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Health insurance issue, need some input here Health insurance issue, need some input here

02-23-2012 , 08:56 PM
If the doctor is not an in network preferred provider then your insurance isn't going to care at all.

You are responsible to verify what your insurance covers and where, no matter what you were told by the doctors office.
Health insurance issue, need some input here Quote
02-23-2012 , 09:39 PM
Quote:
Originally Posted by KatoKrazy
You are responsible to verify what your insurance covers and where, no matter what you were told by the doctors office.
That's on a legal level, not on a human decency level. Op should fight back hard, as Noodleman, the one with the most experience here, indicated.

Legals got nothing to do with it until it's before a judge. Before that, it's just people doing what they need to.
Health insurance issue, need some input here Quote
02-23-2012 , 09:47 PM
Quote:
Originally Posted by Bill Haywood

Legals got nothing to do with it until it's before a judge. Before that, it's just people doing what they need to.
Sure it does (unless of course you don't care about getting collections calls, your credit getting dinged, etc.)
Health insurance issue, need some input here Quote
02-23-2012 , 10:05 PM
Quote:
Originally Posted by KatoKrazy
unless of course you don't care about getting collections calls, your credit getting dinged, etc.
No, I don't care about my credit rating. That way, scammers have less leverage on me. That's an advantage of living within your means -- you can't get jerked around on the credit game. I've took harassing calls for two years rather than pay a fake bill. But that's just me, not wanting to be a bitch for corporations.
Health insurance issue, need some input here Quote
02-23-2012 , 10:08 PM
Right- because your credit score has nothing to do with how much you pay for insurance or employment opportunities, it's only about getting loans, right?
Health insurance issue, need some input here Quote
02-23-2012 , 10:22 PM
Quote:
Originally Posted by KatoKrazy
Right- because your credit score has nothing to do with how much you pay for insurance or employment opportunities, it's only about getting loans, right?
I have superb credit because I live within my means, and got excellent terms on a home loan. But I'm not going to let people rip me off with those kind of threats. The scammers I refused to pay did not change the total picture of my credit worthiness. I'm just saying I refuse to run scared. You, on the other hand, sound like you'll pay last months rent to a landlord known to steal security deposits for fear he'll say something bad about you. You are a victim.
Health insurance issue, need some input here Quote
02-23-2012 , 11:01 PM
bill, if you ate at a restaurant that doesn't take discover and didn't check before hand, do you just dine and dash?
Health insurance issue, need some input here Quote
02-23-2012 , 11:24 PM
Quote:
Originally Posted by dchz
bill, if you ate at a restaurant that doesn't take discover and didn't check before hand, do you just dine and dash?
No comparison. As noodle confirmed, OP was badly burned. He owes something, but Dr. needs to deal. Dr. should share in the cost because 1. patients are always overcharged when insurance isn't paying, and we should on principle bargain down. 2. As noodle explained, they need to let him know, as a matter of basic human decency, that his insurance has been denied and he'll have to pay. He is being shaken down, pure and simple. He should double check in the future for self protection, but that's no reason to let them do the work first, then hit him with the bill.

If you take a car worth $2k into the shop for an estimate, and they do $4k in repairs without consulting you, are you paying?

OP should do what ever's necessary to satisfy his particular psyche. Some people, it's not worth the hassle. Me, I'm leafleting the guys neighborhood and church.

Last edited by Bill Haywood; 02-23-2012 at 11:29 PM.
Health insurance issue, need some input here Quote
02-23-2012 , 11:36 PM
You need to be a big boy and learn how to take care of grown-up things.

Lessons learned: It is the responsibility of the insured to read AND understand the terms of their insurance policy. I know this is daddy's policy, but if you are going to go in by yourself, you need to know what you are getting into.

You also learned that you should talk to the service provider BEFORE any procedure to understand what your financial obligation will be. This should be common sense, but apparently not.

Finally, you are going to learn that insurance paperwork doesn't get processed immediately, and it may take a month or so to see the "this is not a bill" letter from your insurance company, after which your provider will send your bill. Just general terms and can vary a bit but that's the gist. Also, understand that your dad might get the insurance paperwork if you don't live at home.

Yes, everything in life is negotiable. You may get them to agree to bill you at the insurance rate. But they are absolutely not obligated. One of the many reasons that procedures cost less to insurance companies than to uninsured patients is that insurance companies pay their bills and don't come crying poverty or picket in front of their office.

They aren't screwing you though, unless you don't buy much into that whole personal responsibility thing.
Health insurance issue, need some input here Quote
02-24-2012 , 12:02 AM
they've got a responsibility to inform people the bill was rejected, as the guy who worked in the doctors office confirmed. The bureaucratic redtape is set up to put people at a disadvantage, it is not comparable to walking out on the bill at a mom and pop eatery, where you are dealing with human beings.

When corporate sharpies deal with each other, they never get bogged down with esoteric concepts of personal responsibility of corporate personhood. It's a negotiation, based on leverage. If you let them impose an ethic of personal honor on you, that they do not share, then you are their bitch. Fight fire with fire.
Health insurance issue, need some input here Quote
02-24-2012 , 12:22 AM
Quote:
Originally Posted by Bill Haywood

If you take a car worth $2k into the shop for an estimate, and they do $4k in repairs without consulting you, are you paying?
I am if i signed a piece of paper saying i will...
Health insurance issue, need some input here Quote
02-24-2012 , 01:00 AM
I would rather pay twice as much then spend time standing on the sidewalk handing out leaflets like a bum with club "vip" passes
Health insurance issue, need some input here Quote
02-24-2012 , 01:17 AM
Quote:
Originally Posted by dchz
I am if i signed a piece of paper saying i will...
See post immediately above yours. These types are without honor, and deserve only the power manuvering that they pull on us.

Quote:
I would rather pay twice as much then spend time standing on the sidewalk handing out leaflets like a bum with club "vip" passes
People too self conscious to stick up for themselves are the perfect mark for medical clinics and muffler repair shops.

Last edited by Bill Haywood; 02-24-2012 at 01:38 AM.
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02-24-2012 , 02:48 AM
all on you boss. you should have checked before you went.
Health insurance issue, need some input here Quote
02-24-2012 , 09:09 AM
I agree that OP has a responsibility to check his policy provisions regarding providers before going to the doctor's office and he likely signed documents obligating him to pay the costs of uncovered services. That part's on him and it's likely a lesson he'll not forget.

However, I think he's got a legit gripe here and, if I was him, I would not simply pay the bill and chalk this one up to "a hard lesson learned."

Quote:
Originally Posted by meleader2
On 2/3/2012 I went to a doctor's office and had a first appointment. They took my insurance card, scanned it, I had my appointment, paid my copay and left.
On the initial visit, they scanned his card and accepted his copay. I think a reasonably prudent person (albeit one that didn't read his policy beforehand) would conclude that this provider accepts his insurance. The providers I know try to make sure they're gonna get paid before they render any services. (And this usually includes verifying that the policyholder is still covered.) The office staff is- or should be- aware of what insurance they accept before rendering services since it's a lot easier to collect from an insurance company than somebody like Bill Haywood.

Quote:
Originally Posted by meleader2
I had a followup appointment and a procedure done today, 2/22/2012. After the procedure was done I checked out. Upon checking out I was told that this particular office didn't take "HMO" and I had to pay full price for the 2/3 visit and this one.
Then the OP goes back for his procedure almost three weeks later, the doc performs it knowing that it's not covered and tells the OP after-the-fact that he's gotta pay for it out of pocket.

I call bull****... and the BBB and the medical licensing board and whoever else will listen to a legitimate complaint about a bad business practice. Unless, of course, the doc wants to be reasonable and settle the matter amicably and fairly.
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02-24-2012 , 10:14 AM
What amead said. This is 100% on you. Take some ****ing responsibility for once in your ****ing life.
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