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US health insurance

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Old Dec 2nd 2021, 10:57 am
  #151  
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Default Re: US health insurance

Yes the payment/billing person is annoying in US hospitals, probably the most annoying aspect
Thanks, I'll remember to let my collections team know how annoying you find them

Just for the record, everyone, even the people doing the collections, find it hard. Insurance companies are a constant battle, and one thing that most people fail to realize is that healthcare providers are not required by law to bill your insurance company in the first instance at all. We do it as a curtesy to the customer, and because it would make like a lot more difficult if we sent the $104k bill to you in the first instance.
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Old Dec 2nd 2021, 12:18 pm
  #152  
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Default Re: US health insurance

Originally Posted by Steerpike
I have a question no one seems to be able to answer ... if you are having, say, a breast MRI or a stomach MRI, do they still put you in 'head first'? It seems totally illogical / unnecessary that they will put you in head first; they should be able to put you in 'feet first', leaving your head un-restricted, and thus not causing claustrophobia.
I had an MRI on my knee earlier this year and went in feet first, but I don't how far up the body that would hold. They seemed pretty keen that I was comfortable (and still!), so I would guess that they try to minimize the stressors.
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Old Dec 2nd 2021, 12:36 pm
  #153  
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Default Re: US health insurance

Originally Posted by civilservant
Thanks, I'll remember to let my collections team know how annoying you find them

Just for the record, everyone, even the people doing the collections, find it hard. Insurance companies are a constant battle, and one thing that most people fail to realize is that healthcare providers are not required by law to bill your insurance company in the first instance at all. We do it as a curtesy to the customer, and because it would make like a lot more difficult if we sent the $104k bill to you in the first instance.
And it would be incredibly inefficient and cause long delays in payment vs. going to where the "easy" money lies. I very much doubt the decision to bill that way is one designed out of a moral compass and much more likely one that makes the most financial sense for a business, even those that are not for profit.
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Old Dec 2nd 2021, 12:43 pm
  #154  
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Default Re: US health insurance

Well..... obviously. I think any simple minded person would realize that the system has evolved to be as quick and painless as possible. It's just still not that quick or painless.

We can and do sometimes end up sending entire bills to patients where insurance companies repeatedly deny for no seemingly legitimate reason. Doesn't happen often, but it does happen.
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Old Dec 2nd 2021, 2:26 pm
  #155  
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Default Re: US health insurance

Originally Posted by Steerpike
Thanks for the feedback! Did your 'open' one look like the one in the picture? I got worked up just THINKING about the first one I had in 2016, hence the request for the valium on that first one. Now, I just want the valium because I like feeling relaxed .

I have a question no one seems to be able to answer ... if you are having, say, a breast MRI or a stomach MRI, do they still put you in 'head first'? It seems totally illogical / unnecessary that they will put you in head first; they should be able to put you in 'feet first', leaving your head un-restricted, and thus not causing claustrophobia.
My shoulder one was head first but abdomen was feet first.

And yes that is exactly like the open one and I still felt better with the valium
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Old Dec 5th 2021, 8:31 pm
  #156  
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Default Re: US health insurance

I was so pleased with myself last week, finding a 'cash price' MRI for about $450 (instead of the usual 'insurance' cost of $1200+), but I just got a bill from my insurance company for $3,500 for a heart monitor that was fitted for three days; 'not in network'.

I visited a cardiologist a few weeks ago due to some heart issues, making sure he was 'in network'. While in his office, he fitted me with an 'Extended Holter Monitor' - a device glued to my chest to take extended readings over a 3 day period, with instructions to detach the device and mail in using pre-paid label. The device proved very helpful, finding some serious problems. But now I get a bill for $3,500 for the service / device! Since it was fitted by the (covered) doctor in his (covered) office, I didn't have the opportunity to even think about whether it was covered or not. I guess I'll be challenging this one!
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Old Dec 5th 2021, 9:03 pm
  #157  
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Default Re: US health insurance

Originally Posted by Steerpike
I was so pleased with myself last week, finding a 'cash price' MRI for about $450 (instead of the usual 'insurance' cost of $1200+), but I just got a bill from my insurance company for $3,500 for a heart monitor that was fitted for three days; 'not in network'.

I visited a cardiologist a few weeks ago due to some heart issues, making sure he was 'in network'. While in his office, he fitted me with an 'Extended Holter Monitor' - a device glued to my chest to take extended readings over a 3 day period, with instructions to detach the device and mail in using pre-paid label. The device proved very helpful, finding some serious problems. But now I get a bill for $3,500 for the service / device! Since it was fitted by the (covered) doctor in his (covered) office, I didn't have the opportunity to even think about whether it was covered or not. I guess I'll be challenging this one!
Yikes!!! You don’t think to ask if every single doctor, nurse, procedure, equipment etc is covered by your insurance, We have had a couple of instances where similar occurred but not for that amount.
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Old Dec 5th 2021, 11:35 pm
  #158  
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Default Re: US health insurance

Originally Posted by Jerseygirl
Yikes!!! You don’t think to ask if every single doctor, nurse, procedure, equipment etc is covered by your insurance, We have had a couple of instances where similar occurred but not for that amount.
It's just another example of how first class healthcare is combined with an insane system of access.
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Old Dec 5th 2021, 11:48 pm
  #159  
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Default Re: US health insurance

Originally Posted by Giantaxe
It's just another example of how first class healthcare is combined with an insane system of access.
A few years ago I took hubby to the ER during the night with chest pains. Upon discharge, the doctor who had been treating him, asked if we would wait as his attending wanted to introduce himself. Got a bill for a few hundred dollars…the attending was not in network.

Another time my husband had an appointment to see our doctor to go over some results. The doctor had been called away urgently. He was asked if he agreed for the nurse to give him the results. Yup…she wasn’t in network.
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Old Dec 6th 2021, 12:04 am
  #160  
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Default Re: US health insurance

Originally Posted by Jerseygirl
A few years ago I took hubby to the ER during the night with chest pains. Upon discharge, the doctor who had been treating him, asked if we would wait as his attending wanted to introduce himself. Got a bill for a few hundred dollars…the attending was not in network.

Another time my husband had an appointment to see our doctor to go over some results. The doctor had been called away urgently. He was asked if he agreed for the nurse to give him the results. Yup…she wasn’t in network.
What a bloody rort.
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Old Dec 6th 2021, 12:06 am
  #161  
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Default Re: US health insurance

Originally Posted by spouse of scouse
What a bloody rort.
It is…you have to make sure every single person is in network. It may be that the person taking blood, or giving you an injection is not in network. Not easy in an emergency.
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Old Dec 6th 2021, 12:17 am
  #162  
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Default Re: US health insurance

Originally Posted by Jerseygirl
It is…you have to make sure every single person is in network. It may be that the person taking blood, or giving you an injection is not in network. Not easy in an emergency.
Yes, sick or injured people aren't in the best position to question these things. I wonder if some enterprising soul could come up with an app for health professionals, where they could quickly find out if their services were covered by their patient's insurer? At least then most patients could give informed consent.
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Old Dec 6th 2021, 1:06 am
  #163  
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Default Re: US health insurance

Originally Posted by Jerseygirl
A few years ago I took hubby to the ER during the night with chest pains. Upon discharge, the doctor who had been treating him, asked if we would wait as his attending wanted to introduce himself. Got a bill for a few hundred dollars…the attending was not in network.

Another time my husband had an appointment to see our doctor to go over some results. The doctor had been called away urgently. He was asked if he agreed for the nurse to give him the results. Yup…she wasn’t in network.
I have never heard of a nurse not being in network. Surely if she worked for the doctor then she was part of the network?
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Old Dec 6th 2021, 1:11 am
  #164  
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Default Re: US health insurance

Originally Posted by Sugarmooma
I have never heard of a nurse not being in network. Surely if she worked for the doctor then she was part of the network?
That’s what you would think but we were told differently.
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Old Dec 6th 2021, 5:14 am
  #165  
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Default Re: US health insurance

Originally Posted by Jerseygirl
Yikes!!! You don’t think to ask if every single doctor, nurse, procedure, equipment etc is covered by your insurance, We have had a couple of instances where similar occurred but not for that amount.
I've contacted the cardiologist already asking for their assistance, and I plan to call the insurance co. tomorrow and pursue it with them. I think I'll refuse to pay this one and play a game of attrition! The device itself probably cost a few hundred bucks (and I think was re-usable), and the 'service' of reading the results can't have taken more than 30 minutes (receive, unpack, plug in, read results ...).

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