health insurance audits

[gooseberry]

Has anyone had their private health insurance company audit them? Since my husband's diagnosis 2 months ago, I have had to fill out two audit papers for an independant company that the insurer contracted with(I verified it) and I have had to prove my dependants were eligible by providing my marriage certificate,tax forms, birth certificate. Yes , I did verify with my employer this was necessary.

 

[MaxEidswick]

>I have had to prove my dependants were eligible by providing my marriage certificate,tax forms, birth certificate. Yes , I did verify with my employer this was necessary.

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we are having to do the same with hp because of some new federal mandates. hopefully a coincidence.


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Max - Monday, July 14, 2014 6:44:52 PM
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onset 9/2010, diagnosed with ALS by Stanley Appel 8/29/2013
It Is What It Is ...

.

 

[gooseberry]

Max, I am sorry you are going through this too! My insurance is through my work and it is a self insured plan. They have been questioning a lot of my husbands bills. This diagnosis and the testing have thrown us into a billing nightmare. My son is on the autism spectrum so they watch us pretty closely anyways. I am so worried they are going to try to cancel our insurance .

 

[dalvin]

Insurance companies seem to be run by idiots. First they paid for my peg surgery, then questioned why I needed the jevity. Just an example here. I've run in to this sort of thing in the past

 

[affected]

Insurance companies seem to be run by idiots. First they paid for my peg surgery, then questioned why I needed the jevity.

OH me oh my, you wouldn't think that was a difficult equation at all would you?

 

[GregK]

Insurance companies are not run by idiots, they're run by greedy f***ers who want to maximize profits. Every time we 'touch' our benefits it's money out of their pockets.

 

[MaxEidswick]

>they're run by greedy f***ers

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they're run by HEARTLESS greedy f***ers

 

[Dusty7]

The whole purpose of insurance companies is to collect premiums and deny claims. Very simple...

 

[bigmark1954]

Insurance companies are not run by idiots, they're run by greedy f***ers who want to maximize profits. Every time we 'touch' our benefits it's money out of their pockets.

AMEN to that Brother! Insurance companies are the lowest form of life IMO. But then again medical care has become just awful....they can charge whatever they want, and it keeps going up. Examples are all around us, the EMG I just had took 30 minutes and the charged 675.00......of which I had to pay 275.00 because of the new year minimums had not been met.
My health insurance just went up 300.00 per month since my diagnosis.... I now pay 6470.00 per quarter (3 mos for Max).
Health care is one of the biggest failures in this country IMO......the government is more worried about getting gay marriage passed than health care reform.....YEA I SAID IT!
rant over.................

 

[rosec]

When they look at a patient, the medical industrial complex sees an ATM machine.

 

[MaxEidswick]

>I now pay 6470.00 per quarter

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what!?!?

 

[gooseberry]

Today I had my latest battle with the insurance company. The provided a bipap for my husband which has really helped him. We live in FL and get lots of heavy rain and lightening so we lose power with some regularity. Also, it is difficult for him to breath in the hot weather so going to doctors appointments are tough until the air conditioning is really going. Then he is freezing. Anyways, I asked for a battery pack for backup in case of a power outage and a car charger hookup for the bipap so it could be used when traveling. The respiratory therapist told me this was all possible. After 2 months of the insurance dance its been denied. They feel this is not medically necessary and simply comfort care. When did being able to breathe become comfort care and not a necessity?

 

[nebrhahe53]

I would send their response into your local TV station with the als diagnosis. I bet after some bad publicity the moron who made that decision will be overruled. You could also look for a good elder care attorney.

 

[bigmark1954]

>I now pay 6470.00 per quarter

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what!?!?

Regence Blue Cross Blue Shield.....2- 60 year old people...80/20 with stop loss...it SUCKS....I need to figure something else out. I make too much money off my investments to get medicare/caid or disability. They have raised my premium twice a year for as long as I can remember(been with them for 30 years).
It's really starting to piss me off!BASTIDS

 

[MaxEidswick]

>I make too much money off my investments to get medicare/caid or disability.

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healthcare.gov was going to charge me $650/mo for 90% coverage w/Sandy and ALS diagnosis -- bcbs of tx I think ...