Luv it! I've got a chance to use it currently. Hope you don't mind me inserting the link.
Fight Health Insurance
Fight Health Insurance
My wife worked for a health insurance company and she is licensed in I think 27 states to sell life insurance.
Anyway this health insurance company told her to deny 85% of all legitimate claims the first time.
Some legitimate claims get denied the second time also.
Yea she quit working for them and did not deny any legit claims.
Years later she got rejected on a legitimate claim and her knowing the rules and regs better than 90% of the people out there she refiled and got denied and then a person she kind of knew at the insurance commissioners office said call the office and complain that a legitimate claim is being denied.
The office will investigate and this was 15 years ago or more.
The friend of hers also said if we get sicked on a company 3 times in a year then we get to audit them and no company wants that.
Guess what.. she got her claim paid for.
Now dental places try and get money from me on Xrays.
After i tell them do NOT do anything that insurance will not cover.
I tell the receptionist and the DR the same thing do not do it if I have to pay out of pocket because I will not pay a dime.
Quite a few times I get sent a bill and they say we did not know.
TOO BAD. I am not paying it as it is your job to know what is and is not covered and you told me it was covered. Pound sand.
I have never paid when they mess up and nothing ever happens.
Anyway this health insurance company told her to deny 85% of all legitimate claims the first time.
Some legitimate claims get denied the second time also.
Yea she quit working for them and did not deny any legit claims.
Years later she got rejected on a legitimate claim and her knowing the rules and regs better than 90% of the people out there she refiled and got denied and then a person she kind of knew at the insurance commissioners office said call the office and complain that a legitimate claim is being denied.
The office will investigate and this was 15 years ago or more.
The friend of hers also said if we get sicked on a company 3 times in a year then we get to audit them and no company wants that.
Guess what.. she got her claim paid for.
Now dental places try and get money from me on Xrays.
After i tell them do NOT do anything that insurance will not cover.
I tell the receptionist and the DR the same thing do not do it if I have to pay out of pocket because I will not pay a dime.
Quite a few times I get sent a bill and they say we did not know.
TOO BAD. I am not paying it as it is your job to know what is and is not covered and you told me it was covered. Pound sand.
I have never paid when they mess up and nothing ever happens.
Well they've already tore a new one one on me. Ha. Even with top tier insurance, and med flight insurance, cancer policy....the cost of taking a lung and continued treatments and surgeries, I've had to put my foot down as to these surgeries and treatments that only benefited the hospitals and thoracics. Not putting my wife in poverty over a lost cause. It's my job as a man and a husband to take care of her and I am.
The cost of medical care, regardless if it's catastrophic care (like cancer) to shoulder surgery, the cost is nuts. There's zero reason the price of treatment should be this high. NONE.
We are fools to allow this to continue.
The cost of medical care, regardless if it's catastrophic care (like cancer) to shoulder surgery, the cost is nuts. There's zero reason the price of treatment should be this high. NONE.
We are fools to allow this to continue.
1. Insurance is NOT in business to pay out.
2. They will do everything possible to not pay or delay pay.
3. A form not properly filled out or service not worded properly will cause major delays.
We had Met Life ('91), was really good Insurance. They would not pay a dime that wasn't filed on their forms.
Dad was retired and travelling. Was admitted to hospital in Las Vegas.
I took a handful of forms and flew to Las Vegas. Gave the billing office forms, they said it wasn't needed. Six months later, I get a call asking to send them forms. Sent forms and never heard them, again.
Ask WHY payment was refused, can result in an easy settlement.
2. They will do everything possible to not pay or delay pay.
3. A form not properly filled out or service not worded properly will cause major delays.
We had Met Life ('91), was really good Insurance. They would not pay a dime that wasn't filed on their forms.
Dad was retired and travelling. Was admitted to hospital in Las Vegas.
I took a handful of forms and flew to Las Vegas. Gave the billing office forms, they said it wasn't needed. Six months later, I get a call asking to send them forms. Sent forms and never heard them, again.
Ask WHY payment was refused, can result in an easy settlement.
Insurance is such a racket anyway. Take money, take money, take money, file bankruptcy, move to Cancun.
It is not just personal insurance that doesn't get paid. Before my daughter passed she worked in appeals for HPI. She was on the phone all day 5 days a week getting money owed to the doctors and hospitals. The insurance companies try to get out of paying anything to anyone.
That is part of what I do for the hospital, armor up accounts so they survive insurance audits. The docs don't always document every diagnosis they are treating, it's my job to find that and get them to do it.
My wife used to do CDI work. She enjoyed it.
Similar threads
