Insurance Company Weirdness

Gary Blanchard

beloved, local musician
I had a new client today who has an insurance company I am approved to take but have never dealt with before. To check benefits or make a claim, I have to go to the website, type in the Member ID, DOB, and last name. I tried several times and it came up as no member found. So I call the phone number on the card, and they told me, "Oh, we add a two-number suffix to the Member ID number." They were nice enough to look it up for me, but how do they expect us to bill for sessions if they don't give us all the info. I guess I'll have to call them each time someone with that insurance is seen. :rolleyes:
 
...but how do they expect us to bill for sessions if they don't give us all the info.

^ Prosecution rests!

cleesecourt1.jpg
 
They don't want you to bill. That means they have money going out and that's not the way it works. Money only comes in. Never out.
 
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Many insurance companies have sub-contracts for mental health/ substance abuse services. I deal with one of these subcontractors, and they are great to deal with for every other insurance, This particular parent company seems to fit EG's model.
 
I've become very cynical about insurance and Medicare in general. Today, Medicare won't pay for a wheelchair without a pre payment audit first. That means I'm out the cost of the chair (sometimes $10-15k) until they decide they're good and ready to pay.
Fuck that. I'm not their bank.
 
Oddly enough, Medicaid is one of the easiest payers I have. They authorize up front and pay within 10 days and are flexible about paying for stuff that Medicare wouldn't go near.

I had a customer recently who has cerebral palsy. He lives in the boonies and his mailbox is 1/3 mile from his front door. The can walk some...well enough to move around his house. Under Medicare, he qualifies for squat.
However, he falls 2-3 times going to get his mail every day and has to go to bed after because he's so exhausted from the trip.
I explained his situation to Oklahoma Medicaid honestly and they approved it. I was a little shocked but also encouraged that, perhaps, not all people suck.
 
I've become very cynical about insurance and Medicare in general. Today, Medicare won't pay for a wheelchair without a pre payment audit first. That means I'm out the cost of the chair (sometimes $10-15k) until they decide they're good and ready to pay.
Fuck that. I'm not their bank.
I hear you. I see a number of Mass Health (Medicaid) clients for free because the company that oversees some of the benefits won't recognize my license. The state gave me a license, and half the state's insurance providers don't recognize it. Thanks to all the hoopla about the "heroin epidemic", however, the legislature is about to pass legislature requiring all insurance companies in the state to recognize it. They they'll find another excuse.
 
I hear you. I see a number of Mass Health (Medicaid) clients for free because the company that oversees some of the benefits won't recognize my license. The state gave me a license, and half the state's insurance providers don't recognize it. Thanks to all the hoopla about the "heroin epidemic", however, the legislature is about to pass legislature requiring all insurance companies in the state to recognize it. They they'll find another excuse.

:facepalm: Yup.
Ya know, I love capitalism as much as the next robber baron but these greedy fucks are ruining it for the rest of us.
 
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We have a fundraiser going on here in town. A 6 year old needs treatment for cancer. She has a 35% chance at survival using local chemo/rad that her insurance will cover. They WON'T cover the 85% survival chance that treatment at a facility in NY will offer.

If you ever meet me, don't tell me you sell insurance.
 
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Don't get me started about insurance. I have a good health insurance plan through work but they decided that all prescriptions should be done mail order to save money. I was fine with it and my wife moved all of her meds to the online mail order system. She then ran out of every one of her meds as the mail order company began screwing up in just about every way conceivable. After the initial mess ups they gauranteed that there would be no delays going forward until the next shipment never showed up and once again she ran out of her meds. We went to the pharmacy to get her insulin only to be charged full price because our insurance requires all prescriptions be through the mail. I now pay an additional $200 a month for another perscription drug plan so we can get her meds locally.
 
Not wishing to make this political but god (or whichever deity works for you) the nhs.

I have no faith ib the shysters that insure my car or house, I certainly wouldn't want my health and wellbeing left at their mercy.
 
People bitch about the ACA, but this is exactly why they did it. F#cking insurance companies will screw us every time they can.

Two years ago my dad had a severe pancreatitis attack that after three months in ICU was ultimately fatal . His bill for services was 1.1 MILLION dollars. Thankfully , he had long time care insurance as well as supplemental long timecare/emergency thru AARP, so it didn't impact my mom at all financially. But he was smart in that regard. I would not have thought about that.
 
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People bitch about the ACA, but this is exactly why they did it. F#cking insurance companies will screw us every time they can.

^Troof. I've said it many times before that the number one block to quality, comprehensive medical care was, is and continues to be the medical insurance companies. No legislation, no matter how well intended and designed, will ever fix this broken, greedy cluster fuck.

Two years ago my dad had a severe pancreatitis attack that after three months in ICU was ultimately fatal .

I am sincerely sorry for your loss.
I hate cancer and some of the limited, barbarian treatments that sometimes work if they don't kill you first.
My mother was stage 4 when they caught hers and the prognosis was not when, but how long she had left. They could make more money with chemo so that was the treatment, even though it wouldn't save her or prolong her life or quality of life. Instead, it hastened her death.

Also, poorly applied radiotherapy killed my grandmother prematurely as they basically fried her internal organs.
 
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