that one of them screwed up the coding and put in one of the blood tests as diagnostic instead of wellness... and all is fixed.

Just wonder how many people "just pay it" when it's only $16...? Then the next time when it's $160, and then the next time when it's $1600... and so on?

End Rant.
Probably VERY true!

When I go to my PC doc every 6mo. (checkup), I pay a $30(?) co-pay and he gives me a LabCorp sheet to go get bloodwork about a week later - then, they send him the results. I don't pay or get invoiced for the bloodwork from either the doc or LabCorp.

When I was handling my late aunt's estate as executor, the final bill from the hospital (where she passed away) was over $14K for 2 DAYS! In following up with the hospital, they expected me to pay the bill (from the estate).

I asked, "Have you filed with Medicare, yet?" - they said "Yes". I asked if they had filed with Anthem (secondary), yet - they said, "No".

I told them AFTER they had been paid by Medicare AND Anthem, to let me know what the PATIENT'S responsibility would be, and I would pay it immediately - not a DIME before those two companies paid THEIR share!

I was NOT going to pay out $14K and wait "x" months to get reimbursed by the hospital at some later date (they could NOT tell me how long that might be if I paid THEM beFORE the insurance companies paid THEIR share!).

In the end - a little over a YEAR later - I called and the hospital said we owed NOTHING! A full YEAR + bouncing back and forth between Medicare, Anthem, and the hospital!!!!!!!!!!!!!!!!!!!!!!

I think, by law, Medicare is suppose to pay the hospital within 30 days of submission of the bill. The hospital told me that Anthem was also "stragling", as they (Anthem) would get to THEIR "deadline" and then, request MORE info - strictly to DELAY paying them (the hospital)!!!!!!!!!!!!

Same crap with other bills from the SAME hospital - I just said, "NO!" each time for the same reasons!

Sadly, I'm sure my aunt had gone ahead and paid these kinds of bills along the way when she was alive and probably waited MONTHS to get reimbursed. Over about 5 years, she had more than $225,000 in bills from the hospital! Luckily, she had great insurance (retired Fed employee) - it just took FOREVER to get insurers to get things paid to each OTHER.

It's a RACKET!

Regards,
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Old 07-16-2012, 09:30 PM
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No need to worry. Obama is gonna fix this for all of us.
You just have to have some faith in your Government. If you give him just a little more time you will see.
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Old 07-17-2012, 02:54 AM
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I sense a little sarcasm I believe. When the govt. gets involved further, we are all screwed.
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Old 07-17-2012, 03:11 AM
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Originally Posted by CARV View Post
I sense a little sarcasm I believe. When the govt. gets involved further, we are all screwed.
You picked up on that huh
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Old 07-17-2012, 04:28 AM
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Both my local (charitable institution) hospitals got audited a couple years back. One sent me a check to cover an ER co-pay (seven years prior!) that had been coverred due to an automatice apeal/review. The other was for lab fees that they had jumped the gun on after estimating how much my insurance would cover.
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