claims/providers

My daughter was having severe stomach pains while at college so she went to the hospital in Statesboro, GA and they ran some tests, did a CT on the spot, didn’t find anything wrong, and sent her home to follow up with her PCP. We never learned a cause and it hasn’t happened again. Later we got...

Someone explain this to me like I’m five because I’m not understanding. For context: -Insurance is UMR -My plan year runs from July 1-June 30 -OOP Max for family is 6,000 and deductible is 1450 for Tier 3 benefits - 65/35. Had to go w/Tier 3 because we moved in the middle of my pregnancy and...

(Crosspost from r/Insurance) I have Empire BCBS PPO 250 through my job. Ok. So. I’m in a confusing situation here and could really use help figuring out whether my Doctor is secretly overcharging me, why insurance hasn’t reimbursed me after hitting my deductible seemingly months ago, etc. This...

What’s going on?? Is this normal? I’ve paid a couple of times to settle whatever adjustments or things they said insurance didn’t cover. Was told that’s it, you paid off everything. I check my account online and it says I owe them $300. WTH? What steps do I take to find put if I’m being...

Hi, I recently had an ER visit for what we thought what was a ruptured appendix. The hospital we went to was in our network. The appendix wasn’t ruptured after testing & I did not stay the night in the hospital. I received an MRI, a few medications, an ultrasound, & some blood/ lab work. I...

Hi, I’m confused with bills I received and any comment will be appreciated. I had anthem PPO with $1k deductible remaining. I was pregnant and saw a in-network provider. Just regular in office covered visit. They were all paid by the plan. Example below. All the bills last year were paid by the...

What is a "complex E/M visit add on"? We have Meritain/Aetna and this was billed in addition to an "Office O/P Est low 20 Min Must Be met our exceeded". This is for an in network doctor's visit. Our insurance said they won't pay it because it's an administrative charge. The clinic said we need...