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Please folks remember that it isn't compulsory to use a companies byzantine process. Instead, check your insurance policy wording that you are covered, spend t
by londons_explore 3y ago
Please folks remember that it isn't compulsory to use a companies byzantine process.
Instead, check your insurance policy wording that you are covered, spend the money on a new machine, send a single letter to the insurer asking to be reimbursed, and when they don't reimburse within 30 days file in small claims court.
They'll pay. They don't want to physically show up in court or have you send bailiffs to their HQ over $3000 that they probably owe you anyway.
- genocidicbunny 3y agoUnfortunate that you cannot get additional damages against them. That sort of behaviour really needs to be heavily punished -- say, forcing them to cover every single CPAP prescribed for the next year for free, with the executives having to personally pay if the company can't afford to. Byzantine processes when dealing with medical issues should be punished with Byzantine punishments.
- thfuran 3y agoByzantine punishments were more along the lines of castration and facial amputation.
- genocidicbunny 3y agoWho's to say we can't get a little retro? Little late for the new year's stuff, but let's party like it's 499!
- spacecadet 3y ago[flagged]
- philwelch 3y agoReminds me of the funniest Crusader Kings bug of all time—a performance issue where the game laboriously calculated over and over again whether or not every character in the Byzantine Empire wanted to blind every other character in the Byzantine Empire.
- genocidicbunny 3y agoI loved that bug. To the point that I actually spent a (probably unnecessary) number of hours QC'ing it to try to figure out what was causing it. I didn't manage to figure out that it was the blinding check that was a problem, but I did discover that if you basically murdered all the people in the Byzantine empire, or you elimited the cultures that allowed blinding people, your game perf would go way up. So I made a little personal mod that immediately castrated (if there was something to castrate) and blinded all characters of the Byzantine empire on game start, and it seemed to solve the problem.
- londons_explore 3y agoIn most places you can at least get back the court fees (which are typically a few hundred bucks). Unfortunately sometimes you can't get back the court fees, and in situations like that, rather than spending $3000 on some new medical gear and battling insurance I would be very tempted to go to eBay, buy it 2nd hand from someone for $150, and just use that. Better time/effort/money/result tradeoff IMO.
- patja 3y agoeBay is pretty good at enforcing their policy banning sales of medical equipment requiring a prescription. They yank any listing for a CPAP very quickly.
- londons_explore 3y agoTook me literally 30 seconds to find one: https://www.ebay.com/itm/404778680293 https://www.ebay.com/itm/404778680293 They even have a category for "Medical equipment > ventilators". If they do have such a policy, they enforce it very poorly.
- patja 3y agoI guess it varies by country. In the US they pull CPAP listings very quickly. Policy: https://www.ebay.com/help/policies/prohibited-restricted-items/medicine-medical-devices-healthcare-products-policy?id=4322 https://www.ebay.com/help/policies/prohibited-restricted-ite...
- hypercube33 3y agoA lot of stuff is over the counter now so why aren't cpaps and other durable (overpriced) medical equipment?
- genocidicbunny 3y agoI don't want to get back just my court fees. If I could have it, heads would roll, but in lieu of that, I will take severe personal penalties to all those involved. Their tunes will change really frakking quick if the consequence is being put out on the street (or worse) for frakking around with people's medical coverage.
- q7xvh97o2pDhNrh 3y agoSomeone should start a SaaS that just automates this process. Thinking about it, the only moderately difficult part would be compiling a list of small-claims courts and understanding the different paperwork each one requires. After that, the whole thing could just be a single page with a few form fields (email, insurance company info, upload purchase receipt), a credit card form for the SaaS to collect its fee, and an API integration that uses one of those physical-mail APIs to send out the paperwork.
- jasonjayr 3y agoA use of AI/LMM I could support: read the policy documents and produce (or execute) the exact steps to get the insurance company to honor their obligations.
- danuker 3y agoHell, even reading the policies and responding whether I'm covered (and where it says so/hints towards) would be a worthwhile service.
- ericjmorey 3y agoThe policy is largely written in code that will not be released to a policy holder.
- nojs 3y ago> the only moderately difficult part would be compiling a list of small-claims courts and understanding the different paperwork each one requires. In reality the difficult part would actually be getting your service in front of people like OP at the right time. How do you imagine the guy in this post finds you and pays for your service? Have you ever looked for a similar service yourself when you faced similar issues?
- lolc 3y agoI think this is where search engine ads would work. The keyword is Anthem. The message is "File Anthem claims through us. Get paid in no more than 60 days or we waive your $10 fee."
- epgui 3y agoThat would be great if more than 0.2% of the population had a vague idea of how to access the legal system.
- silverlyra 3y agoand this gets me wondering; what could we accomplish if we took 0.2% of the time we spent writing (let alone reading) internet comments, and instead used that time to engage in our state democratic processes, and help update our public school education standards to build a robust civil society! my high school made sure I knew how to use both a band saw and a stand mixer; why not a courtroom? that's a systemic failure we could yet address
- xrd 3y agoDoes small claims court work in some states and not other ones? I'm assuming you are us based? And my understanding was that small claims courts are very different in each state.
- londons_explore 3y agoThey are, but the basic idea works pretty much everywhere. In general, small claims courts aren't very strict on the correct procedure being followed - they are explicitly designed to be accessible to non-experts.
- chrisandchris 3y agoThinking about that I really start to love the Swiss version of health insurance where (with most providers) you'll just provide your insurance card and they'll pay first and then decide whether to get reimbursement from you. Much more easier to fight than if you'll have to bring them to pay something you paid first.
- from-nibly 3y agoThat's generally how it works in the US as well.
- Waterluvian 3y ago> and when they don't reimburse within 30 days file in small claims court The very nature of having to be adversarial and “guard up” on everything is what exhausts people and sours a culture. It’s also inaccessible to many who are already exhausted and just don’t have another manual process and battle in them.
- Moto7451 3y agoWe lost my wife’s CPAP while traveling. Through insurance it would have been a month of paperwork, an exception made, and $600. Without insurance it was no wait and $650. Guess which way we went… I’m sorry the author had to deal with any of this. A lot of pandemic scarcity and multiple recalls made it hard to get supplies for a long time. My wife’s first CPAP is out of commission because the parts will simply never be made again. In between the pandemic start and the “well we all gave up” point three new models, recalls, and various mergers happened but not one replacement set of filters were delivered. If it was any sort of other filter I’d just buy a replacement from Amazon and call it a day, but that doesn’t seem appropriate for this situation. Some people did and apparently (per doctors not my own research or anything I can verify) old OEM and new but improperly made third party filters can start flaking off while the machine runs due to how CPAPs work. Now though? Apparently it’s easy to get a new model and all the components from a supplier… at least if you skip insurance.
- syndicatedjelly 3y agoIf you need repairs done in the future, see if the local university’s biomedical engineering department has a student chapter of Project C.U.R.E. Students may volunteer to fix the device (off warranty of course). They work for free for needy families, and if you’re not in the former category, consider donating to their organization https://projectcure.org/ https://projectcure.org/
- jedberg 3y agoThey'll pay and then drop you at the next anniversary. Can only use that trick a few times.
- dmvdoug 3y agoHowever, your policy might also contain (more likely) an arbitration clause, requiring you to submit any dispute to arbitration or (sometimes) a form selection clause, requiring you to submit a dispute in a particular legal forum other than arbitration. Note: some states do not allow forum selection clauses in insurance contracts, by statute or by case law. However, that will not stop a company from boilerplating it in. so, just because the policy might have the clause does not mean it’s necessarily enforceable. On the other hand, I get the point that they may just pay the money rather than send it to legal to handle. YMMV.