Actuarial Outpost
 
Go Back   Actuarial Outpost > Actuarial Discussion Forum > Health - Disability
FlashChat Actuarial Discussion Preliminary Exams CAS/SOA Exams Cyberchat Around the World Suggestions

Browse Open Actuarial Jobs

Life  Health  Casualty  Pension  Entry Level  All Jobs  Salaries


Reply
 
Thread Tools Search this Thread Display Modes
  #41  
Old 06-19-2018, 01:09 PM
Dr T Non-Fan Dr T Non-Fan is offline
Member
SOA AAA
 
Join Date: Sep 2001
Location: Just outside of Nowhere
Posts: 91,536
Default

Quote:
Originally Posted by mathmajor View Post
Update: I requested the two Dr. appts to be downgraded in severity. The Dr. herself emailed back and refused, offering that I can pay self-pay (for the first claim it's actually less) but questioning their codes will have me dropped as a patient.
What a shithead.

I mean, as a payer, should you have to pre-approve all procedures?

You should reply that it is unfortunate that you'll have to forward these to your insurer's fraud department.
__________________
DTNF's Basic Philosophy Regarding Posting: There's no emoticon for what I'm feeling! -- Jeff Albertson (CBG)
DTNF's Trademarked Standard Career Advice: "pass some exams and get back to us."
DTNF's Major advice: "Doesn't matter. Choose major that helps you with goal of Career Advice."
DTNF's Résumé Advice: Have a good and interesting answer to every item on it for the interviews.
DTNF's Law of Job Offers: You not only have to qualify for the position, but you also have to be the best candidate available for the offer.
DTNF's Work Philosophy: I am actuary. Please insert data. -- Actuary Actuarying Rodriguez.
Twitches' Advice to Crazy Women: Please just go buy your 30 cats already.
Reply With Quote
  #42  
Old 06-19-2018, 01:17 PM
Childish Gambino's Avatar
Childish Gambino Childish Gambino is offline
Member
SOA
 
Join Date: Jul 2014
Posts: 23,685
Default

Quote:
Originally Posted by mathmajor View Post
Update: I requested the two Dr. appts to be downgraded in severity. The Dr. herself emailed back and refused, offering that I can pay self-pay (for the first claim it's actually less) but questioning their codes will have me dropped as a patient.
this is my new favorite TV show. when is the next episode?
__________________
Quote:
Originally Posted by Pseudolus View Post
Trump's biggest weakness is that he utterly lacks the knowledge, experience, interest, attention span, temperament, and common decency to be the marginally effective President of a reasonably-large HOA.
Reply With Quote
  #43  
Old 06-19-2018, 02:18 PM
YetAnotherCareerChanger's Avatar
YetAnotherCareerChanger YetAnotherCareerChanger is offline
Member
CAS
 
Join Date: Jan 2014
Posts: 2,782
Default

Quote:
Originally Posted by Dr T Non-Fan View Post
What a shithead.

I mean, as a payer, should you have to pre-approve all procedures?

You should reply that it is unfortunate that you'll have to forward these to your insurer's fraud department.
so much.
Reply With Quote
  #44  
Old 06-19-2018, 02:22 PM
Dr T Non-Fan Dr T Non-Fan is offline
Member
SOA AAA
 
Join Date: Sep 2001
Location: Just outside of Nowhere
Posts: 91,536
Default

Downside is that the Fraud Department will look at them and say, "so what? MM's paying."

Upside is that they pore through MM's provider's claims for the past several years. And that would be such a shame.
__________________
DTNF's Basic Philosophy Regarding Posting: There's no emoticon for what I'm feeling! -- Jeff Albertson (CBG)
DTNF's Trademarked Standard Career Advice: "pass some exams and get back to us."
DTNF's Major advice: "Doesn't matter. Choose major that helps you with goal of Career Advice."
DTNF's Résumé Advice: Have a good and interesting answer to every item on it for the interviews.
DTNF's Law of Job Offers: You not only have to qualify for the position, but you also have to be the best candidate available for the offer.
DTNF's Work Philosophy: I am actuary. Please insert data. -- Actuary Actuarying Rodriguez.
Twitches' Advice to Crazy Women: Please just go buy your 30 cats already.
Reply With Quote
  #45  
Old 06-19-2018, 05:45 PM
mathmajor's Avatar
mathmajor mathmajor is offline
Member
SOA AAA
 
Join Date: Dec 2010
Location: Nowhere in particular
Studying for Japanese
College: B.S. Applied Math
Favorite beer: La Croix Grapefruit
Posts: 9,130
Default

This is infuriating waiting for my facility claim to come in. Now you're telling me there's some kind of lag between incurral and reporting? When did this happen?
__________________
FSA
Reply With Quote
  #46  
Old 06-19-2018, 05:58 PM
Dr T Non-Fan Dr T Non-Fan is offline
Member
SOA AAA
 
Join Date: Sep 2001
Location: Just outside of Nowhere
Posts: 91,536
Default

Quote:
Originally Posted by mathmajor View Post
This is infuriating waiting for my facility claim to come in. Now you're telling me there's some kind of lag between incurral and reporting? When did this happen?
We do have several threads about IBNR, if that is what you're asking.

Just pay them $800. That is my estimate of your payment, knowing absolutely nothing about it.
__________________
DTNF's Basic Philosophy Regarding Posting: There's no emoticon for what I'm feeling! -- Jeff Albertson (CBG)
DTNF's Trademarked Standard Career Advice: "pass some exams and get back to us."
DTNF's Major advice: "Doesn't matter. Choose major that helps you with goal of Career Advice."
DTNF's Résumé Advice: Have a good and interesting answer to every item on it for the interviews.
DTNF's Law of Job Offers: You not only have to qualify for the position, but you also have to be the best candidate available for the offer.
DTNF's Work Philosophy: I am actuary. Please insert data. -- Actuary Actuarying Rodriguez.
Twitches' Advice to Crazy Women: Please just go buy your 30 cats already.
Reply With Quote
  #47  
Old 06-20-2018, 09:08 AM
mathmajor's Avatar
mathmajor mathmajor is offline
Member
SOA AAA
 
Join Date: Dec 2010
Location: Nowhere in particular
Studying for Japanese
College: B.S. Applied Math
Favorite beer: La Croix Grapefruit
Posts: 9,130
Default

lol
__________________
FSA
Reply With Quote
  #48  
Old 06-20-2018, 09:42 AM
Werewolf's Avatar
Werewolf Werewolf is offline
Weremember
SOA AAA
 
Join Date: Jan 2003
Location: Fighting with courage
Studying for the Battle of the Bands
Favorite beer: Presidente
Posts: 18,684
Blog Entries: 1
Default

Quote:
Originally Posted by mathmajor View Post
Update: I requested the two Dr. appts to be downgraded in severity. The Dr. herself emailed back and refused, offering that I can pay self-pay (for the first claim it's actually less) but questioning their codes will have me dropped as a patient.
Personally, I suggest forwarding your bill and this e-mail to the office of your state attorney general and the department of insurance.
__________________
Sideshow Bob's a psychopath who uses proper Kelsey Grammer.


Spoiler:
Quote:
Originally Posted by Hydraskull
Turns out, annuitize IS DB. Directed by M Night Shyamalan.
Quote:
Originally Posted by limabeanactuary
I realized WIS was his dump stat a while back.
Quote:
Originally Posted by ShebaPoe
Ideologues should be kept far away from power. Starbucks is a good place for them to work.
Quote:
Originally Posted by nonlnear View Post
There's no such thing as an overqualified barista. You need somebody who can not only make drinks and run a register, but also engage customers who might have questions about the genderqueer or Hegelian subtext of the latest pretending-to-not-be-from-a-big-label album being hawked on their counter.
Reply With Quote
  #49  
Old 06-20-2018, 10:20 AM
celalta's Avatar
celalta celalta is offline
Member
SOA
 
Join Date: Oct 2012
Studying for Health Foundations
Posts: 849
Default

Quote:
Originally Posted by mathmajor View Post
My patient portal has CPT codes.
I was thinking, man I'm somewhat jealous of this, and then I looked closer, and ours does too. We see our same providers for the same things regularly, and the bill is always the same by provider (I could pay the exact dollar amount at the office before we get the EOB, that's how regular the billing is), so I've never paid attention. Thanks for "making" me look

Related but unrelated, our deductible/OOP max are so low that they hardly seem like a deterrent (to me), but my spouse has a somewhat similar reaction as you've mentioned surrounding the deductible. Before the deductible, they're annoyed/worried about the cost with every bill (even though I'm the one paying/tracking for the HSA), and after the deductible, eh 10% who cares. We hit OOP max every year, I really don't care when it happens, it's the exact same amount of money out of my pocket whether it happens slowly, or quickly.
__________________
P FM MFE VEEs MLC C FAP APC waiting on March list ASA
Reply With Quote
  #50  
Old 06-20-2018, 10:20 AM
celalta's Avatar
celalta celalta is offline
Member
SOA
 
Join Date: Oct 2012
Studying for Health Foundations
Posts: 849
Default

Quote:
Originally Posted by Werewolf View Post
Personally, I suggest forwarding your bill and this e-mail to the office of your state attorney general and the department of insurance.
Also,
__________________
P FM MFE VEEs MLC C FAP APC waiting on March list ASA
Reply With Quote
Reply

Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off


All times are GMT -4. The time now is 06:52 AM.


Powered by vBulletin®
Copyright ©2000 - 2018, Jelsoft Enterprises Ltd.
*PLEASE NOTE: Posts are not checked for accuracy, and do not
represent the views of the Actuarial Outpost or its sponsors.
Page generated in 0.26747 seconds with 9 queries