My son has two insurance policies, one with me and one with his Dad. Both plans are with BCBS. Dr office called to tell me they can't run the claim because BCBS website is showing that he is inactive on Dads plan. Dad says plan should be fine. So no idea why the Dr office is seeing that. I asked if they could just run it under mine and they sad it won't work because Dads plan is inactive and the my plan won't pay until it's resolved. This doesn't make sense to me. Why would it not process with my plan just because Dad's plan is inactive? Wouldn't this be the same as my son only having one insurance plan now and run it without the secondary attached? Can someone break this down for me?

I am getting some MRI's done at a outpatient facility and wanted to get an estimate by my insurance on my copay. My insurance asked me to get the NPI /taxid for the radiologist that will be doing the MRI so they can get the best estimate. I have BCBS I contacted the outpatient facility (NJ imaging network), and they gave me an NPI number but thats the NPI nubmer of the facility. I asked for NPI number of the radiologist, but they said that they bill under the facility, not the radiologist. How am I supposed to get an accurate estimate here? Also by "provider" billing I mean physician billing

What am I missing here? It looks like Anthem BCBS is acknowledging my provider is in-network and then processing it as out-of-network. * Provider has been processed as in-network for visits both before and after the visit in question, always with a $30 copay and no balance. This was another routine, non-emergency visit with the exact same provider. * EOB clearly says in big bold print that "Going to this doctor uses in-network benefits" and elsewhere has the words "(in your plan)" after the provider's name. * EOB shows no copay, a portion applied to my deductible, and a balance in the "Your total cost" column. * EOB gives a reason code: "015: The amount shown here is more than your plan allows for this care. If this was not an emergency, the doctor/facility might bill you for the difference between what your plan allowed and what the doctor/facility charged." How is this possible for an in-network provider? It seems this EOB is just contradictory on its face. I've been trying to get them to fix it, but haven't had any success yet. Any advice?

My 1 year old, went to urgent care first and then they asked us to take her to emergency as she was having trouble breathing. We went to emergency and her oxygen level was 82%. A chest xray and couple test later she had rhinovirus and bronchitis. She was admitted by the ER doctor to the hospital. My insurance denied the claim because they need more info from doctor, from which doctor ER or the pediatrician that monitored her at the hospital I'm not sure.I have the sydney app it shows the bill for the provider and also shows the plan discount paying the full amount of that bill so my total is 0. Is that pending the doctors note? Not familiar with how plan discounts work, I have blue cross HPN.

My husband and I signed up for BCBS of Illinois PPO+ plan through his work this year. I started seeing a physiatrist who was in network. When my claim was submitted, they only approved a discount from $360 to $219 leaving me having to pay $219 out of pocket. I previously had United Healthcare from my last company and with that insurance my physiatry appointments were only $30. I have read through our policy agreement but have to admit, I have no idea what I am reading. Can someone help explain what is different between my currently BCBS plan that only approves a discount vs other plans who only make you pay the co-pay? Thank you!

Location, North Carolina Our family has a marketplace health plan with Blue Cross. It includes free dental for children under 18. I bought a marketplace dental insurance for my husband and I but didn’t include the kids because they had the free dental on the health plan. I have been trying to make dental appointments for the kids, and of course, there is a very limited number of dentists on the list that are in network. I have called a couple to make appointments and I keep getting told the same story. Blue Cross completely ghosts the dental office when they try to submit claims so the dentists won’t bother billing them anymore. If I had known this, I would have just added the kids to the dental policy I purchased for my husband and myself. Of course open enrollment is over so it’s too late now and they haven’t really had a change in circumstance except that their coverage only exists on paper and is impossible to use. Now my only option is to pay out-of-pocket for their dental care. Anyone else experienced this? What are my options?

I got diagnosed with sleep apnea and I was delaying my treatment because I found out that its very expensive. After a few months, the cpap company based in Houston, TX reached out again that my deductible has been met and I just owe 171$ and then insurance will take the charges. After I started my sleep apnea treatment, I got the call again from the medical company that they made a mistake on their end and the benefit information was not correct. So now, they are asking me to pay 45$ for supplies and 65$ for cpap rental every month till the payments are complete. I am just a loss of what the hell is this! I get screwed up and left with more charges for a treatment which was quoted wrongly to me. I called Blue Cross Blue Shield OF TX and they said they cannot help me. My current insurance is ending in one month and I am changing insurance from next month. So, it doesn’t make sense why pay deductible towards an insurance which will not be there in 30 days. What are my rights?

I am getting some MRI's done at a outpatient facility and wanted to get an estimate by my insurance on my copay. My insurance asked me to get the NPI /taxid for the radiologist that will be doing the MRI so they can get the best estimate. I have BCBS I contacted the outpatient facility (NJ imaging network), and they gave me an NPI number but thats the NPI nubmer of the facility. I asked for NPI number of the radiologist, but they said that they bill under the facility, not the radiologist. How am I supposed to get an accurate estimate here? Also by "provider" billing I mean physician billing

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?

Hey y'all This is my first time posting here. I am going to be starting a job here soon where I need to get my pre exposure rabies vaccine prior to starting. The issue I am having is my health insurance (Anthem blue cross blue shield) doesn't cover it and it is gonna put me down like $800 with finical compensation from my employer. I live in Kentucky. I was wondering if anyone has any advice or ideas of ways I could try to get that price down. I'm not sure of theirs any good answers but figured I would ask. Thank you all.