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  #41  
Old 06-19-2018, 02:09 PM
Dr T Non-Fan Dr T Non-Fan is offline
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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.
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  #42  
Old 06-19-2018, 02:17 PM
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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?
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  #43  
Old 06-19-2018, 03:18 PM
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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.
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  #44  
Old 06-19-2018, 03:22 PM
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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.
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  #45  
Old 06-19-2018, 06:45 PM
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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?
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  #46  
Old 06-19-2018, 06:58 PM
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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.
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  #47  
Old 06-20-2018, 10:08 AM
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lol
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  #48  
Old 06-20-2018, 10:42 AM
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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.
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  #49  
Old 06-20-2018, 11:20 AM
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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.
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Old 06-20-2018, 11:20 AM
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Personally, I suggest forwarding your bill and this e-mail to the office of your state attorney general and the department of insurance.
Also,
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