Author Topic: A good experience with the ACA?  (Read 2463 times)

Car Jack

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Re: A good experience with the ACA?
« Reply #50 on: March 02, 2017, 09:06:58 AM »
Don't confuse ACA with insurance.  The ACA sets requirements that insurance plans have to meet to be qualified plans.  Insurance is still provided by private insurance companies and some of them still suck.  We had to choose a facility for my son to go in-patent last summer.  Our private insurance, bought through my employer simply sucks.  The best facility in our region told us that they would not accept the insurance because they have a history of not paying their bills.  Nothing to do with ACA......just that the insurance sucks.  I won't tell you that it's Cigna or anything.....oooops.

Tom Bri

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Re: A good experience with the ACA?
« Reply #51 on: March 08, 2017, 04:04:15 PM »
Good news. The colonoscopy came back paid 100%!

I am still fighting to get my cholesterol panel paid. It's small beans. Really small beans, less than $15 after insurance adjustments, but it just annoys me.

misshathaway

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Re: A good experience with the ACA?
« Reply #52 on: March 09, 2017, 06:52:08 AM »
Don't confuse ACA with insurance.  The ACA sets requirements that insurance plans have to meet to be qualified plans.  Insurance is still provided by private insurance companies and some of them still suck.

It hasn't been that simple in my experience. It's the interaction of ACA with the insurance provider. In my case a screwup caused my fully paid on time ACA policy to lapse and then the insurance cancelled the policy. Did ACA not record the payment or did the provider not register the policy as paid? They both blamed each other. ACA interjects another point of failure.
Passed ER first year anniversary - settling in

iris lily

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Re: A good experience with the ACA?
« Reply #53 on: March 09, 2017, 06:55:54 AM »
Don't confuse ACA with insurance.  The ACA sets requirements that insurance plans have to meet to be qualified plans.  Insurance is still provided by private insurance companies and some of them still suck.

It hasn't been that simple in my experience. It's the interaction of ACA with the insurance provider. In my case a screwup caused my fully paid on time ACA policy to lapse and then the insurance cancelled the policy. Did ACA not record the payment or did the provider not register the policy as paid? They both blamed each other. ACA interjects another point of failure.

Yes. There is plenty to blame on the ACA bureaucracy.

 I am somehow entered into the ACA system twice, and I get duplicate letters. I am  afraid to alert them to this and cancel one account (or whateever they call it)  because I am so fearful that they will cancel my entire insurance policy.

We actually used an insurance broker who deals with this stuff every day because the bureaucracy creeps me out and also, DH needed t hear facts from someone besides me, and her office was confused about the final deadline for signing up this year. There were several messages out there.
« Last Edit: March 09, 2017, 07:00:46 AM by iris lily »

Dicey

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Re: A good experience with the ACA?
« Reply #54 on: March 09, 2017, 07:47:21 AM »
Good news. The colonoscopy came back paid 100%!

I am still fighting to get my cholesterol panel paid. It's small beans. Really small beans, less than $15 after insurance adjustments, but it just annoys me.
Just curious, if you know what the correct codes are, couldn't you just confirm them with the billing office before ypur claims are submitted? Seems like that would be a whole lot easier and better use of your time, Tom Bri.

Say what you will about Kaiser, it's nice not to have to deal with that shit any more.
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Tom Bri

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Re: A good experience with the ACA?
« Reply #55 on: March 09, 2017, 09:25:08 AM »
Good news. The colonoscopy came back paid 100%!

I am still fighting to get my cholesterol panel paid. It's small beans. Really small beans, less than $15 after insurance adjustments, but it just annoys me.
Just curious, if you know what the correct codes are, couldn't you just confirm them with the billing office before ypur claims are submitted? Seems like that would be a whole lot easier and better use of your time, Tom Bri.

Say what you will about Kaiser, it's nice not to have to deal with that shit any more.

A good point, and yes, I did ask the colon doc about how he was going to submit the claims.

I also had asked the GP if he was using preventative codes off the ACA list, and he assured me he was. However, he is not a good coder, and failed to choose the right code. He is a good doctor, so I'll stick with him, but he admitted his coding training was just a few days in med school. That is fine with me. I prefer a doc I TRUST WITH MY BODY over one who is OC about codes. The current problem is small. But over the last few years it originally amounted to about $1500 before I called and called and called and got it reduced to about $30. Same with my wife. She had a breast ultrasound done, and before the procedure was assured by both the doc and insurance that it would be 100% covered. The bill came back for >$1000. We called to complain, and it was forgiven. I think the clinic just forgave it rather than correcting it with insurance, since we never got any updated EOBs showing it had been reprocessed.

misshathaway

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Re: A good experience with the ACA?
« Reply #56 on: March 12, 2017, 08:33:39 AM »
Don't confuse ACA with insurance.  The ACA sets requirements that insurance plans have to meet to be qualified plans.  Insurance is still provided by private insurance companies and some of them still suck.

It hasn't been that simple in my experience. It's the interaction of ACA with the insurance provider. In my case a screwup caused my fully paid on time ACA policy to lapse and then the insurance cancelled the policy. Did ACA not record the payment or did the provider not register the policy as paid? They both blamed each other. ACA interjects another point of failure.

Yes. There is plenty to blame on the ACA bureaucracy.

 I am somehow entered into the ACA system twice, and I get duplicate letters. I am  afraid to alert them to this and cancel one account (or whateever they call it)  because I am so fearful that they will cancel my entire insurance policy.

I have the payments auto withdrawn from my bank. Every month I get two stamped paper bills, one for med and one for dental. Both of them have printed on them something like "You are on automatic payment. Please do not pay this bill". N recipients on autopay times the cost of two stamps ...

Passed ER first year anniversary - settling in

geekette

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Re: A good experience with the ACA?
« Reply #57 on: March 12, 2017, 09:26:31 AM »
You might be able to turn that off - our account has an email only option.  They do like to remind you ahead of time to reduce the chance of a bounce.  Our credit cards do the same thing (email only).