I'm in a pickle with a doctor's office billing after insurance says they paid. What are my next steps? Appointment in Sept 2023 with a verified in-network provider. Doctor office submitted an insurance claim under a different OON provider who I never met/saw/knew about when I went to my appointment. Insurance didn't pay but applied it to my OON deductible. Then a couple weeks later Doctor office submitted a new claim (NOT A REVISED ONE) for the same date but listed an in-network provider. Insurance covered it 100% less copay. Even though it was under a different provider, I know he works closely with the PA I saw so figured it was accurate enough for insurance purposes. I thought this was settled. From my view of EOBs it looks like insurance paid my bill and I paid my copay. Fast forward to now, I get a bill from my doctor office saying you owe us for the original appt. I had no idea there was a balance and I've been to this practice about 30 times since the original appointment in Sept 2023. I told them I have EOBs showing that they were actually paid by insurance, I forward them to them to verify. They are sticking to their guns saying I owe. I called insurance. They said it is too long ago for them to re-work the claims but from their point of view, they believe I should not owe anything beyond the initial copay. Doctor's office billing will not go over details on the phone. They want all communication to go through email, of which I've sent 2 (one with the 2 EOBs and one asking them to please look again at the second EOB which shows they were paid for the appointment), both emails they responded "please pay your bill". Where do I go from here? Insurance doesn't seem interested in stepping in to help since it's an almost 2 yr old charge. And doctor office is being very difficult to deal with. ETA: if it matters the doctor's office was recently or in the process of being bought out by a private equity company from a different state when I went in 2023. The OON provider they initially billed insurance with is the owner or CEO or something with the private equity.

On July 31, I saw a steady ream of water coming out of my ceiling! Coming from the bathroom upstairs and even going down to my basement! Long story short after checking though pipes, and doing my own investigation I cannot, CANNOT find a cause. Only thing I can maybe think of is one of the children flooding the bathroom and hasn’t told me. I’m a mess, I’m a single mom of two hardly getting by and a giant mess and so many things destroyed I CANNOT pay for this out of pocket, will this be covered by my insurance if it was my child at fault who’s yet to claim blame?

Is it even legal for Healthy Paws pet insurance to increase premiums at almost 200% in CA? This is outrageously high!! Anyone experiencing the same? #healthypawspetinsurance

Last June, I went to urgent care because I was leaving for a vacation out of the country the next day and started feeling sick. I couldn’t get into my primary doctor before leaving and just wanted a steroid shot or antibiotics to avoid being miserable during my trip. I went to an urgent care near my job, knowing it would be more expensive than my normal copay. I usually pay a $25 copay at my primary doctor, but urgent care costs $50. When I arrived and checked in, the receptionist asked for my insurance cards, which I provided. I’m double insured, as I’m still on my parents' insurance, but I use my insurance as primary and my parents’ as secondary. I’ve never had any issues with this setup and typically don’t have medical bills because of it. The receptionist asked if another name (I assumed it was another patient) was on my insurance policy. I confirmed that I’m the only one on my insurance policy and explained that my parents’ insurance is secondary. Both of my insurances are Blue Cross Blue Shield, though I’m not sure if that matters. The receptionist seemed confused but said, "Okay, it’s going to be expensive, but your copay is $50." I agreed, since I felt awful, and paid with my HSA card. I was only tested for strep and flu (both negative) and was diagnosed with a sinus infection, for which I received a steroid shot. Fast forward to my trip abroad, where I had to visit a doctor at my resort, pay $500, and was diagnosed with bronchitis and the flu. Last week, I received a call from a collections service saying I owed $244 for my urgent care visit. I asked how that could be possible since I was double insured, but they couldn’t answer. I called the urgent care, and they directed me to their billing number. After waiting for an hour and a half on hold, I was told I owed the amount. I asked again why, given my double insurance, and they said they only had my parents' insurance on file, and that their insurance had denied the claim. I asked why it was denied, explaining that my primary insurance at the time was through my job and my parents’ was secondary. They asked to put me on hold to investigate, but the call was dropped. I called back and was on hold for 45 minutes. I then received a call from an unfamiliar number, and the voicemail said the call had been disconnected and to call back to resolve the issue. I called back and reached a different urgent care I’d never heard of. I asked for the person who left the voicemail, and they said they didn’t know anyone by that name. I explained the situation, and the person said they had been receiving similar calls from others and advised me to be careful with the information I shared, as they were unsure if their office number had been linked with spam. I then went to the original urgent care, which is 10 minutes from my job, and asked for clarification. They explained that my primary insurance was never added to my account, but when I went in for clarification, they added it to my file. Since their billing has been outsourced to a third-party company, they can no longer access statements or accept payments. They directed me to that number but said they would speak to their manager and call me back since they’ve received multiple complaints since moving to this company. I’m unsure what to do now, as the urgent care never billed my insurance correctly, and the bill has now gone to collections. Any advice on how to proceed?

I was rear ended last week. The dude gave me his info, and we both talked with my insurance company and decided to file a claim through his insurance (State Farm). During the phone call he talked about damages to our vehicles. Earlier this week, state farm called and said he denied his car making contact with my car, and they are investigating this. I have some pics of my cars damage, some pics of his insurance info and his id taken at the scene. What’s my best move here? It just seems kinda absurd because why would he give me his insurance info and let me take a picture of his id if there was no contact? Also, his car has no damage because he has a metal front bumper. My cars rear bumper cracked.

I was in an accident that wasn't my fault (other party received a summons), I called my insurer (state farm) to report it and begin the repair process. I was told by SF rep that I shouldn't have called them. I should have gone directly to the other party's insurance so I wouldn't have a claim on my record. I'd always thought my insurance company just worked it out with the other company. Am I wrong?

For the past 507 days, I’ve been dealing nonstop with AAA Insurance over my BMW X5 M. In July 2023, my car was repossessed (shit happens), but I got it redeemed in September. When I picked it up from Sacramento, multiple dashboard warning lights were on, and it smelled like something was burning. I later found out the repo guy towed my all-wheel drive vehicle by two tires from Chico to Sacramento — completely destroying the transfer case. These types of cars are supposed to be flat-bedded. I got nowhere with the repo company, so I filed a claim with my insurance (AAA) and brought the car to BMW Pajouh/Courtesy Automotive in Chico. It was in their shop from September 11 to November 3 for repairs. Then in February 2024, it started feeling like my tire was going to fall off. I took it back to BMW Chico and got a rental car from them while they looked at it. A couple days later, Nick, the service advisor (not the same one who helped during the first repair), called and asked what the issues were. I had already told them that when I dropped it off, so I was annoyed. The next day, he called again and said, “Whoever did your transfer case didn’t do it correctly.” I reminded him it was their shop that had done the work, and it had been an insurance repair — so the claim should be reopened. A few weeks went by, then I got a call from the AAA adjuster saying the new estimate was too high and they were going to total the car. I told them I would be getting a second opinion from a specialty European shop. I wasn’t able to take the car there until the following week, but I made sure to notify both BMW Chico and AAA. Then a few days later, I started getting calls and texts from both BMW and CoPart, saying they needed my authorization to tow the car to CoPart (a salvage yard). I told them I hadn’t signed anything and had NOT agreed to the total loss — I was still getting a second opinion. Later that night, I went outside and noticed the BMW rental car was gone from my parking space. I ran upstairs thinking I had left the key fob in the car and it got stolen, but it was still in my purse. My daughter reminded me my spare house keys were in the rental, and they had an AirTag on them. I checked FindMy, and sure enough — it pinged at BMW Chico. I called the dealership, and the front desk guy acted clueless. I told him my AirTag showed the car was there. He suddenly put me on hold. A few minutes later, he came back and transferred me to Michael Mumbus, the director. Mumbus told me they removed the car because they don’t allow loaners past 30 days — but it had only been 29 days, and no one had said a word to me about any rental limit. The next day I went down there to pick up my belongings from the car. I came prepared and was recording everything. Mumbus got heated with me, accused me of “holding the key fob hostage,” and said I owed them $650. I had the key fob with me, ready to return it. Then he hit me with it — “Your BMW is gone. CoPart towed it yesterday.” Blaming AAA for giving the consent. They took my car without any consent or authorization. One of the staff members handed me a printout of the repair documentation. That’s when I found out they had installed a junked transfer case in my vehicle — not remanufactured, not OEM, just a used one from a salvage yard. And my insurance policy clearly included OEM endorsement, meaning it should have been brand new from BMW. That’s when I realized not only had they done a terrible job, they had completely violated my policy. I immediately put a hold on the car at CoPart, telling them they had no legal right to it. That gave me time to start digging deeper. Over the course of the year, I reached out to more than 100 lawyers. Every single one said no. They didn’t want to go up against AAA or BMW — said it wasn’t worth the fight. So I kept pushing. I requested every document from AAA and went through everything line by line. That’s when I noticed a payment made to CoPart for $7,000 in “storage fees” — which made no sense. I filed formal complaints with: • California Department of Insurance • Bureau of Automotive Repair And then — this morning — I got the call. AAA told me they had good news: • I can take my car to any shop that does mechanical work and paint (it was severely oxidized from sitting outside this whole time)— and they’re covering all of it. • They’re paying me $35/day for 507 days of loss of use. • They’re removing the salvage title and returning the clean title back into my name. • And… the car is paid off. DMV will take 3–6 months to process the title, but I can wait. I honestly don’t know how this kind of shit always ends up happening to me, but one thing I know for sure — I never stop fighting. It’s exhausting. It’s stressful. It feels impossible. But I do not give up.

Hi all! So I'm in the appraisal process for my homeowners- mine is a hurricane claim (wind only not flood damage). Do they halt processing stuff like ordinance in law while they are in the appraisal process? What about personal inventory items (yes, 5 months since milton and they have done nothing with that)? I want them to see the house stripped down so we still have another month until appraisal. What should I do? I have waited a very long time to replace things. I need stuff like a frige and other essentials. Atleast for the personal items i feel like i should get atleast an "estimate/supplement" thing generated before they start using it as a tool to negotiate paying me less.They said it will be resolved at the end but they have not been forthcoming to resolve anything nor do we see an end in sight. We are kinda going out on a limb and assuming that we are going to sue even after appraisal. It's Florida and this is with citizens if that info is relevant.

Hi there, I was in a car accident in DC that I believe was not my fault. I was attempting to turn left (had been sitting at a light for awhile). When the light turned yellow, it appeared clear and I began to turn. Out of nowhere, someone sped up and rammed into the driver side front corner of my car, going so fast he drove onto a curb, taking out a park bench, two small trees, and a trash can in the process. No airbags deployed on either car and no one was injured, luckily. Police came and we gave statements, but I got the police report back, which was rather sparse - there was nothing in the statement section, no one named at fault, and only a rudimentary sketch of the impact. Policeman told me he gave the other driver a ticket for running the light and failure to produce evidence of insurance. Since the other driver likely did not have insurance, I started a claim with mine. I have a solid policy through Travelers with uninsured motorist coverage, $500K bodily injury, $100K property damage limits. I just learned that he is now claiming he was injured (despite walking around fine, assuring me he and his passenger were totally fine that day), got a lawyer, and is saying I "T boned" him and am at fault. I did not -- his car was barely side swiped and the damage is due to him running over all of those objects. I also did not accept responsibility then or now, and I gave my statement to my adjuster. I've never been in an accident before, and now it seems it is his word against mine (to my knowledge the intersection did not have cameras). I guess it doesn't matter if it is determined to be my fault partially, or even wholly, because I am well insured either way. I just can't help but suspect he is trying to use my insurance to cover his own recklessness and failure to obtain insurance. Does anyone have experience with Travelers in a situation like this? I know at a certain amount they are likely to settle, but it doesn't sit right with me that this dude is likely to get a payout that I am effectively covering for him (and my premium will also go up).

Location: Massachusetts Hello. Up until today I've only ever been a silent lurker in this sub but I'm feeling kind of lost in this situation of mine. I've tried to keep as much information vague as I could while still maintaining relevance. Apologies in advance for how long this turned out to be. I (28F) am a field technician. I was injured on the job in a car accident (not at fault) while driving between work locations. It was a pretty bad accident, but I was lucky enough to get away with only a couple of injuries. Long story short, after a 13 hour stint in the ER they told me to follow up with my primary and sent me on my way. I knew I’d be out of work for a while, but I had a small nest egg to fall back on in the meantime so I wasn’t all that worried.  The next day I called my primary care doctor and found out he had recently left the practice, and the only other doctor there did not take Worker’s Comp claims. None of the clinics or urgent care centers I contacted would take workers’ comp cases either, without prior approval or referral from WC themselves. I returned to the ER in my town about a week later and was referred to a clinic (Let’s call them OC) that would treat me—but only if my workers’ comp insurer (WC) signed a fee agreement. Shortly after, a rep from WC called me. I mentioned that I was considering legal counsel for a possible third-party claim against the at-fault driver and she replied that if I retained a lawyer, it would be unethical for her to speak to me any further and that she would only speak to my attorney from here on. A day or so later I did eventually retain a lawyer—but only for the personal injury case, not workers’ comp. From that point on, both my lawyer and I called the WC rep daily for over two weeks, with no responses or voicemails. I had to get my HR rep from work to reach out directly and received a reply from the WC rep almost immediately. She told my HR rep that they could not sign this fee agreement until she had completed her investigation. At this point it’s been like 19 days since the accident with no communication from her whatsoever. I called every day and left a voicemail every day, more so to document the lack of follow up on her end.  After three more weeks of this I reached out to my HR person again and she was able to see that my claim was denied about two weeks after my accident. The denial haad a note that said I was unreachable (false) and she also found a letter that was formally filed with the state saying I was denied because I had deviated from my route (also false, and never discussed with me). My HR person was able to get WC’s supervisors involved, and the WC rep contacted me shortly after to report herself that the denial was due to “failure to report in a timely manner.” At this point, I won’t lie, I was pretty angry hearing that, but I was still trying to keep cool. Calmly, I pointed out that WC rep’s lack of communication was the sole cause of this denial and she pretty much just brushed me off and started asking other questions related to my claim, presumably to actually file it properly this time around. She then verbally accepted the claim “without prejudice” and told me the OC fee agreement would be signed that day.  I went over this whole issue with my attorney and she said I shouldn’t rock the boat if they’re cooperating now. My problem is, it’s been a month and four days since WC rep said that she’d sign that agreement “before the end of the day” and the agreement is still not signed, so are they really cooperating? I have not seen a specialist for my injuries to this day and without going into detail, I’m basically bedridden at the moment.  Roughly one week after that call a WC supervisor reached out and told me I would need to sign and notarize a Section 19 agreement. This was the first time this agreement was mentioned, and no one indicated it was a condition for approving treatment. Over the following weeks, I continued to check in with both the supervisor and the original WC rep as they negotiated the fee (or so they claimed) with the specialist’s office. At one point the WC supervisor says that they have reached an agreement and that they were preparing to sign a finalized version. After about a week or so I reach out to the WC supervisor, who hands me off to the WC rep, who then says that she was waiting for the signed Section 19 from me first—implying that the fee agreement was being held up until then, although no one had explicitly stated that before. When I asked for that clarification, the WC rep clammed up again and stopped responding. I’ve asked twice with no answer, and when I asked a different question on an email chain she and her supervisor are both on, she responded right away to THAT question, refusing to answer the last two in the email chain where it is just her and I.  As of now, I’ve been without medical care for about three months. I’ve received no workers’ comp wage benefits, and I’m unable to qualify for state assistance because there’s no formal record of accepted benefits. My injuries are not improving, possibly from lack of care, and I’m growing increasingly concerned about long-term damage. My current attorney has advised against escalating things with WC, fearing they might stop communicating again, but at this point I’ve lost all hope that this company is acting with any sort of good faith and I feel like something else needs to be done. At the very least, I really believe that this level of dishonesty shouldn’t go unpunished by their supervisors or the state if need be. If I didn’t have my savings to fall back on I’d be in a lot more trouble, but even so this money won’t last forever.   My problem is: If I pull the trigger and start playing offense here it sounds like it might be much, much longer before I see any specialist for my injuries. Everyone has warned me that Workers’ Comp is a nightmare but I never expected this much of a problem. The way I’m feeling right now, I’m very close to pursuing legal action against them as well, but every time I mention what I’m going through in my close circle the consensus seems to be “Yeah they suck but it is what it is.”  Does the state take these kinds of complaints seriously? Does it sound like I am justified to pursue legal action if I decided to go there? It sounds to me like they’re withholding care unless I sign this agreement so they can cover themselves first. I need a realistic opinion before I decide what to do next. I try to never act in the heat of the moment but I’m kind of at the end of my rope.  TL;DR Workers’ Comp is doing what they do best. Would I be making it worse if I tried to hold them accountable?