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Any non US goons feel free to mock our lovely health care system. Scenario is as follows: Wife is pregnant, and we decide to see a nurse midwife for our prenatal care (think nurse practitioner specializing in baby deliveries, not hippy dippy). Kid is due early January, a bit lovely because deductibles reset January 1. Midwife informs us at our first visit that she has sold her practice to a larger medical group, she assures us that it will not really be anything but a change in name. We like the larger medical group, and have had good experiences with them. The wife will not meet her deductible this year, unless by the grace of God the kid, shows up prior to January 1. Prenatal care in the USA billed at the time of delivery - this is called 'global billing'. We really like this woman, and I think she's a very good fit for what we need. Some time in early September we get a letter saying OK this transition is happening Oct 1, just to let you know that it'll all be good no big deal. So here is the kicker, when we are moved from her old practice to a new one, apparently her Tax ID is changed. According to her billing person, this is basically the same as us switching doctors/providers. As a result, her old practice sends us a bill for the first 5 visits, to the tune of $600. This bill is a direct result of merger. Normally, all of the bill would be hitting our 2016 deductible, and we most likely will simply hit our max out of pocket. The change in her business is loving me over to the tune of $600. I have followed up with my insurer and with the midwife. I had a civil conversation with the midwife about the fact that I was being penalized because of her business decision, and we had no prior warning about this. I really do feel that the midwife should have been willing to negotiate on the bill, but that wasn't going to happen. In just about any other business on this planet, if they make a decision that penalizes their customer through no fault of their own, I would expect some consideration because of it. This is mostly just a rant than anything else. gently caress our medical system.
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Nov 12, 2015 15:42
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| # ? Apr 26, 2024 04:11 |
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America is great in so many ways, then we have poo poo like this. I doubt you should change delivery people but I would personally do it. Just going to be a bitter taste every time you see the lady.
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Nov 12, 2015 16:00
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n8r, we ran into a similar situation with our birth. The prenatal doctor switched firms right in the middle of our care. I'm not 100% on this, but I think with global billing it all goes towards the same deductible anyway. I'd check with your insurance company. I'm thinking that the payment we made in 2014 went towards our 2015 deductible.
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Nov 12, 2015 16:37
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The change in firm has made the first visits hit our 2015 deductible instead of our 2016. I'd rather spend this $600 on pretty much anything.
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Nov 12, 2015 17:50
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The only positive here is it's only $600. Our healthcare system regularly fucks people for five figures on all kinds of things, including births.
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Nov 12, 2015 17:57
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That sucks, but it's more an artifact of how insurance works than something the practice controls. Everyone plays by silly rules with you trying to game the deductible and the practice trying to maximize what it takes in and the insurance company trying to shift as much of the cost to you as possible. But as someone else said, getting hosed for only $600 is the kindlest, gentlest loving the American health care system has to offer. I genuinely mean that, and it's a sad reflection on how we handle health care.
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Nov 12, 2015 18:02
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Hoo boy, getting hosed on healthcare in the US and it's only going to cost you 600 clams? I mean, it sucks, I get it, but it is usually soooo much worse. Maybe make lots of phone calls and annoy people, maybe someone will fix it before you decide that it's worth $600 to not have to deal with it anymore.
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Nov 13, 2015 04:41
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slap me silly posted:Hoo boy, getting hosed on healthcare in the US and it's only going to cost you 600 clams? I mean, it sucks, I get it, but it is usually soooo much worse. Maybe make lots of phone calls and annoy people, maybe someone will fix it before you decide that it's worth $600 to not have to deal with it anymore. Nah I hit the end of the road on this one. There was this time that United Healthcare denied a hospital stay that would have resulted in a $25k+ bill. Luckily after months of fighting, it went to some sort of arbitration and I got it overturned.
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Nov 13, 2015 07:58
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I worked in insurance for a little while and I'm not claiming expert knowledge but I have two pieces of advice. First always call your insurance company when a provider tells you some crazy stuff like this. Providers are surprisingly terrible at billing things correctly. Most of my time in insurance was spent reviewing claims for insurance plan members and fighting with providers to get the claims re-billed correctly so the insurance would cover it as it should. Providers also have a habit of billing for things that are not the plan member's problem and trying to claim the plan member has to pay for it. This sounds like it might fall under that umbrella a bit. Second it's been awhile but if you call your insurance company ask them about this as it is directly related to pregnancy and pre-natal care the Women's Mandate from the health care reform package should be absorbing some of these costs I'd think. I can't say for sure you'll come out of this any better off then you are now but you have nothing to lose by calling up your insurance company and asking at the very least.
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Nov 13, 2015 14:48
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If she agreed to bill you at delivery ask her why the she is not honoring that promise? Then sue her.
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Nov 13, 2015 15:10
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Brother you're getting the shaft and I agree, $600 is a lot of money. But the fact that you're getting hosed for well under a grand??? Chalk it up as the price you pay for freedom  and move past it. People with insurance get hosed 7 figures+ every day. Just be glad you're all still healthy and can live normally.
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Nov 13, 2015 16:07
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Healthcare in the US  I hate my life
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Nov 21, 2015 00:39
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spwrozek posted:America is great in so many ways How do you figure?
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Nov 21, 2015 14:33
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my health insurance applies out of pocket expenses incurred in 4th quarter against the next plan year as well. Check on that.
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Nov 21, 2015 17:29
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Weatherman posted:How do you figure? I'm trying to figure that out myself. There's only a small number of people getting the benefits of the US economy and the other 90% are getting shafted. Like one of my friends who lives in the US and owes $250k in medical bills (because I have no idea why she didn't have medical insurance). She'll be making payments on that bill for the rest of her life. That said the $600 cost for no reason is terrible.
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Nov 22, 2015 22:28
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Don't be mad at the midwife, she has more than likely zero say in the bill. Instead, there should be a separate billing department that you can contact. After that, there is an appeals department through your insurance.
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Nov 23, 2015 01:12
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Weatherman posted:How do you figure? Cheap bananas courtesy of United Fruit/Chiquita and all we had to do was install a dictatorship! You don't even have to be in the US to get some of the weapons grade dickings that are available, be glad you're not in some CIA black site for having the same middle initial as some guy who once tipped a (suspected) al Qaida recruiter more than 10%. e. Also yeah even with insurance I ended up getting something like 20k+ worth of bills after my wife's delivery because the incompetent fucks at the hospital billed us incorrectly at first, billed us again to fix it, and then billed it in my kids name to remind him how American he is. Took a year and change to fix. Guest2553 fucked around with this message at 12:14 on Nov 23, 2015 |
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Nov 23, 2015 12:07
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NarwhalParty posted:Don't be mad at the midwife, she has more than likely zero say in the bill. Instead, there should be a separate billing department that you can contact. After that, there is an appeals department through your insurance. Nah the midwife is the right one to be mad at. She was the owner of the practice prior to being purchased by the larger community healthcare provider. The only way she could have worked around this is to continue to bill us on her old practice. When she moved to the community healthcare provider, it was the same as moving to a new midwife/doctor.
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Nov 23, 2015 16:59
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Weatherman posted:How do you figure? If you don't know then I can't explain it to you. This isn't the thread to debate about why America is generally a great place to live.
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Nov 23, 2015 21:16
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n8r posted:In just about any other business on this planet, if they make a decision that penalizes their customer through no fault of their own, I would expect some consideration because of it. This is mostly just a rant than anything else. gently caress our medical system. In any other business, the consumer would find another provider and leave a nasty yelp review. They have us by the short and curlies and they know it. edit: love my new av
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Nov 25, 2015 04:24
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spwrozek posted:If you don't know then I can't explain it to you. This isn't the thread to debate about why America is generally a great place to live. It is now. What's there that's (a) great and (b) objectively not available in other better countries?
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Dec 2, 2015 12:56
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Lots of 24 hour restaurants and convenience stores, thanks to the poors.
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Dec 2, 2015 13:37
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...and another mass shooting today. Quite a place you have there.
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Dec 2, 2015 22:30
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Weatherman posted:...and another mass shooting today. Quite a place you have there. You wonder why I am not engaging you... Not at all worth it.
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Dec 2, 2015 22:35
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| # ? Apr 26, 2024 04:11 |
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Weatherman posted:...and another mass shooting today. Quite a place you have there. The bad news is that people died. But the good news is that you got to make lemonade and score some points in an internet argument.
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Dec 2, 2015 23:19
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