3 ms·

It would be really nice to know IF my claim was denied. Health billing is so messed up.

munk-a 3y ago
If it's an expensive procedure and you want to know what the cost will be you'll usually want to submit for prior authorization before the procedure. In an emergency this isn't an option but for any other treatment this can give you a lot of clarity about what your out of pocket will be - doctors (or their offices) should be able to handle this if you ask.
- eric_the_read 3y ago
  I had a doctor once recommend a temporary treatment that would be provided by a third party. I called the third party and asked how much it would cost; they had no idea. I called my insurance company and asked how much it would cost; they had no idea. I called my doctor and asked how much it would cost; they had no idea. Literally nobody involved in the entire chain of providers had any idea how much it would cost. The best advice anybody could give me was to get the treatment, then look at the bill afterwards. (Oh, and nobody had any idea when I might get a bill either-- my wife is still receiving bills from the birth of our most recent child, 18 months ago.)
  - evancordell 3y ago
    > my wife is still receiving bills from the birth of our most recent child, 18 months ago I've been dealing with this as well, and the uncertainty has been the most frustrating thing. Medical bills from the same institution should be required to be high watermarks - i.e. if you give me a bill in March, you can't send me a bill in April that has charges from February that _weren't on the bill from March_. It feels like fraud (and maybe it is, but who has time to figure that out?)
- callalex 3y ago
  Prior authorization does not come with any binding guarantees, insurance companies can and do reneg on their promises all the time.
  - munk-a 3y ago
    This is true - but they're usually more predictable. Absolutely nothing in the US healthcare market is guaranteed. And, tbh, in healthcare there can always be complications - a simple surgery or treatment might turn into something much more extensive if things weren't as they appeared initially or there's some abnormal response to treatment.

If it's an expensive procedure and you want to know what the cost will be you'll usually want to submit for prior authorization before the procedure. In an emergency this isn't an option but for any other treatment this can give you a lot of clarity about what your out of pocket will be - doctors (or their offices) should be able to handle this if you ask.

eric_the_read 3y ago
I had a doctor once recommend a temporary treatment that would be provided by a third party. I called the third party and asked how much it would cost; they had no idea. I called my insurance company and asked how much it would cost; they had no idea. I called my doctor and asked how much it would cost; they had no idea. Literally nobody involved in the entire chain of providers had any idea how much it would cost. The best advice anybody could give me was to get the treatment, then look at the bill afterwards. (Oh, and nobody had any idea when I might get a bill either-- my wife is still receiving bills from the birth of our most recent child, 18 months ago.)
- evancordell 3y ago
  > my wife is still receiving bills from the birth of our most recent child, 18 months ago I've been dealing with this as well, and the uncertainty has been the most frustrating thing. Medical bills from the same institution should be required to be high watermarks - i.e. if you give me a bill in March, you can't send me a bill in April that has charges from February that _weren't on the bill from March_. It feels like fraud (and maybe it is, but who has time to figure that out?)
callalex 3y ago
Prior authorization does not come with any binding guarantees, insurance companies can and do reneg on their promises all the time.
- munk-a 3y ago
  This is true - but they're usually more predictable. Absolutely nothing in the US healthcare market is guaranteed. And, tbh, in healthcare there can always be complications - a simple surgery or treatment might turn into something much more extensive if things weren't as they appeared initially or there's some abnormal response to treatment.