SingleCare comes through again. Our marketplace insurance plan didn’t cover one prescription at all (as opposed to a different one that was simply expensive), so I looked up the drug on SingleCare’s site and had the prescription transferred to Kroger, since they accept the card. It’s still completely stupid that I can Google for a drug discount, find some code numbers, and give them to the pharmacist, but hooray from going from not having our insurance cover it to paying $13 for a 90-day supply.
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WARNING: LOTS OF PUKING
(but she is quite funny)
I have family in South Carolina. My aunt had a “mini stroke,” or TIA, earlier in August. She went to the emergency room and waited for like 12 hours, before they sent her home on the promise she’d see her GP asap. … (which she did) … Yesterday apparently it happened again, while shopping. 911 was called, they took her to the ER and she’s now been sitting for 13 hours waiting.
Apparently a doctor and bed shortage?
Obviously that’s absurd but my question is on how the hospital can have this on its web site …
Like, they check you in and tell you to wait, within 2 minutes?
Well are they waiting to see a doctor? Or are they waiting to get an MRI? I’m guessing the latter. It can take awhile to get an MRI done in the ER
we, mere mortals, have no hope of ever understanding how the greatest economy in the history of the world truckks along. just accept the invisible hand of the freeest of markets.
I have a bit of a gap in between my two front teeth so some years ago I got a cosmetic filling.
Three days ago I bit into an ear of corn and out came that filling. Good thing (not really) that Japan is still masked, as it spared everyone around me exposure to my best Leon Spinks impression.
Here’s what happened next.
Right after biting into that ear of corn, I called my dentist for an appointment to replace the filling.
“Sure, come on in day after tomorrow at 5:30 and we’ll fix you right up.”
On the appointed day:
- I arrive at dentist at 5:28
- I’m in the chair at 5:32
- I have a brand new filling by 5:50
- And I’m back home by 5:56, just in time to watch Ura upset the Yokozuna in the final sumo bout of the day.
The cost (based on current exchange rate):
$19.23.
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One thing I have learned through my own recent issues is that just paying nothing at the hospital/doctor when you go even if they insist is almost always better. My recent MRI they wanted me to pay over $1000 out of pocket at the appointment. I paid nothing and when the bill came after insurance and all the insane adjustments it was $30. Going to go out on a limb and guess if i had paid i was getting $0 back.
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They were 100% trying to finesse you out of 1k
i dunno i’ve gotten some big checks later on from a few different practices.
But yeah I wouldn’t have expected much back in any reasonable time frame.
yea I have a health care advocate right now going through all my stuff and it very much looks like blue shield has ripped me off of a decent 5 figure chunk, I always tell them to charge me the copay and then send me a bill now, it’s definitely the play. sometimes they just go away and you never hear about them.
Forgiveness…permission…all that jazz.
I was combing through my mom’s medical bills from when she had an infection that required surgery and they were definitely double dipping. It’s basically a double dip freeroll: they bill you for shit you absolutely are not obligated to pay, and if you’re “gullible” enough to pay it, haha fuck you free money. If you call them on it, you get a Phone Karen that blames it on computers and gives you the number for the Kafka dead end hotline.
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I’m out about 30k this year and I didn’t even know I had an out of pocket maximum, they were just billing me and I was paying it. healthcare advocate says that I’ll definitely get it back but it’s a massive pain
It is likely that your doctor’s office doesn’t know what your out of pocket maximum is. Even if they did, there is no way for them to know how close to that because you could be racking up charges all over town seeing multiple doctors for various different things. Also as far as billing you is concerned, generally they will run it through the insurance first and only bill you after (see below)
Did they bill you before they ran it through insurance? If not that seems weird. When I’ve experienced something similar it normally goes like this
- Get service
- Doctor’s office (or whatever) bills insurance
- Insurance either refuses to pay or drags their feet
- After dealing with above for a while, Doctor’s office tells patient, insurance hasn’t paid the claim, so you owe us X
- Patient pays X
- Doctor’s office eventually wins the fight against insurance company initiated in step 3 so they get paid again, so they’ve received ~2X
- Now doctor’s office has 2X and your account has a credit of X on it. They’ll just hang on to it for the next time you come in. What that you say? You didn’t know you had a credit of X? Well if you had read the (often several) explanations of benefits your insurance company sent, you would have realized this, so we thought you knew. You want us to send you the cash back? Sure, we can do that here’s some hoops to jump through (or as you put it, the Kafka dead end hotline).
Yeah, this whole system sucks. There are other ways it can go down, of course. Above is just one (not uncommon) example. But I don’t think it’s quite a “double-dip freeroll”. The insurance company is jerking them around too and thinking maybe the doctor’s office will get the patient to pay up and then doctor’s office will stop trying to appeal the bullshit denial that they eventually will have to give in on.
At step 3 and 4 the service provider really can’t be sure anyone will pay, so they just keep shaking trees until someone pays up. Sometimes they do get some extra payments. Some scrupulous practices will just send you a check (i.e., that’s their version of step 7). But yes, there are assholes out there who will make you beg for it back. It’s bad, but I guess I’d just describe it a bit differently. It’s definitely not a freeroll. Insurance companies stiff doctors and hospitals all the time.
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yea I just started skipping 4 and 5 and it’s been going way better. All this stuff is from my hospital. It’s a big interconnected network of doctors, like a major major hospital.
like, I will get an MRI and they send me a bill for 2k. i’m not paying that dude. “well your insurance says you pay 20%.” Yea, 20k ago I went over that limit, I don’t owe it, goodbye, no way an MRI costs 10k anyway, DUDE.
haven’t been getting collections notices so I guess its working.
Yeah, skipping step four/five is a pro move. I recently got a step 4 bill for $180. I knew with certainty it was a covered service. I just ignored it. A couple months later I got a corrected EOB and it was paid.
While it’s true that a single hospital could know that they have billed you a value that is greater than your out of pocket max, that number is really only readily known to you and the insurance company. I’m sure they could find it out with some effort, but my guess is the insurance company wouldn’t make it that easy. They want the hospital to keep coming after you so it will go after them with less vigor.
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Think you might be in the wrong thread with this one.
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Yeah getting some weird error.
yea what I found out is I was getting 20% of the insurance-billed version of the cost, not the out of pocket version, so i was paying with insurance far more than I’d pay out of pocket for the same thing, but I have had like, a major knee surgery and a massive brain infection this year, among the usual stuff that plagues me, so it hasn’t been easy to just say no when another bill comes your way, you need the care desperately
it does feel like you’re always caught in a battle between docs and the insurance, but that’s not my problem, I don’t know why it always becomes my problem. shit like my leg was an “elective” surgery, I had basically no soft tissue left and could barely walk. it’s not about providing good care, at least in the system I’m in, that’s like the absolute last concern