Comments on: Open Mic – Claims Dispute http://www.healthinsurancecolorado.net/blog1/2007/10/17/open-mic-claims-dispute/ Research and discussion of the Colorado health insurance industry and the healthcare crisis in America. Wed, 17 Mar 2010 21:46:03 +0000 http://wordpress.org/?v=abc hourly 1 By: Brian Clark http://www.healthinsurancecolorado.net/blog1/2007/10/17/open-mic-claims-dispute/comment-page-1/#comment-8383 Brian Clark Thu, 24 Jan 2008 20:57:04 +0000 http://www.insuranceshoppers.net/blog1/2007/10/17/open-mic-claims-dispute/#comment-8383 This is just how the system works. The hospital has made these two different procedures, so you have two different copays. A $100 copay per MRI isn't too bad in my opinion. The policy you have is pretty rich compared to most. If you had an HSA type policy or one of the other high deductibe options that most self employed people are being herded to these days, you would be paying for the first $2000, $5000, or even $10,000 worth of expenses. This is just how the system works. The hospital has made these two different procedures, so you have two different copays. A $100 copay per MRI isn’t too bad in my opinion. The policy you have is pretty rich compared to most. If you had an HSA type policy or one of the other high deductibe options that most self employed people are being herded to these days, you would be paying for the first $2000, $5000, or even $10,000 worth of expenses.

]]> By: Michael Samuels http://www.healthinsurancecolorado.net/blog1/2007/10/17/open-mic-claims-dispute/comment-page-1/#comment-7695 Michael Samuels Thu, 18 Oct 2007 12:27:43 +0000 http://www.insuranceshoppers.net/blog1/2007/10/17/open-mic-claims-dispute/#comment-7695 The problem with most disputes with your carrier is that just cutting through the red tape can be problematic. Also, most people don't know that they can fight when your carrier refuses to pay certain claims. But when you have a hospital that has created a whole new fee system, then of course that spells trouble. I found a very interesting video on YouTube called 'The Raymond Report'. The host is a veteran of the industry and is now starting a web-based show geared towards helping consumers with problems and you can write them to help solve disputes. You can search it on YouTube and they also have a website: theraymondreport.com I'd love to hear that it works out for you. It sounds like the hospital has found a way to make more money and others will pick up on it quickly if it can't be stopped. The problem with most disputes with your carrier is that just cutting through the red tape can be problematic. Also, most people don’t know that they can fight when your carrier refuses to pay certain claims. But when you have a hospital that has created a whole new fee system, then of course that spells trouble. I found a very interesting video on YouTube called ‘The Raymond Report’. The host is a veteran of the industry and is now starting a web-based show geared towards helping consumers with problems and you can write them to help solve disputes. You can search it on YouTube and they also have a website: theraymondreport.com

I’d love to hear that it works out for you. It sounds like the hospital has found a way to make more money and others will pick up on it quickly if it can’t be stopped.

]]> By: Jay Norris http://www.healthinsurancecolorado.net/blog1/2007/10/17/open-mic-claims-dispute/comment-page-1/#comment-7690 Jay Norris Wed, 17 Oct 2007 23:29:37 +0000 http://www.insuranceshoppers.net/blog1/2007/10/17/open-mic-claims-dispute/#comment-7690 <p>Oops. I should have made that clear. Tim is not our client and I'd never talked to Tim until we received his letter to submit on the blog. If our clients ever do submit a post to the "open mic" category, I'll make that point clear. </p> <p>I'm guessing his policy is through his employer (CSU-Pueblo?), so he probably doesn't have an agent.</p> Oops. I should have made that clear. Tim is not our client and I’d never talked to Tim until we received his letter to submit on the blog. If our clients ever do submit a post to the “open mic” category, I’ll make that point clear.

I’m guessing his policy is through his employer (CSU-Pueblo?), so he probably doesn’t have an agent.

]]> By: Damon http://www.healthinsurancecolorado.net/blog1/2007/10/17/open-mic-claims-dispute/comment-page-1/#comment-7689 Damon Wed, 17 Oct 2007 22:39:31 +0000 http://www.insuranceshoppers.net/blog1/2007/10/17/open-mic-claims-dispute/#comment-7689 This sounds like a glitch in the insurance company's billing system. You should be able to contact the hospital and have them give you documentation that only one MRI was done. If the insurance company doesn't remove the extra copay for the extra MRI that never happened, I think you would have a case for the insurance commissioner. I would think your agent should be able to help you with that. Is Insurance Shoppers the agent? This sounds like a glitch in the insurance company’s billing system. You should be able to contact the hospital and have them give you documentation that only one MRI was done. If the insurance company doesn’t remove the extra copay for the extra MRI that never happened, I think you would have a case for the insurance commissioner. I would think your agent should be able to help you with that. Is Insurance Shoppers the agent?

]]>