by Guest » Wed Jul 18, 2012 01:49 pm
Recently my spouse had a csection. Before choosing the hospital i made sure the hospital is in the network.
I see the claims being submitted to insurance company and its processed as in-network.
Howver one claim for anesthesia alone treated as off network and got a huge bill.
Is there a way i can request insurance company to process it as in network?.
As i have no way to know/control the internal on the surgery. All i made sure is hospital is covered.
I see the claims being submitted to insurance company and its processed as in-network.
Howver one claim for anesthesia alone treated as off network and got a huge bill.
Is there a way i can request insurance company to process it as in network?.
As i have no way to know/control the internal on the surgery. All i made sure is hospital is covered.
Posted: Thu Jul 19, 2012 07:35 am Post Subject:
This is one of the unfortunate problems with HMO coverage. Your hospital may be in network, your surgeon/physician may be in network, but the hospital contracts with the radiologist, the laboratory, the anesthesiologist, all of whom may not be in your network. You have no control over that and you have 100% responsibility for their charges.
But there's great news! You have someone you can complain about this to.
Here's who you complain about this to:
Barrack H. Obama
President of the United States
1600 Pennsylvania Avenue
Washington, D.C. 20500-0001
He will make sure you get everything for free from your insurance company. He tells everyone that. You can believe it. He wouldn't lie. He loves America, the Land of Everything Free, and the Home of the Bankrupt.
Posted: Wed Jul 25, 2012 02:33 pm Post Subject:
Yes, we have the worst health insurance in the World. In Europe, you dont have to pay any cent for health insurance, but you can go to any hospital you want.
Posted: Wed Jul 25, 2012 07:02 pm Post Subject:
Yes, we have the worst health insurance in the World
No,we don't. There are few countries in the world that have anything that closely resembles our health insurance system.
You are confusing the difference between health insurance and health care systems. And while we're on the subject, the US health care system is about the best in the world, as well.
In Europe, you dont have to pay any cent for health insurance,
That's because no one has it, except those who pay for it PRIVATELY in some countries.
People in Europe don't have the same out of pocket expenses for health care because they are being TAXED to death to pay for it.
Here, in the US, people refer to that form of health care as "socialized" medicine, and most people here DON'T WANT that kind of system.
Our health care/insurance complex is all screwed up because politicians, like "BHO", who have no real idea of how things actually work outside the "beltway" stick their collective noses into something and force the rest of us to make accommodations.
The real trouble with HMOs -- which is the health insurance most people in the US now have -- is that when Congress enabled those systems, they gave the insurance providers (not all of them are actual insurance companies) certain protections against policyowner/insured lawsuits, which allowed them to gain more control over a person's health care than that person's physician. In the wake of that, the insurers began cutting the payments to both physicians/surgeons and hospitals in order to raise profits, and make shareholders happy.
Well, that causes physicians and hospitals to charge more money in order to make ends meet, and that fuels health care inflation, which has been running at a faster pace than general inflation for years.
The whole system needs correction, and everyone knows it. Obamacare was not the proper solution, but it seems as though we are now stuck with it for the time being.
In America, we will all have to pay higher taxes, SOONER rather than later, to cover the health care expenses of the elderly (Medicare and its related programs) and the poor and illegal aliens (Medicaid, which is paid for in part with Medicare dollars). Those systems are bankrupting America.
Obamacare only accelerates our impending drive over the cliff, currently scheduled for about 2037. In the next couple of years, that will shrink to some where closer to 2030 or even in the 2020s. If you think Greece, Spain, and a few other European countries are the problem, you haven't seen anything yet.
When you add in the UNFUNDED LIABILITIES of the Social Security and Medicare systems, America has more debt than it has resources to pay for them. And that includes selling all the gold in Ft. Knox, and taxing every person in America 100% of their incomes, making all US citizens and residents sell all their worldly possessions, their stocks, bonds, and mutual funds, their homes and cars and boats and RVs, and give all the proceeds to the government, and even then, there will still be trillions of dollars of unmet need.
America is BANKRUPT today, but your elected officials refuse to admit it.
No one in Washington, DC, wants to admit this. You can tinker all you want with health insurance (which is only going to get more expensive) or the health care system (which is on its financial last legs, even though it is functioning well), but if nothing is done about Social Security and Medicare in the next few years (by 2015 at the latest), you might as well order up those cyanide tablets tomorrow. Because in a few more years, you won't be able to afford to buy them.
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