this post was submitted on 08 Apr 2024
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Mildly Infuriating

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Just so tired of almost every time a doctor submits stuff to insurance, we have to be the ones to make multiple phone calls to both the doctor's office and insurance to iron everything out, figure out what the issue is (it's always a different issue), and basically be the go-between for the office and insurance. What am I paying $500+/month for?! It's like paying for the privilege of having an exhausting part-time job.

And yes, I understand that insurance wants to weasel out of paying anything, but this isn't even shadiness, just straight up incompetence and lack of communication/following procedures. The amount of emotional energy we have to spend untangling this stuff leaves us drained.

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[–] [email protected] 7 points 7 months ago

The amount of emotional energy we have to spend untangling this stuff leaves us drained.

That's the point. Take a look at the Fortune 500 and Global 500, and notice how many of them are US healthcare companies. No company gets that big doing all the work themselves...

[–] [email protected] 2 points 7 months ago

Come on now. If you really had to do your insurance company's job for them, you'd have to think of your own reason why they won't pay up.

[–] [email protected] -3 points 7 months ago

Another post to feed America Bad and EU Good circlejerk on Lemmy.

Yes, the system is bad and we should have universal healthcare but I never had to call anyone to figure anything out in the past 15 years. The hospital sends me the bills after getting it through insurance. Not sure who your insurance provider is but this issue is not common.

[–] [email protected] 6 points 7 months ago (1 children)

Living in Europe with single payer health care, this sounds crazy. I just go to the doctor, leave, pick up my drugs, etc. It's all handled by the insurance except maybe a few bucks on some drugs. Worst case I have to show my insurance card but that rarely even happens.

[–] [email protected] 2 points 7 months ago (1 children)

It is crazy because OPs case is not very common, at least in my experience. The hospital sends the bills to the insurance and later I get a bill for what I owe. I don’t need to make any calls.

[–] [email protected] 0 points 6 months ago (1 children)

Oh no, it's very common, especially with large bills

[–] [email protected] 1 points 6 months ago

Not sure how large but I recently got a bill for $3000 without having any issues. It took a while for it to get through the insurance but I didn’t have to make any calls. If you are disputing each charge and getting them to reduce the bill, then that’s a different story. Again, maybe only my experience has been good.

[–] [email protected] 13 points 7 months ago

The amount of inefficiencies in the healthcare system is staggering. Like, you almost wouldn't believe it kind of staggering. I can't go into much detail without doxing myself, but it's bad.

[–] [email protected] 7 points 7 months ago (1 children)

Same with HSA cards. I quit paying into mine because they wanted proof I got work done after using at a dentist.

Yeah, because dentists usually sell fun things. Fuckin morons

[–] [email protected] 4 points 7 months ago (1 children)

I never had an issue with my HSA card. Paid into one from 2016-2020 when I had a state job. Then switched off a high deductible to a standard plan with an FSA. Left the state job in August 2021 to go private. finally burned through the last of the HSA money in June 2023. Switched jobs back to the state last August and started paying into the FSA. They hassled me over every charge that wasn’t a copay. Go go the eye doctor. Prove it. Buy contacts. Prove it. Go to a chiropractor. Prove it. They deactivated my FSA card over $1.60 that the insurance said was over the standard amount.

Sorry, I pay into the account for medical purposes. I go to a doctor and you pay it. You have no business knowing WHAT the doctor did to me. They were demanding stuff as documentation from my wife that was a blatant privacy violation.

[–] [email protected] 1 points 7 months ago

Similar issue with me! In our case both were HSAs and my employer changed companies. The first was awesome (and super helpful considering it was pre tax) and the second was horrible.

[–] [email protected] 4 points 7 months ago

It's the first time they've ever done a claim. Take it easy on them.

[–] [email protected] 23 points 7 months ago

I don't know if I should say this but I will.

The last time it was an issue for my kids I conferenced called the insurance and the doctor's office. I then laid into the insurance adjuster saying things that were truly revolting with as much profanity as I could cram into it.

Haven't had an issue since. Turns out the system only works if they think you are unstable enough to make it work.

[–] [email protected] 4 points 7 months ago

This happened to me today. Dreading the hold times tomorrow.

[–] [email protected] 44 points 7 months ago (1 children)

Vote for a single payer system (Medicare for all) if you want out

[–] [email protected] 7 points 7 months ago (1 children)

How? Who do I vote for to make that happen?

[–] [email protected] 1 points 7 months ago (3 children)

Doesn't USA have referendums?

[–] [email protected] 6 points 7 months ago

No, but there's a pile of guns.

[–] [email protected] 4 points 7 months ago (1 children)
[–] [email protected] 1 points 7 months ago (2 children)
[–] [email protected] 2 points 7 months ago (1 children)

Nope. Given how many Americans are obese as shit, believe in angels, and are obliterating public education... That's probably a good thing.

[–] [email protected] 1 points 7 months ago

That explains why so many politicians from America I hear about sound like idiots obliterating literacy. But I disagree with this being good thing. Lack of national referendum gives loud idiots more power.

[–] [email protected] 3 points 7 months ago

Afaik, no there isn't a federal referendum as a option in the US, could be wrong but given I'm pretty sure it's illegal in some states (can't have those pesky citizens making their own rules)

[–] [email protected] 9 points 7 months ago

Yep. The powers that be routinely ignore the ones they don't like.

[–] [email protected] 6 points 7 months ago

Poor souls are weighed down by the egregious amounts of money they have to take in and hand out. Leaves little time to do much else

[–] [email protected] 51 points 7 months ago (5 children)

My favorite is pre-authorization.

I need a pre-auth before my insurance will cover the Adderall for my ADHD. Every year I must renew this pre-auth or I will not get covered for my prescription.

What is a pre-auth, exactly? It's a Dr. Promising that yes, this medicine they prescribed is medically necessary. No, prescription alone does not count. Yes, it can come from the same Dr. who prescribed it.

And yes, I have to do it yearly to "ensure it's still medically necessary" because my ADHD could magically go away one day, apparently

[–] [email protected] 6 points 7 months ago* (last edited 7 months ago)

Same with my MS. It's frustrating to know that if they fuck around and drag their feet one year, i could be getting further brain damage without my meds.

[–] [email protected] 12 points 7 months ago (1 children)

Wow. This is similar to what disabled people have to deal with in Russia. Like arm will grow back.

[–] [email protected] 5 points 7 months ago* (last edited 7 months ago)

Oh don’t worry, disabled vets deal with it all the time in America too. Oh, that leg you lost during your deployment? Gotta prove it’s still missing, and that you’re still disabled every year. And if you fail to get personal copies of everything in triplicate, the VA will magically “lose” your paperwork and you’ll be stuck without benefits until you start the entire process all over again.

[–] [email protected] 8 points 7 months ago

I have to do it quarterly for some reason. Annually would be...better, but still stupid. My doctor even thinks it's dumb, so he usually just asks me all the rote questions...

...no he doesn't, he usually goes blahblahblah you've been doing this for 10+ years we know the routine. Unfortunately I still have to make an appointment, have an appointment, pay the deductible for said appointment, just to get 3mos of a medication that, thus far, I have a medical need for.

[–] [email protected] 5 points 7 months ago

It means they have to compare your request to a list of allowances that change annually at the whim of Corporate

[–] [email protected] 24 points 7 months ago (2 children)

It's beyond belief, but insurance companies do the same thing to amputees.

[–] [email protected] 8 points 7 months ago* (last edited 7 months ago)

Any hassle they can create to manufacture a reason to deny coverage.

It's not "beyond belief" it's disgustingly evil.

[–] [email protected] 21 points 7 months ago

Oh I know, I had a family member make the joke about suddenly regrowing a limb

It's disgusting and absolutely should result in anyone who's ever approved that being put against the wall for their pure evil

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