This was 14 days in NICU and two open heart surgeries.Originally posted by: Turin39789
Originally posted by: alchemize
Large bills like this are also commonly pended for review as hospitals/doctors are known for stuffing all kinds of shit into a case like this.
I had a $300K bill with my son when he was born, had to make some calls to get it pushed through.
babies are the most expensive one time claims, but usually only if they stay in NICU for a month or more.
Originally posted by: her209
Who wrote the program?Originally posted by: alchemize
It's simply a business rule that by default denies the claim. Of course, a phone call fixes it.
Checks DOB, checks enrollment date, checks date of treatment, tosses the claim. No human did this, but a human will fix it.
Originally posted by: JulesMaximus
Originally posted by: zerocool84
Originally posted by: JulesMaximus
Originally posted by: panipoori
obamacare
Don't be a fucking douchebag. The kind of shit the OP is going through is typical of the insurance industry in this country. It's all about the bottom line...this is what happens when you trust businesses and the free market.
Well seeing as they pay-off pretty much anybody they want they do as they please.
EXACTLY!!! Our government is for sale people...and surprise, the corporations have all the money! Does ANYONE see a problem with this? ANYONE?
Originally posted by: alchemize
This was 14 days in NICU and two open heart surgeries.Originally posted by: Turin39789
Originally posted by: alchemize
Large bills like this are also commonly pended for review as hospitals/doctors are known for stuffing all kinds of shit into a case like this.
I had a $300K bill with my son when he was born, had to make some calls to get it pushed through.
babies are the most expensive one time claims, but usually only if they stay in NICU for a month or more.
Originally posted by: Turin39789
Originally posted by: alchemize
This was 14 days in NICU and two open heart surgeries.Originally posted by: Turin39789
Originally posted by: alchemize
Large bills like this are also commonly pended for review as hospitals/doctors are known for stuffing all kinds of shit into a case like this.
I had a $300K bill with my son when he was born, had to make some calls to get it pushed through.
babies are the most expensive one time claims, but usually only if they stay in NICU for a month or more.
Most of the ones I see that go over 1mil are 30 days or more. Sorry to hear the little guy got a rough start.
Originally posted by: RoloMather
Pregnancy = preexisting condition
Yep. Private insurance is good until you get screwed.
Originally posted by: Turin39789
Originally posted by: alchemize
Large bills like this are also commonly pended for review as hospitals/doctors are known for stuffing all kinds of shit into a case like this.
I had a $300K bill with my son when he was born, had to make some calls to get it pushed through.
babies are the most expensive one time claims, but usually only if they stay in NICU for a month or more.
Originally posted by: Redfraggle
I'm pregnant now, and I was under the impression that the baby is covered as soon as it's born. I mean, it's essentially being covered now, because insurance covers the pregnancy and birth. That seems sketchy that this happened. Hopefully, they will get that overturned.
Originally posted by: Uhtrinity
Originally posted by: Redfraggle
I'm pregnant now, and I was under the impression that the baby is covered as soon as it's born. I mean, it's essentially being covered now, because insurance covers the pregnancy and birth. That seems sketchy that this happened. Hopefully, they will get that overturned.
When my son was born we were under the same impression. However as soon as the baby is born it needs to be listed separate on the policy. We got nailed for a few thousand dollars due to him being in distress when born (ruptured placenta). He only had to spend about 6 hrs in the icu, but it still cost about $3,000.
Originally posted by: Turin39789
Originally posted by: Uhtrinity
Originally posted by: Redfraggle
I'm pregnant now, and I was under the impression that the baby is covered as soon as it's born. I mean, it's essentially being covered now, because insurance covers the pregnancy and birth. That seems sketchy that this happened. Hopefully, they will get that overturned.
When my son was born we were under the same impression. However as soon as the baby is born it needs to be listed separate on the policy. We got nailed for a few thousand dollars due to him being in distress when born (ruptured placenta). He only had to spend about 6 hrs in the icu, but it still cost about $3,000.
IIRC you have 30 days to add the child retroactive to the birth, at least on every plan I have worked on.
Originally posted by: vi edit
Originally posted by: Turin39789
Originally posted by: Uhtrinity
Originally posted by: Redfraggle
I'm pregnant now, and I was under the impression that the baby is covered as soon as it's born. I mean, it's essentially being covered now, because insurance covers the pregnancy and birth. That seems sketchy that this happened. Hopefully, they will get that overturned.
When my son was born we were under the same impression. However as soon as the baby is born it needs to be listed separate on the policy. We got nailed for a few thousand dollars due to him being in distress when born (ruptured placenta). He only had to spend about 6 hrs in the icu, but it still cost about $3,000.
IIRC you have 30 days to add the child retroactive to the birth, at least on every plan I have worked on.
Yeh the pre-natal visits and delivery should be charged to the Mother's insurance. Once the baby is born a new account is created under a "baby boy smith" account and linked to the mothers. All charges before discharge should be applied to the mothers insurance. You then typically have 30 days after delivery to update your insurance to family policy.
Where it would maybe get messy is if you get discharged, go home, and then the child immediately admitted back into the hospital before updating the insurance policy. The next admission will have a different account and they'll want insurance info that isn't technically up to date yet.
Hopefully a call to the company will quickly resolve it.
An $80,000 out-of-pocket medical emergency falls quite differently on upper/middle/lower class citizens.Originally posted by: aigomorla
how does it not effect the rich?
Originally posted by: ric1287
Originally posted by: JulesMaximus
Originally posted by: zerocool84
Originally posted by: JulesMaximus
Originally posted by: panipoori
obamacare
Don't be a fucking douchebag. The kind of shit the OP is going through is typical of the insurance industry in this country. It's all about the bottom line...this is what happens when you trust businesses and the free market.
Well seeing as they pay-off pretty much anybody they want they do as they please.
EXACTLY!!! Our government is for sale people...and surprise, the corporations have all the money! Does ANYONE see a problem with this? ANYONE?
I DO!!!! PANIC!!!!
Originally posted by: Turin39789
Originally posted by: Uhtrinity
Originally posted by: Redfraggle
I'm pregnant now, and I was under the impression that the baby is covered as soon as it's born. I mean, it's essentially being covered now, because insurance covers the pregnancy and birth. That seems sketchy that this happened. Hopefully, they will get that overturned.
When my son was born we were under the same impression. However as soon as the baby is born it needs to be listed separate on the policy. We got nailed for a few thousand dollars due to him being in distress when born (ruptured placenta). He only had to spend about 6 hrs in the icu, but it still cost about $3,000.
IIRC you have 30 days to add the child retroactive to the birth, at least on every plan I have worked on.
Originally posted by: CrimsonWolf
My new baby cousin was born about a six weeks premature. He's been under neonatal intensive care for about two weeks, and has been doing great. Once they're sure he can be bottle fed ok, the hospital will release him. That's the good news!
Bad news is the insurance company. My aunt and uncle were told to add him within 30 days after the birth. So, they've done that, but now the insurance company is refusing to pay for the neonatal care because they are saying the premature birth is a pre-existing condition. WTF?
I don't even want to think about how big the bill will be without coverage (which included helicopter transport from a rural hospital to a larger hospital...) I heard all this from my other aunt, so I don't know any more details and it would probably be awkward to ask. The only thing I can think of is that they should have added the "baby" to the plan way before it was born, but that's not what the insurance company told them.
Has anyone heard of this happening or have suggestions of dealing with it?
Originally posted by: Darthvoy
A wise man once told me that insurance companies are business for two reasons; collecting premiums and denying claims.
Originally posted by: chuckywang
Originally posted by: CrimsonWolf
My new baby cousin was born about a six weeks premature. He's been under neonatal intensive care for about two weeks, and has been doing great. Once they're sure he can be bottle fed ok, the hospital will release him. That's the good news!
Bad news is the insurance company. My aunt and uncle were told to add him within 30 days after the birth. So, they've done that, but now the insurance company is refusing to pay for the neonatal care because they are saying the premature birth is a pre-existing condition. WTF?
I don't even want to think about how big the bill will be without coverage (which included helicopter transport from a rural hospital to a larger hospital...) I heard all this from my other aunt, so I don't know any more details and it would probably be awkward to ask. The only thing I can think of is that they should have added the "baby" to the plan way before it was born, but that's not what the insurance company told them.
Has anyone heard of this happening or have suggestions of dealing with it?
My god stories like this make me seethe. Health insurance companies will go to the ends of the earth if it meant they can deny a claim and make more money. At least the baby will be fine.
Originally posted by: fleabag
Originally posted by: chuckywang
Originally posted by: CrimsonWolf
My new baby cousin was born about a six weeks premature. He's been under neonatal intensive care for about two weeks, and has been doing great. Once they're sure he can be bottle fed ok, the hospital will release him. That's the good news!
Bad news is the insurance company. My aunt and uncle were told to add him within 30 days after the birth. So, they've done that, but now the insurance company is refusing to pay for the neonatal care because they are saying the premature birth is a pre-existing condition. WTF?
I don't even want to think about how big the bill will be without coverage (which included helicopter transport from a rural hospital to a larger hospital...) I heard all this from my other aunt, so I don't know any more details and it would probably be awkward to ask. The only thing I can think of is that they should have added the "baby" to the plan way before it was born, but that's not what the insurance company told them.
Has anyone heard of this happening or have suggestions of dealing with it?
My god stories like this make me seethe. Health insurance companies will go to the ends of the earth if it meant they can deny a claim and make more money. At least the baby will be fine.
Make more money? Man you people are stupid. You sound like the people who complain about the price of medicine or the price of health care. Fact is, we need tort reform because otherwise these ridiculous costs aren't going to go away. There is a reason why the insurance companies aren't so eager to pay out claims and it's because if they did, they'd be bankrupt because there are too many people with too many "expensive" medical problems. If the insurance companies raised the rates so that they could pay out anybody who made a claim, then nobody could afford the insurance, nullifying it in the first place.
What do you guys seriously think the government is going to do better than the private sector has done? Has the government EVER done anything efficient? NO!!!!! So what makes you idiots think that the government is going to "fix" this healthcare problem? You all probably think taxing the rich until there are no more rich is an acceptable solution and if you do, then you're a douchebag and an idiot because that's what socialism is and socialism stops working when you run out of OTHER PEOPLES MONEY.
Originally posted by: zerocool84
Originally posted by: fleabag
Originally posted by: chuckywang
Originally posted by: CrimsonWolf
My new baby cousin was born about a six weeks premature. He's been under neonatal intensive care for about two weeks, and has been doing great. Once they're sure he can be bottle fed ok, the hospital will release him. That's the good news!
Bad news is the insurance company. My aunt and uncle were told to add him within 30 days after the birth. So, they've done that, but now the insurance company is refusing to pay for the neonatal care because they are saying the premature birth is a pre-existing condition. WTF?
I don't even want to think about how big the bill will be without coverage (which included helicopter transport from a rural hospital to a larger hospital...) I heard all this from my other aunt, so I don't know any more details and it would probably be awkward to ask. The only thing I can think of is that they should have added the "baby" to the plan way before it was born, but that's not what the insurance company told them.
Has anyone heard of this happening or have suggestions of dealing with it?
My god stories like this make me seethe. Health insurance companies will go to the ends of the earth if it meant they can deny a claim and make more money. At least the baby will be fine.
Make more money? Man you people are stupid. You sound like the people who complain about the price of medicine or the price of health care. Fact is, we need tort reform because otherwise these ridiculous costs aren't going to go away. There is a reason why the insurance companies aren't so eager to pay out claims and it's because if they did, they'd be bankrupt because there are too many people with too many "expensive" medical problems. If the insurance companies raised the rates so that they could pay out anybody who made a claim, then nobody could afford the insurance, nullifying it in the first place.
What do you guys seriously think the government is going to do better than the private sector has done? Has the government EVER done anything efficient? NO!!!!! So what makes you idiots think that the government is going to "fix" this healthcare problem? You all probably think taxing the rich until there are no more rich is an acceptable solution and if you do, then you're a douchebag and an idiot because that's what socialism is and socialism stops working when you run out of OTHER PEOPLES MONEY.
Yes cus all those socialist countries are the only ones that have universal healthcare and you're a red commie if you support it.