Health insurance - pedda bokka

[Allarinaresh10]

Just now, Srin said:

Yeah naku adey cheptaru anipinstundi kani how do I appel the claim, inusrance vadu is telling this

 

I can see a patient responsibility of $13,679.22 which $247.89 was subjected to the deductible. Based on this claims, the members benefit plan limits the payment to maximum reimbursable charge. As this claims was processed as out of network. Meaning on this claims, the allowable for out of network on the procedure is what was subjected to the deductible and the provider may bill you for the balance. This was processed accordingly based on your out of network coverage

Insurance ki call chesi appeal cheyyali anukuntunna ani cheppu.. they will give mailing address and what is the process ani kanukko like write up cheyyala ani. 
 

Obgyn tho matladithe neeeku clarity vastundhi. 

[stark]

Naku ilane ayindi for out of network pediatric . My son was in NICU. 9k vachindi Bill. Insurance was Cigna. After making lot of calls and appeals  to Cigna they finally paid all the amount . Medical bills ki chala time untadi ventane collections ki vellavu. So call chesthane undu after you receive that bill from surgeon. Oka right person thagalali anthe

[Srin]

18 minutes ago, stark said:

Naku ilane ayindi for out of network pediatric . My son was in NICU. 9k vachindi Bill. Insurance was Cigna. After making lot of calls and appeals  to Cigna they finally paid all the amount . Medical bills ki chala time untadi ventane collections ki vellavu. So call chesthane undu after you receive that bill from surgeon. Oka right person thagalali anthe

Thanks, will do that

 

inka bill aaa suregon nundi raledu, eee sodi insurance vallu edo 180 days lo cheyali idi antaru kada apati varaki surgeonbill send cheyakapotey elam, moreover adi claims lo patient responsibility ani undi 

[yemdoing]

Sometimes surgery or emergency times lo we don’t have control which doctor treats us . Sadly sometimes out of network vallu undacchu .

 

ask for itemized bill, this may reduce the bill 

keep calling insurance guys as someone suggested 

[Srin]

1 hour ago, yemdoing said:

Sometimes surgery or emergency times lo we don’t have control which doctor treats us . Sadly sometimes out of network vallu undacchu .

 

ask for itemized bill, this may reduce the bill 

keep calling insurance guys as someone suggested 

enta chesina vadu manaki pettey bokka matram taggadu kada, when paying high premium and malli eee amount antey i cant digest

 

ninna telisnapati nundi proper sleep ledu 

[Srin]

Cigna rep says as below

 

As per checking here , the provider is out of network that is why you have been charged the total amount. Because your benefit is only limited for In network benefit coverage only. And I'm so to say this but your plan does not have an Out of network coverage 

 

 

Out of Network - 100% pay cheyali anta since plan lo out of network ledu anta 

[Srin]

2 hours ago, stark said:

Naku ilane ayindi for out of network pediatric . My son was in NICU. 9k vachindi Bill. Insurance was Cigna. After making lot of calls and appeals  to Cigna they finally paid all the amount . Medical bills ki chala time untadi ventane collections ki vellavu. So call chesthane undu after you receive that bill from surgeon. Oka right person thagalali anthe

ipudey insurance tho matlada, wife insurance plan lo out of netwrk ledu anta anatey we have to pay 100% anta.

 

nee plan same aaa 

[yemdoing]

25 minutes ago, Srin said:

enta chesina vadu manaki pettey bokka matram taggadu kada, when paying high premium and malli eee amount antey i cant digest

 

ninna telisnapati nundi proper sleep ledu 

I can understand, e time lo unexpected kharchulu ante very scary . Try to have calm demeanor . Wife will have full emotional changes because of hormones , don’t show your frustration or anger to wife or on new born .
 

Try everything you can to reduce the bill at the same time enjoy the fatherhood . Don’t let financial things take away that joy from you .  
 

 

[yoda123]

ok ... first things first ...

1. hearty congratulations ... enjoy the time with baby and spouse ...

2. don't let this non sense effect your day to day life

that being said ....

 

3. as stark bhayya said above ... insurance bills 2-3 years to resolve ... so ... don't panic ...

4. NEVER agree for a payment plan  with insurance until you are comfortable for a price ...

5. When a service is rendered out of network ... the bill will be rated triple to quadruple times what actual bill is ... so .... here in this example ... that surgeon bill was 9k so means ... actual bill would be ~ 2k .... that we have to negotiate with that assistant surgeon's office directly ...

6. so ... figure who is that surgeon ... why his services were necessitated ...  once figured out who that asst surgeon ... reach his office and explain situation ... and request to bill at regular contracted insurance rate ... ( he may accept or may not accept, but reaching out to him will help)

7. keep reaching out to insurance again and again ... and keep tell them that you can't pay that money (remember this issue takes any where from 2-3 years ... minimum of 18 months )  ... also figure out what was the other 4k bill ....

8. also reach out to the hospital and tell them that u can not pay the bill ... they can claim that money from federal government ...

dm  if any thing required

 

good luck

[AverageDesiGuy]

I don't think we can do anything now, mostly payment plan thesukoni pay cheyadame!

[ShruteSastry]

Assalu Aa surgeon bill pampe varaku wait chey bro,

Don't contact your insurance guy until you receive the bill. 

 

[Srin]

9 minutes ago, yoda123 said:

ok ... first things first ...

1. hearty congratulations ... enjoy the time with baby and spouse ...

2. don't let this non sense effect your day to day life

that being said ....

 

3. as stark bhayya said above ... insurance bills 2-3 years to resolve ... so ... don't panic ...

4. NEVER agree for a payment plan  with insurance until you are comfortable for a price ...

5. When a service is rendered out of network ... the bill will be rated triple to quadruple times what actual bill is ... so .... here in this example ... that surgeon bill was 9k so means ... actual bill would be ~ 2k .... that we have to negotiate with that assistant surgeon's office directly ...

6. so ... figure who is that surgeon ... why his services were necessitated ...  once figured out who that asst surgeon ... reach his office and explain situation ... and request to bill at regular contracted insurance rate ... ( he may accept or may not accept, but reaching out to him will help)

7. keep reaching out to insurance again and again ... and keep tell them that you can't pay that money (remember this issue takes any where from 2-3 years ... minimum of 18 months )  ... also figure out what was the other 4k bill ....

8. also reach out to the hospital and tell them that u can not pay the bill ... they can claim that money from federal government ...

dm  if any thing required

 

good luck

Thanks mama

I will ping you if I need anything else.

[Srin]

Just now, ShruteSastry said:

Assalu Aa surgeon bill pampe varaku wait chey bro,

Don't contact your insurance guy until you receive the bill. 

 

Sure Bro, will wait thanks

[Srin]

3 minutes ago, AverageDesiGuy said:

I don't think we can do anything now, mostly payment plan thesukoni pay cheyadame!

ilanti situation face ina vallu undey untaru ani ikada mana DB lo post chesa, how they handled ani 

[Srin]

33 minutes ago, yemdoing said:

I can understand, e time lo unexpected kharchulu ante very scary . Try to have calm demeanor . Wife will have full emotional changes because of hormones , don’t show your frustration or anger to wife or on new born .
 

Try everything you can to reduce the bill at the same time enjoy the fatherhood . Don’t let financial things take away that joy from you .  
 

 

Thanks Bro for your kind words. ilanti time lo scray a untadi moreover anta pedda amount bill epudu chuda ledu manam adokatey