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Healthcare industry behaving badly

humblescribe
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Re: Health insurance companies really are the worst

#51

Post by humblescribe »

raison de arizona wrote: Thu Jun 09, 2022 7:02 pm
RTH10260 wrote: Thu Jun 09, 2022 6:54 pm @r.d.a: about your kid being at grandmother or any other family member: does the insurance not let you register any alternate caretakers? Registering an alternate cc with the caretaker is of course tricky as one cannot know which card will be used.
I dunno, but that is a good question I'll be sure to ask them next time I'm in contact. Which will undoubtedly be soon.
My burning question: What if you pay all your bills in cash? I know, unheard of these days. How will the insurance companies know whose cash was used to pay the medical bills?
"Some cause happiness wherever they go; others whenever they go." O. Wilde
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raison de arizona
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Re: Health insurance companies really are the worst

#52

Post by raison de arizona »

We did card over the phone. Insurance denied it anyway, but the provider says it is BS and they will get it reversed on appeal for us. Hope so.

Anyway, drug companies are also the worst. A state shouldn't have to go into the drug manufacturing business just to deal with price gouging for life saving medication, but here we are. At least he has a solution for Californians, right on.
Gavin Newsom @GavinNewsom wrote: California is going to make its own insulin.

It’s simple. People should not go into debt to get life-saving medication.
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raison de arizona
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Re: Health insurance companies really are the worst

#53

Post by raison de arizona »

We need real health insurance in this country.
Judge Karin Crump @karincrump wrote: Texas requires couples to wait 72 hours after the issuance of marriage license before they marry. I just waived that requirement for good cause so that I could officiate over a Zoom wedding for a couple..in their car. 1/3
Husband is about to ship out to the Army and he wanted to ensure that his (new) wife & baby had insurance before he left. I asked if they wanted to get out and stand for the ceremony, but they didn't want to wake the baby + they were in the parking lot of a convenience store.2/3
Despite the unusual and not so formal wedding venue, they were grateful, weepy, and full of joy. I just want to wish that adorable couple a long marriage and a very happy life together! ⚖️
https://twitter.com/karincrump/status/1 ... 9580571650
“Remember, democracy never lasts long. It soon wastes, exhausts, and murders itself. There never was a democracy yet that did not commit suicide.” —John Adams
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Re: Health insurance companies really are the worst

#54

Post by Kriselda Gray »

raison de arizona wrote: Fri Aug 05, 2022 2:25 pm We need real health insurance in this country.
Judge Karin Crump @karincrump wrote: Texas requires couples to wait 72 hours after the issuance of marriage license before they marry. I just waived that requirement for good cause so that I could officiate over a Zoom wedding for a couple..in their car. 1/3
Husband is about to ship out to the Army and he wanted to ensure that his (new) wife & baby had insurance before he left. I asked if they wanted to get out and stand for the ceremony, but they didn't want to wake the baby + they were in the parking lot of a convenience store.2/3
Despite the unusual and not so formal wedding venue, they were grateful, weepy, and full of joy. I just want to wish that adorable couple a long marriage and a very happy life together! ⚖️
https://twitter.com/karincrump/status/1 ... 9580571650
I"m just glad they were able to find a compassionate judge in Texas. The odds of that aren't necessarily all that good.
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pipistrelle
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Re: Health insurance companies really are the worst

#55

Post by pipistrelle »

Isn't the 72 hours between license and ceremony antiquated?
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sugar magnolia
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Re: Health insurance companies really are the worst

#56

Post by sugar magnolia »

pipistrelle wrote: Fri Aug 05, 2022 10:00 pm Isn't the 72 hours between license and ceremony antiquated?
It varies by state, I believe.
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Health insurance companies really are the worst

#57

Post by raison de arizona »

Routine births are turning into moneymaking ‘emergency’ events at hospitals that work with private equity-backed staffing companies
:snippity: Three of the four major companies that set up and staff OBEDs are affiliated with private equity firms, which are known for making a profit on quick-turnaround investments. Private equity has been around for a long time in other medical specialties, and researchers are now tracking its move into women’s health care, including obstetrics. These private equity-associated practices come with a promise of increased patient satisfaction and better care, which can help the hospital avoid malpractice costs from bad outcomes.

But private equity also is trying to boost revenue. Dr. Robert Wachter, chair of the Department of Medicine at the University of California-San Francisco, calls the private equity encroachment into medicine “worrisome.”

“Hospitals will do what they can do to maximize income as long as they’re not breaking the rules,” Wachter said. “And it sounds like that’s sort of what they’re doing with this ER gambit.”
:snippity:
https://fortune.com/2022/10/12/obstetri ... ne-births/
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jez
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Healthcare industry behaving badly

#58

Post by jez »

I don't know if this is the industry in general behaving badly. It might be.

A few days ago, got a call from a bill collector. I don't get them often, and if I do, it's typically a bill from a doctor that fell through the cracks from one of my hospital stays. Usually, it's around $100 or less and I just missed it somehow when paying the out of pocket stuff. Anyway, on to the call.

When I talked to the very nice person on the phone (no snark, she was very nice), I asked if they could send me the details on the bill, because the amount (over $500) was odd. Those usually catch my attention and I try to take care of them as soon as possible. Even working out payment plans, etc. Today, I got the invoice for the account, and yes, it's a medical bill. The name of the doctor was on it, along with the name of her group. Looked for both in 2 years worth of EOBs. Only found one. Which, yes, this one fell through the cracks. The EOB said I probably will need to pay $133.40 out of pocket. Fine, I can do that. But there is a balance forward on the bill for almost $400. I have no idea where it came from.

Of course, everything is closed now (7 pm ET) so I'll probably call the group tomorrow and see if they can explain that balance forward. I can find nothing from them going back to March 2021. So, I'm curious about where the balance forward came from.

Wish me luck. I may have to call the insurance company as well to see if they can dig back further than I can see from the website.
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Healthcare industry behaving badly

#59

Post by HoperUp »

jez wrote: Thu Mar 16, 2023 7:08 pm I don't know if this is the industry in general behaving badly. It might be.

A few days ago, got a call from a bill collector. I don't get them often, and if I do, it's typically a bill from a doctor that fell through the cracks from one of my hospital stays. Usually, it's around $100 or less and I just missed it somehow when paying the out of pocket stuff. Anyway, on to the call.

When I talked to the very nice person on the phone (no snark, she was very nice), I asked if they could send me the details on the bill, because the amount (over $500) was odd. Those usually catch my attention and I try to take care of them as soon as possible. Even working out payment plans, etc. Today, I got the invoice for the account, and yes, it's a medical bill. The name of the doctor was on it, along with the name of her group. Looked for both in 2 years worth of EOBs. Only found one. Which, yes, this one fell through the cracks. The EOB said I probably will need to pay $133.40 out of pocket. Fine, I can do that. But there is a balance forward on the bill for almost $400. I have no idea where it came from.

Of course, everything is closed now (7 pm ET) so I'll probably call the group tomorrow and see if they can explain that balance forward. I can find nothing from them going back to March 2021. So, I'm curious about where the balance forward came from.

Wish me luck. I may have to call the insurance company as well to see if they can dig back further than I can see from the website.
It's frustrating when bills don't align with what you're expecting.

It's always a good idea to double-check. I'd definitely recommend reaching out to both the doctor's group and your insurance company. Sometimes, there's just a miscommunication or a glitch in their system that results in discrepancies like these.

I'm with Covering Central Florida and honestly, they've been great so far. Haven't had a single problem with them covering my medical expenses. You can read about when is open enrollment 2024.
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Healthcare industry behaving badly

#60

Post by Slim Cognito »

It’s happened to us several times. Like you said, fell through the cracks, and before a bill ever made it to my mailbox, we found ourselves in collections. Of course, by now, we owe every hospital in the Fort Myers metro area (plus one in Tampa) so they’ll get what they get when they get it. I have bigger issues to deal with.

Like a former boss once said, “I live in fear of clerical error.”
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sugar magnolia
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Healthcare industry behaving badly

#61

Post by sugar magnolia »

My physical therapist for my lymphedema told me at my last appointment that my insurance was refusing to pay because I had hit my 20 visits per year limit for PT. Two issues with that. I've only had 5 visits this year, and the lymphedema is supposed to be covered 100% because it is related to my cancer anyway. Not looking forward to the fight I know is coming with the insurance company.
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Healthcare industry behaving badly

#62

Post by AndyinPA »

While the vast majority of the bill for my husband's hospitalization was paid, there were a few bills that filtered through in the month after he died. I tried to pay each as soon as they came in. One slipped through, and I got a letter from a collection agency. It took a few phone calls, and I paid it as soon as I was sure that it was real, but it was a real headache. They also were going after $2,500 for payment on a credit card. Not only had I paid that, but the account was closed, and I had gotten a higher line of credit on my own account. Very aggravating at a time like that.
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Healthcare industry behaving badly

#63

Post by Slim Cognito »

I should have added that the vast majority of Hubs bills are covered by insurance, but after a long illness with monthly treatments, and now, apparently, monthly hospitalizations, copays add up.

(His chemo-induced typhlitis is rearing its ugly head again. sigh)
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raison de arizona
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Healthcare industry behaving badly

#64

Post by raison de arizona »

We just hit our maximum out of pocket. The wife just had a $32k surgery, our portion, closing out max, was $211. Three and a half months of freedom until we hit the dreaded deductible again. The first part of the year is ultra expensive.
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Healthcare industry behaving badly

#65

Post by Suranis »

I just saw this facebook video of what it costs to have a baby in the USA, and... Sweet mother of holy fuck.



I think the black guy is hilarious and on point as well
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Healthcare industry behaving badly

#66

Post by RTH10260 »

for comparison:

Standard delivery in Switzerland with about five day stay past delivery: below chf/$ 3000.
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Healthcare industry behaving badly

#67

Post by AndyinPA »

We know. :bag: :bag: :bag:
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RTH10260
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Healthcare industry behaving badly

#68

Post by RTH10260 »

Why Drugs Are Disappearing From Your Insurance Coverage
Powerful companies are removing hundreds of medicines from insurance plans — and they’re spending millions to stop attempts at reform.

NOV 29, 2023

For the millions of Americans that take one or more prescription drugs, having a health insurance plan that covers their medications is crucial. The list of covered medications — called a drug formulary — can mean the difference between a $10 copay at the pharmacy and paying thousands out-of-pocket for a vital medication.

Yet unbeknownst to many patients, insurers can change their drug coverage throughout the year, thereby removing medications that enrollees were promised. When this happens, those who lose access to their medicines are usually barred from immediately moving to a different insurance plan. The problem is widespread and growing: In the last nine years, the number of medications being eliminated from many insurance plans skyrocketed by around 1,584 percent.

Drug formularies are dictated by pharmacy benefit managers, or PBMs — powerful companies that determine drug benefits on behalf of health insurers, Medicaid Part D drug plans, employers, and other health care payers. These companies negotiate with pharmaceutical manufacturers to determine what drugs health plans will cover and how much the drugs will cost. The three largest PBMs are owned by major health insurance companies, a form of vertical integration that some health care experts worry may be leading to higher drug prices and lower quality care for patients.

For the same reasons, PBMs are incentivized to only keep drugs on formularies that make them the most money.



https://www.levernews.com/why-drugs-are ... -coverage/
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raison de arizona
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Healthcare industry behaving badly

#69

Post by raison de arizona »

I get half my prescription from Mark Cuban's Cost Plus mail order pharmacy these days, my insurance has been dropping coverage for them. So I suppose I'm a little glad it isn't a personal problem, but come on. This is some bullshit, it should be up to the doctor what medication the patient needs, not the insurance company. And my work is switching insurance companies on the first of the year, so I'm going to have to justify all my meds all over again. Poop.
“Remember, democracy never lasts long. It soon wastes, exhausts, and murders itself. There never was a democracy yet that did not commit suicide.” —John Adams
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