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> Another whacky thing I discovered: the insurance company gets to decide how much, if any, of your uncovered, out-of-pocket bill counts towards your deductible
by JadeNB 5y ago
> Another whacky thing I discovered: the insurance company gets to decide how much, if any, of your uncovered, out-of-pocket bill counts towards your deductible. In this case they deemed $109 of $832 to be the right number, with no explanation as to how they arrived at that sum.
Not that I think much of the likelihood of success, but aren't you, for any such decisions, entitled to (a) receive a justification on request, and (b) appeal that decision?
- postoak 5y agoYes, but when the insurance company controls the appeals process, they will likely deny it.
- handrous 5y agoScrewing around with insurance process bullshit can easily exceed the value of whatever you're trying to regain/figure-out. Hours, literally, of on-hold time, likely more than once, and if you're trying to get them to pay for something they don't want to, you're likely going to need to get state regulators or lawyers involved, which means even more time (and money, in the latter case). Probably you'll end up having to do the same thing with one or more hospitals or healthcare providers, playing go-between with them and insurance, and usually those places subject you to the same malicious-incompetence as the insurer does.