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  1. J

    Copays, Deductibles, OOPs and WTF is Happening Here?

    @jane_ Oh I have like 6 of varying expense 😆😭 there's a spreadsheet. The charges aren't even consistent. Oi. I didn't even think to call HR. I did email her yesterday and let her know that we're having some billing problems related to the kids and asked for a scan of our our original...
  2. J

    Copays, Deductibles, OOPs and WTF is Happening Here?

    @jane_ If this is what my plan says: PHYSICIAN OFFICE-OUTPATIENT VISIT AND CONSULTATION A primary care doctor for plans such as PPOs, EPOs, and HDHPs, where you don't have to select one at the start of your plan You can expect In Network 0% Copay: 35 Dollars Apply Only 1 Copayment, per Date of...
  3. J

    Copays, Deductibles, OOPs and WTF is Happening Here?

    @jane_ We have a couple that they've been trying to get paid for since March. Insurance and billing are definitely a sunk cost business. Even at federal minimum wage (7.25/hr) you can only work on a $73 claim for 10.06 hours (completely ignoring employment taxes and employee healthcare and the...
  4. J

    Copays, Deductibles, OOPs and WTF is Happening Here?

    @jane_ Oi well nothing like a little light reading in the evening. Our benefits book is sitting next to me I had a feeling I was going to need to read it again. Thank you!
  5. J

    Copays, Deductibles, OOPs and WTF is Happening Here?

    @charmaine93 I don't know. I'm in uncharted territory here having a routine office visit at the primary, in network, care provider be charged above the copay. I have a PPO from the same company my copays are less and my OOP is lower and all I ever pay is my copay. My husband sees the same PCP I...
  6. J

    Copays, Deductibles, OOPs and WTF is Happening Here?

    @catalystsocial AFAIK it's a $500 deductible for the 2019 benefit year. I have to call HR but someone died yesterday that works there so I'm going to wait until the end of the week. It's not like the health insurance shenanigans can't wait a few more days
  7. J

    Copays, Deductibles, OOPs and WTF is Happening Here?

    @resjudicata I have an email out to them with all the claims that are messed up. I tried resolving it on the phone but I like an electronic paper trail to follow. We have lab work on one of them we owe a whopping $3 on that. 🤣 EOB linkage...
  8. J

    Copays, Deductibles, OOPs and WTF is Happening Here?

    @resjudicata No they're listed in network and are selected as the preferred provider for the kids. It's so odd. We just switched to this PPO plan from his employer from another PPO plan with the same company just a slightly different rate structure on the copays and deductible and it's been...
  9. J

    Copays, Deductibles, OOPs and WTF is Happening Here?

    @inspiredwalk I'm guessing I'm reading our benefits information/explanation for office visits incorrectly? We have a PPO this is directly from our plan site. PHYSICIAN OFFICE-OUTPATIENT VISIT AND CONSULTATION A primary care Pediatrician for plans such as PPOs, EPOs, and HDHPs, where you don't...
  10. J

    Copays, Deductibles, OOPs and WTF is Happening Here?

    @inspiredwalk The EOB I copied above is a routine med check for ADHD meds
  11. J

    Copays, Deductibles, OOPs and WTF is Happening Here?

    @buildfaith777 Link to benefits summary: https://drive.google.com/file/d/1eZof55wf7eg_lImZoIhQ_rXV34R12isr/view?usp=drivesdk
  12. J

    Copays, Deductibles, OOPs and WTF is Happening Here?

    @buildfaith777 I edited and added a drive Link to a redacted EOB 🤦 sometimes I forget people can't just see into my brain. 😆🤷
  13. J

    Copays, Deductibles, OOPs and WTF is Happening Here?

    Our health insurance plan is killing me. Like I’m dropping them for the other plan my husbands company offers when open enrollment comes killing me. THIS IS ONLY HAPPENING ON OUR KIDS VISITS TO THEIR PRIMARY CARE DOCTOR. I know yelling I’m so frustrated. One of us takes a kid to their PCP...
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