https://boards.hellobee.com/ Pregnancy, Baby and Parenting blog, by Hellobee en Thu, 07 May 2026 23:27:16 +0000 https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681241 Thu, 05 Jun 2014 11:48:32 +0000 MsLipGloss 1681241@https://boards.hellobee.com/ <p>@Mrs. Jump Rope: The amount of litigation over words and phrases in everything from contracts (which would include insurance policies) to notices to legal decisions/opinions and. . . . well, *to infinity and beyond* would pretty much cover it. *sigh* </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681225 Thu, 05 Jun 2014 11:45:11 +0000 Mrs. Jump Rope 1681225@https://boards.hellobee.com/ <p>@MsLipGloss: My aunt writes policies for Highmark and the stories she tells me... oh my god. Let's just say she is *told* what words to use. </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681221 Thu, 05 Jun 2014 11:43:57 +0000 MsLipGloss 1681221@https://boards.hellobee.com/ <p>@Mrs. Jump Rope: Yes. That is exactly the problem. The chaos that can ensue simply because somebody somewhere was imprecise with word choice, or punctuation, or both (!), is mind-boggling . . . annnnnnd a reason why there will always be need for certain professions (like mine!). </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681207 Thu, 05 Jun 2014 11:40:27 +0000 Jellyfish 1681207@https://boards.hellobee.com/ <p>I feel for you, insurance companies are evil. I spent all morning arguing with a CSR because each time I call I get a different response...so frustrating!! good luck! </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681201 Thu, 05 Jun 2014 11:39:01 +0000 Mrs. Yoyo 1681201@https://boards.hellobee.com/ <p>I don't even want to know how many phone calls it took my husband to get ours to pay what it was supposed to after DS2 was born. So annoying. </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681200 Thu, 05 Jun 2014 11:38:36 +0000 Mrs. Jump Rope 1681200@https://boards.hellobee.com/ <p>@MsLipGloss: My biggest issue with that terminology is that it's open to interpretation. Our plan definitely has some grey-area terms, and depending on who you talk to it's interpreted differently.</p> <p>For us, personally, we've reviewed our health plan in great detail then called to confirm coverage. One of our huge problems a few years ago was that we were given wrong information -- terminology was interpreted incorrectly by the CSR we spoke with -- and we ended up with massive bills!</p> <p>Other than going up the food chain, I don't know what to do about it. I really shouldn't have to spend 2903482309483 hours on the phone to have my health benefits explained to me. I should be able to open my benefits book and understand clearly what is covered and what isn't. In other words, I shouldn't have to call and ask questions. </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681193 Thu, 05 Jun 2014 11:36:40 +0000 Mrs. Jump Rope 1681193@https://boards.hellobee.com/ <p>@jedeve: HAHA I would. I like to think I make my insurance company shake in fear if I have to call about a claim. </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681176 Thu, 05 Jun 2014 11:32:04 +0000 MsLipGloss 1681176@https://boards.hellobee.com/ <p>@jedeve: There are a few key words and phrases in there that indicate cost-sharing is not expressly prohibited (an example would be *enrolled in new group . . .* and *eligible* . . . that serve as qualifiers). Also, when preventive care items or services are provided as part of an office visit, it may be difficult to determine whether the office visit itself may be subject to normal cost-sharing requirements. </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681174 Thu, 05 Jun 2014 11:31:39 +0000 jedeve 1681174@https://boards.hellobee.com/ <p>@Mrs. Jump Rope: Can you do it for me? :-) </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681167 Thu, 05 Jun 2014 11:30:09 +0000 Mrs. Jump Rope 1681167@https://boards.hellobee.com/ <p>@jedeve: My advice would be to contact the insurance company. It sounds like the claim isn't being processed by them for some reason. The hospital simply wants paid for services rendered, and you're responsible for the payment if insurance doesn't cover. The billing company has their hands tied because the insurance isn't processing the claim.</p> <p>So, I'd start with them. I'd demand to speak with a Supervisor, have them conference call you into the billing department or hospital, get the claim taken care of and throw in some "impacting our quality of care" (because who wants to go to the doctor if insurance isn't going to cover their costs?!) and tell them you want the call recorded AND a reference number. </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681158 Thu, 05 Jun 2014 11:27:39 +0000 jedeve 1681158@https://boards.hellobee.com/ <p>@Mrs. Jump Rope: Good advice! I think for the ER visit my next step is call the insurance, hospital, and billing company one more time (side note - why is their a third party billing company? That drives me crazy), ask for everyone's name, and that the call be recorded, and tell them my next step is to contact my attorney (which is DH - haha), and the state auditor (who luckily, I know). I don't really care who folds first between the three of them, but someone's got to! </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681120 Thu, 05 Jun 2014 11:22:54 +0000 Mrs. Jump Rope 1681120@https://boards.hellobee.com/ <p>@jedeve: Insurance makes me insane. I'm to the point where I know our plan inside and out, better than the CSRs, and can tell the provider "No, we have a co-pay/co-insurance, please recheck!"</p> <p>I won't bore you with details unless you'd like me to, but here's the magic words:<br /> - "I'd like to speak to a supervisor"<br /> - "This is impacting my quality of care"<br /> - "I'll need a reference number for my records"</p> <p>The quality of care one really sets a fire under their asses. Make sure you speak to a supervisor, NOT a CSR, and request that the call be recorded. Don't hesitate to get your state attorney general involved if necessary -- we've had to get ours involved three times now, and each time they found in our favor. It's kind of helpful when the calls are recorded &amp; it's cut and dry!! </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681113 Thu, 05 Jun 2014 11:21:39 +0000 MsLipGloss 1681113@https://boards.hellobee.com/ <p>@jedeve: I think what bothers me the most is repeated issues with the same insurance company (and same plan with same company). I had to repeatedly challenge non-payment of claims for the exact same reason during my pregnancy . . . you would think after the first 2 or 3 times with claims being given the same code that things would go more smoothly afterward, but yeah, not so much! : / </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681106 Thu, 05 Jun 2014 11:19:33 +0000 jedeve 1681106@https://boards.hellobee.com/ <p>@MsLipGloss: I thought there couldn't be cost sharing for certain vaccines for children? This is what I found on HHS website:</p> <p>Immunization Services for Children<br /> Beginning September 23, 2010, children 0 through 18 years that are enrolled in new group or individual private health plans will be eligible to receive vaccines recommended by the ACIP prior to September 2009 without any cost-sharing requirements when provided by an in-network provider. </p> <p>Diphtheria, Tetanus, Pertussis<br /> Haemophilus influenzae type b<br /> Hepatitis A<br /> Hepatitis B<br /> Quadrivalent Human Papillomavirus vaccine for females<br /> Inactivated Poliovirus<br /> Influenza<br /> Measles, Mumps, Rubella<br /> Meningococcal<br /> Rotavirus<br /> Varicella </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681100 Thu, 05 Jun 2014 11:18:50 +0000 Boogs 1681100@https://boards.hellobee.com/ <p>@jedeve: What gets me lately is why every single ultrasound is a different price, with the cheapest being the longest one we had, the anatomy scan! It all just makes no sense and yet there's no list of prices for them to send us so we know ahead of time. </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681066 Thu, 05 Jun 2014 11:10:49 +0000 MsLipGloss 1681066@https://boards.hellobee.com/ <p>@jedeve: Cost-sharing for vaccines is not illegal. </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1681041 Thu, 05 Jun 2014 11:05:26 +0000 jedeve 1681041@https://boards.hellobee.com/ <p>@Cole: I know, I'm texting DH saying we need to schedule some time to deal with this!!</p> <p>@Greentea: thanks!</p> <p>@brownie: Ugh, I'm sorry!</p> <p>@Boogs: I know, right? A lot of times I get one and think "this seems high..." but there are no details about what it is for and the insurance payment doesn't make sense and I just pay it. But now that we are pinching pennies I'm trying to figure it all out.</p> <p>@MamaMoose: I have always done the finances, but I need to get DH involved with this. I just can't handle it. And he's good at using his lawyer voice and getting results. I'm too "oh...okay..." When our last company wouldn't get me a pump (the third party they used just wasn't sending it, and they said it "wasn't their fault") it took me months before I realized I could say "can I talk to your supervisor?" I had one a few days later.</p> <p>@looch: that's great! I used to really, really like my old insurance company. I called once to ask why they hadn't covered any part of my ultrasound (I think they just hadn't been billed correctly) and they covered the whole thing voluntarily! </p> <p>I've had 9 different insurance plans (8 companies) in the last 6 years. (That's what I think is funny about the whole people getting upset over the "if you like your plan you can keep it" - our jobs have always been switching insurance on us!) You think I would be an expert by now! </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1680979 Thu, 05 Jun 2014 10:54:38 +0000 looch 1680979@https://boards.hellobee.com/ <p>I've actually had really good service when I've called, and I have been calling a lot while I figure out this speech therapy thing. </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1680946 Thu, 05 Jun 2014 10:50:17 +0000 MamaMoose 1680946@https://boards.hellobee.com/ <p>Hoenstly, despite the fact that I handle all other billing/finance stuff for our family health insurance causes me too much anxiety. My husband handles it all and doesn't even tell me about it because it gets me too upset. So I have NO clue what's going on at this moment but probably multiple battles. </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1680940 Thu, 05 Jun 2014 10:48:48 +0000 Boogs 1680940@https://boards.hellobee.com/ <p>I continue to be shocked by the amount of our bills, yet no one is intelligent enough to answer my questions when I call to ask about them. </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1680925 Thu, 05 Jun 2014 10:45:31 +0000 brownie 1680925@https://boards.hellobee.com/ <p>Yes! We have dual insurance and I am fairly certain his ENT only billed one of them. Yippee!!! So now I have to track all of that down. </p> <p>And I got a new job and the benefits are really looking horrible now. I couldn't get into a PCP until August I need referrals NOW. So looks like I'm not going to take insurance (have hubby's so still covered). </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1680924 Thu, 05 Jun 2014 10:44:59 +0000 Greentea 1680924@https://boards.hellobee.com/ <p>Insurance is evil. DH is still battling a claim from years ago! I'm sorry, good luck! </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1680914 Thu, 05 Jun 2014 10:41:31 +0000 Cole 1680914@https://boards.hellobee.com/ <p>How frustrating! I hate when it feels like you need to take an afternoon off and do nothing but sit on hold with 50 people. I agree with you about the vaccines, I don't know that it is illegal but they should be covered under preventative care. </p> <p>I am thankful our insurance is pretty great when it comes to customer service and we have never had an issue with coverage. However, they can't seem to send me an updated insurance card for some stupid reason. It keeps getting sent to an old address even though they supposedly have the right one...</p> <p>Good luck! </p> https://boards.hellobee.com/topic/does-anyone-else-feel-like-they-are-locked-in-a-permanent-battle-with-insurance#post-1680879 Thu, 05 Jun 2014 10:31:25 +0000 jedeve 1680879@https://boards.hellobee.com/ <p>I am so sick of dealing with insurance. We are having issues with somewhere around 4 claims right now. I can't keep it all straight!</p> <p>1: ER visit for LO - the billing company says they have contacted are insurance who hasn't replied, insurance says they have contacted the hospital and they haven't replied.</p> <p>2: Got a gigantic bill from LO's pediatrician for all services rendered this year (I guess I hadn't noticed they hadn't been billing us regularly?) It includes a bunch of cost sharing from vaccines. That's illegal, right?</p> <p>3. My ultrasound was out of network, even though they were the only provider in my area. I'm trying to get them to bill it as in-network instead.</p> <p>4. I don't know if this is an issue or if it's just the way the billing department sucks at the hospital, but it's not showing our insurance adjustment or how much we've paid down so far on LO#1's birth.</p> <p>Not to mention I still have to figure out how to get a breast pump for after LO#2's birth. With our last insurance company, it took me 3 months to get one!!! </p> <p>I hate it so much. The bills never make sense - they are always just in short hand, or from a third party, or aren't detailed. The hospital will randomly not send me a bill one month and then send me an over due notice the next. Half the time my EOBs are wrong. </p> <p>GAHHH. Anyone else hate dealing with insurance? </p>