Has anyone had a really good experience with 'Obamacare'? I understand that previously uninsurable people would be happy to get anything at all, but that's not my question here.
I recently had my yearly checkup, and, as usual, have to pay out of pocket for supposedly covered services, like the cholesterol check. This has happened every year since my first compliant plan. The problem is NOT the insurance companies. The doctors do NOT understand that in order to get payment, they have to choose codes from the approved list. Invariably, they code with whatever likely code they see, probably whatever they had always used in the past, and the insurance company rightly applies it to deductible.
I worked in medical insurance claims during the transition to the ACA, so I know what codes work and which don't, and I can, eventually, get the doctor to re-code the claims and the insurance company to pay. I just do not like the hours I spend on the phone getting this done. Happened to both my daughters and my wife too, from multiple doctors over several years.
So my question. Is my experience normal? Do you get your claims paid easily for your yearly physicals? From my years working insurance claims, a huge portion of my time was advising our clients on how to get their doctors to properly code claims so that my company would pay them.
I suspect a lot of people just pay the claims, not knowing that the services should be 100% covered.