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United Healthcare - United healthcare denying claims.
So I have really bad neuropathy and have had for like 15 years. Can't feel anything below my knees. I developed a foot ulcer that was just not healing and after going to a foot specialist for 3 years my GP sent me to a wound specialist in Jan. My company had just switched to united health care so I wasn't very familiar with them. I went to the wound specialist every week or every other week for 2 months and
I was actually seeing a lot of improvement and was feeling pretty good about it when my insurance told me they were denying a lot of the services so now I owe over $6,000! And this is on top of the $200 I had to pay every time just to go see him as a specialist.
But the things that they are denying are things like the wound pad and the gauze that they wrapped my foot in for me to leave the office. The Doctor cuts away a lot of old flesh every time and its on the botton
of my foot so am I just supposed to leave his office with a big open wound? Am I supposed to bring my own gauze? It's also saying that I got a device several times, but I never got any type of device. Also the amount that the doctor's office is charging for just a little bit of gauze is insane. It's saying that the gauze or pads are 16-48 sq in and they were just small squares so maybe my doctors office was padding the bill, but I'm not sure.
I've tried appealing it but what else should I be doing?
I've stopped seeing the doctor because I can't afford that so now I'm just back to not healing and having a constant worry that it's gonna get infected and I'm going to end up having my foot amputated.
The claims say things like:
Service description:
A saline- or hydrogel-soaked gauze pad, 16-48 sq. In., used to cover a wound. The dressing protects the wound.
Claim codes:
Benefits for this service are denied. Your plan does not cover this medical supply, prosthetic, orthotic appliance, or durable medical equipment.
Service description:
Any one item used during a surgery.
Claim codes:
Benefits for this service are denied. Your plan does not cover this medical supply, prosthetic, orthotic appliance, or durable medical equipment. Please refer to the Exclusion and/or
the Additional Coverage Details of your plan document for additional information. (CAD128)
Service description
Any sealant, protectant, moisturizer or ointment. The product is used no to protect nntont the the skin ckin against against tears tears or or breakdown breakdown caused caused by by tape or other adhesive material.
Claim codes:
Benefits for this service are denied. Your plan does not cover this medical supply, prosthetic, orthotic appliance, or durable medical equipment. Please refer to the Exclusion and/or
the Additional Coverage Details of your plan document for additional information. (CAD128)
Service description:
A sterile pad, 16 sq. In. Or smaller, made of gel fibers to cover a wound. The pad is used as a protective dressing
Claim codes:
Benefits for this service are denied. Your plan does not cover this medical supply, prosthetic, orthotic appliance, or durable medical equipment. Please refer to the Exclusion and/or
the Additional Coverage Details of your plan document for additional information. (CAD128)
Blue Cross Blue Shield of North Carolina - Constantly Fighting Denied Claims with BCBSNC — Is It Just Me?
I'm honestly at my breaking point dealing with BCBSNC. I’ve had multiple claims denied that should be routine — and I’m exhausted from trying to get clear answers.
Recently, I had in-network bloodwork done that was ordered by my doctor. BCBS denied the entire claim — not even applied to my deductible — and there was no EOB at first. The exact same tests were processed last year with no issue.
In Dec. I had a bad sinus infection, I went to urgent care, and even though the provider billed it correctly as urgent care (POS 20), BCBS processed it as outpatient hospital and denied the appeal.
Last year, I also got stuck with a $1,300 bill after seeing a cardiologist who ordered a stress test at a local hospital. That claim was denied too, because they classified it as an outpatient hospital visit — even though it was a specialty care appointment.
I’ve submitted appeals, contacted billing departments, and chased down paperwork, and BCBS just keeps giving vague, inconsistent responses. I haven’t contacted HR yet, but I’m seriously considering it, along with a complaint to the Department of Insurance.
I’m using in-network care and following the rules. I just don’t know what else to do at this point. Has anyone else dealt with this kind of mess?
GEICO - Crashed back in July, GEICO can't insure the ambulance ride?
So like the title says, I crashed my car in July. It was stated that I was at fault and geico covered every bill, except the ambulance one. The thing is, I didn't know there was an ambulance bill until a month ago, they said somehow the ambulance wasn't able to get the insurance or anything but I called GEICO and sent over the bill, and now they are saying they can't cover it and it has to be sent through my health insurance. I'm confused on that part because I thought if it was a vehicle accident then GEICO would cover it, but now they're saying otherwise.
I'm just trying to understand the policies cuz I'm just confused right now.
Edit:
I live in NJ, and they said my coverage wasn't exhausted yet.
GEICO - GEICO wants me to get them the police report.
Hi Insurance!
I had a roommate with a mental health condition who wrecked my apartment when I was gone. They had to be medically detained for mental health reasons. I filed a claim right after and included police report number in it with list of items and proof of ownership. They said they accepted the proof of ownership and claim but want me to get them the copy of the police report. Now I have to wait 10 business days. Doesnt GEICO have like backend ops team or something that does this kind of work?
TLDR: GEICO wants me to get them the police report, which will take 3 weeks approximately (buffer included). Why cant they do this faster themselves?
Spot Pet Insurance - Spot Pet Insurance
Please don't fall for them . They are a scam . Besides internist personally writing to them that my cats who (needed biopsy )condition was not pre-existing sending 2 years of medical records calling emailing speaking with several people who barely know what their doing they denied my claim. Don't fall for their lying sales people . I report them to BBB I hope more people will ,Spot can't keep scamming people.
Liberty Mutual - Post cancellation bills?
I’ve been paying 436 a month for a 22 Honda for the last few years, which I haven’t been able to afford, but always managed to pay on time with autopay. I’ve never had a missed bill. My last payment was on February 28th. It came out of my account, and put me deeply in the negative, and then got returned because I had insufficient funds, which has never happened before when bills put me in the negative. I switched over from Liberty Mutual to Geico after that and am only paying 159 a month now. Geico sent Liberty a letter declaring cancellation and demanding returned funds for the rest of my coverage this month that I’m not using- bill was on the 28th, canceled on the 6th of this month I believe. I called Liberty to double check, they claimed they never got the letter, refused to refund anything, set another date to pull that 436 from my account since it got returned previously, and charged me 90 something dollars on top of that, due the 22nd of this month, but didn’t tell me what that added fee was for. I went to my bank and told them to halt autopay for Liberty after that 436 bill, since I do technically owe that outside of any returned funds. They messed up and halted ALL autopay, so the 436 won’t come out, which I didn’t mean to do. The app now, since I’m no longer a customer, will not allow me to manually pay it. Is there any legal or credit ramification for unpaid bills post cancellation?
Mr. Cooper - Mortgage company said our loan is in “default”
So I reside in Minnesota, our loan company is Mr. Cooper.
We are behind a little bit February and March, but will come through before the end of the month to fully catch ourselves up again.
They sent me an email stating our loan is in default? How is that possible when it states we are barely in their words 39 days late on the payment? Can they default our loan just for that?
I’m going to be calling tomorrow to ask since we’re paying the full amount before the end of the month if it’s okay.
But I really can’t wrap my head around the fact they defaulted so quickly. Has anyone else dealt with something like this? Or specifically this company? Much appreciated for answers!
State Farm - Desperate, poor, + confused
I bought a used 2012 Volvo during the pandemic at the height of used car prices out of desperation. I needed a car. I have $12600 left on the loan. The car itself is now valued at $4000. It currently requires $15000+ in repairs to pass safety and emissions. I’ve had nothing but problems with it since purchase a couple of years ago. I have put about $1500 into the car so far in repairs. I suspect I was sold a lemon, one shop suspected a history of flood damage, another refused to comment if that was a possibility. I do have gap insurance, not sure if that can apply here. I cannot afford to fix the vehicle or pay out the loan and get a new vehicle. Between the original dealer, the lender, State Farm, auto repair shops, I feel pretty constantly let down by customer service. I also struggle to understand all of the policies and legalese. Is there anything I can do here? I’m so overwhelmed.
Progressive - First accident, subrogation, person handed me expired license policy
The other day I was at a grocery store where I parked my car far away form the busy area purposefully with a Mustang. I was walking out, saw the accident happen live, and turns out the person messed up the front left side of my car. bumper also kinda came off. Some dent/paint damages. No tire damages. Nothing internally (hopefully). Still drivable.
The car was parked, plenty of space in the park lane, and thankfully I was able to be there and watch it happen to stop the person, grab some pictures of their license plate, exchange contact, and even snap a picture of the person's insurance policy. Thinking back, I probably should have called the police and filed a police report, but immediately I filed an insurance claim with my insurance company, Progressive.
Unfortunately, my policy doesn't have an uninsured motorist vehicle coverage for collision. On top, my deductible is pretty high. 2500.
I had to learn a lot of these things and also like what a subrogation is, but that's basically what's happening right now because I sent my car to the shop and I tried getting in contact with the other party after I figured out i learned that their insurance policy has expired and seems like my agent as well tried contacting them with no response. I even tried contacting their policy with the expired information to see if there was anything active and it turns out there wasn't in their logs. And the insurance company basically just kind of hinted me to screw off after they realized that there was no other information available or logs on their end.
So after speaking with my agent and I'm still waiting to get the final quote and stuff from the shop, I believe they're going to start a subrogation process. I have no idea if they have an active policy there or if they have something else.
Now, with all this in mind, I'm not sure what to expect here. Unfortunately, I do have to put up the 2500 for the repairs. I think what's gonna happen is that they're gonna try to get my money back somehow, see if they have any active policies, and from what I've heard online is that this can take anywhere from a few weeks to months to maybe even years, I'm not sure.
But from what I understand, is it right that there is no guarantee that I'll get my money back, especially if they were not insured? And if they were not insured, does that mean my insurance company is going to try to come after them In any way possible to get the money back?
I'm just kind of concerned here because this is my first accident. it was kind of a BS since it wasn't my fault. Happened right in front of me and at the same time, I'm just not sure what to expect here.
Kaiser - Are covered california certified enrollment counselors trustworthy?
My question in the title does not in anyway mean as an attack, simply my genuine curiosity based on my personal experience.
My parents recently migrated to California so we went to a certified enrollment counselor in NorCal. For some reason this counselor keeps pushing BenefitsCal and also to sign up for her clinic's health care plan. I am already a Kaiser member myself, so I wished to sign my parents up for Kaiser as well. But she kept pushing back, I assume because she benefited if we signed up for her orgs plan.
The whole thing made me very uncomfortable. Wondering if anyone has experiencedthe same?
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