 Can you please help me with this question on probability? |
| an insurance company reckons the probability of an accident occuring during the year is 0.1 for a low risk person and .35 for a high risk person. 25% of the customers are low risk and the rest are ... |
|
 Which company has the best *TERM* life insurance quotes for people over 50 ? |
Obviously, people over 50 years old will pay a high premium--but is there a company out there that won't "soak the customer" , and at the same time are a reputable company ?
... |
|
 What health insurance is recommended for a single dad with 3 kids, with a budget but have decent coverage? |
| I am a single father of 3 kids and looking for health/dental/vision insurance for my family. We don't really go to the doctor as much but still want decent coverage in case I need to do so. Any ... |
|
 I feel down a flight of stairs at work. Is this considered worker's comp? |
| I wasn't seriously injured. i have scrapes and bruises and had x-rays done, but nothing was broken. Is this a worker's comp case?... |
|
 HELP ME!! URGENT!? =:( Please!!? |
| I've not had a car for a few days, and I've been driving my grandpas, well he found me a new car, and he's going to buy it for me (I'm going to pay him back) He's going out ... |
|
 What happens if your tv license direct debit payment is cancelled? |
| Had trouble with my bank and had to open new account and cancel all my direct debits including tv license does this mean i will have to buy a whole new tv license?? (i am currently on the quartly ... |
|
 Can you choose to pay solely with cash instead of using insurance at the doctor's? |
I'm 18 and I need to go the doctor without my parents knowing (without it showing up on the insurance or bill). I have plenty of money to pay but will doctor's agree to do this?
A... |
|
 Can an insurance company use the fact that I had an HIV test as the basis for increasing my premiums? |
| I heard through the grapevine that someone from GB was in the U.S. and had a mandatory HIV test. My understanding is that subsequent to the test (and independent of the result - the test was ... |
|
 Life insurance? |
my husband and i have been talking about trying for our second child in the next year and i have a question. we are only 21 and make about $60,000/yr.
im wondering about life insurance. i am a ... |
|
 In the state of Ohio, how can I insure a house and property that is still deeded to my deceased grandmother? |
| We have a house and acreage that is still in my long deceased grandmother's name. There are 8 kids in our immediate family and nobody wants it solely in their name, as it would be unfair to the ... |
|
 Why would people want to put their savings in life insurance? |
| And when they want to take it out, its not a withdrawal but a loan? What kind of insurance scheme is this?... |
|
 Insurance claim? |
After I bought my flat in April 2006, I discovered that the left hand side upright of my bay sash windows is rotten.
When making the enquiries for some quotes to get the window repaired, I... |
|
 What is better universal or term life insurance |
| could someone give me the pros & cons on both?... |
|
 Will home owners insurance pay to replace windows? |
| My windows are really, REALLY old in my house and I heard that home owners insurance might pay for it. Is there something in particular that I need to say?... |
|
 Just married and I need insurance for me and my wife? |
I just got married. Im 19 she is 18 and we need health insurance because she is prone to getting UTIs.
I have no idea what to do for heath insurance. I make about $1300 a month. I dont want to ... |
|
|  |
yaojun s | If insurance rejected claims from a hospital and the hospital sent bill to me, what should I do? |
my son had a operation in a hostpital in the insurance network. But some of the hospital claims were rejected by the insurance saying the providers are not in the network. The hospital is in the network, I don't understand why insurance says the provider is not. So, what will be my steps to resolve the issue? Certainly, I believe it should be the issue between the hospital and the insurance company.
Thanks, |
 |
 
steffo
|
Contact your insurance company. This is a very common problem the anethesiologist or pathologist were prob. not contracted with the insurance company. So explain to them that this is out of your control, and as long as the insurance company was notified of your procedure before the surgery it really shouldn't be a problem. |
|
Mom madness
|
The hospital may indeed be in network but the physicians have to have a contract with the insurance as well in order to get paid. What type of insurance do you have. Try calling the insurance to get help or try calling the Dr.'s office that was out of network and work something out with them. Unfortunately its up to the patient to make sure services and doctors are covered under your plan. You are ultimately liable for the bill. Good luck. If you need more help on this or some insight send me a message |
|
malaysiainsuranceguide
 |
Find out from the insurance company on 'How they inform the policyholders if there are changes in the hospitals network'.
If you are not satisfied with the reason given to you, find out your 'Consumer Rights' and negotiate with the insurance company. If this way cannot solve your problem, then you can seek help from the Related Goverment Organisation which is handling dispute between consumer and healh insurance claim. |
|
blaquechyna1
|
Don't leave it up to the insurance company and the medical provider to sort things out. They will take months to years to resolve this problem. You need to be take the initiative to resolve this issue. If you have any supporting documents that the hospital is in the network, provide it to your health insurance. The person at the insurance company may have over looked that fact and send a form letter stating the claim is rejected. Provide them the provider's code number and make sure the insurance was in effect at the time the provider rendered their medical services to you. Contact the hospital and get them involved. Don't ignore their letters. Make them help you solve the problem. If a customer service is giving you a hard time, get a supervisor. As an incentive, tell them "look if you want to get paid, I need your assistance." Emphasize they will not get paid unless they make ssome effort. Make the hospital aware of this problem. That will slow down the process of sending you to a collections agency. If the insurance company change their provider network prior to your medical treatment services and did not notify you of this change, they should (not that they will) pay for your medical bills. If there is a co-payment, you should go ahead and payment. It shows good faith in attempt to paid the bill in full. Be sure you make both the insurance company and the medical provider aware of this problem. Follow up with the them and get the hospital involved to put more pressure on the insurance company for payment. Good luck. |
|
Judy1
|
It's very common for doctors to have privileges in multiple hospitals, and for a hospital to be in your insurance network but a doctor who might have priveleges there not to be in network.
I'd contact the insurance company or check your contract to see if ANY benefits are paid for out-of-network providers - sometimes partial payment is given, usually with a higher deductible.
If not, you're likely legally responsible for the additional sums. I know this isn't what you wanted to hear. Many people aren't aware of this possible situation, and don't check ahead of time to see if everyone who will be involved is covered by their insurance.
Usually the doctors bill separately from the hospital bill. You say "some of the hospital claims were rejected" - were those bills that actually came from the hospital, or from somewhere else like from a doctor's practice? If the bills were directly from the hospital, you might have an arguing point. If they came from a doctor who is not in network, then you're likely responsible for the payment.
Good luck. |
|
James
|
1) Notify your insurance company that the hospital sent you a bill.
2) Use the bill as toilet paper. |
|
F T
|
I would call the insurance company to see what providers are in network for the hosipital, and then check with the hospital to see why they weren't used. It may be the hospital's fault for not chosing the right doc per your insurance coverage. |
|
mbrcatz
 |
Well, it's not. The insurance company is the third party, paying on behalf of the hospital. But don't panic, this is actually usually pretty easy to resolve. Here's what you do:
1. With the claims rejection form in front of you, call the number on the back of your insurance card, and tell them that you have these rejection forms - if the procedures were done at an in network hospital, all the employees working at that hospital should be considered "in network". BE SURE TO WRITE DOWN THE NAME OF THE PERSON YOU TALK WITH, and the date and time of the call.
2. They "should" either say, oh, yes, we're resubmit the bill, this should be covered, OR give you a more clear explanation about why a procedure performed at an in network hospital is not considered in network. In either case, take notes. But I'd expect they'll resubmit, and send payment out.
3. Also, call the billing office at the hospital, tell them to note your file that the insurance company is reviewing the charges, and are expected to pay. That should buy you a little time. |
|
sacayouette
|
You will need to demand that the insurance company show how they are not responsible for these claims.
You may find the insurance company will require you to pay them and then be reimbursed later. Not every department in a hospital is owned by the hospital so they may not take payments from your insurance company.
If you are not satisfied with the answers you get a letter to your state insurance board will be the next step (explain what happened and what you have done to try to resolve it.) You will need to include copies of all bills (paid or not) and copies of all letters you send to the insurance company.
If that doesn't get you anywhere (about a 50/50 chance it will) you will need to see a weasel, (Umm lawyer) for breach of contract. |
|
| |
|
| | |
| Questions List |
Answers | Last Post
| | | |
7 | 18 minutes(s) ago
| | | |
9 | 45 minutes(s) ago
| | | |
10 | 2 hour(s) ago
| | | |
10 | 7 hour(s) ago
| | | |
10 | 2 day(s) ago
| | | |
9 | 5 day(s) ago
| | | |
10 | 1 week(s) ago
| | | |
10 | 2 month(s) ago
| | | |
10 | 4 month(s) ago
| | | |
10 | 7 month(s) ago
| |
|
Homepage 
Financial
Forum 
Insurance 
No Spam
Adult 
Gambling
Unfinished
Deception
Plagiarism
Not English
