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Health Plan Administration/Questions

SubjectDate AskedExpert
cost of surgery8/6/2011Gail Nowacky
  Q: My apologies if this is out of your expertise, but could you tell me what kind of prices are for ...
  A: I can surely help you research this. If you would be kind enough to email me directly, I would ...
letter stating no longer on insurance7/13/2011Gail Nowacky
  Q: I am retiring; going on Medicare so will no longer be carrying the HealthPartners insurance as of ...
  A: Have you submitted a termination notice to HP yet? If not, I suggest that you let them know you are ...
out of network lab charges5/27/2011Gail Nowacky
  Q: After a recent pap test I received a bill for the lab work. I called my insurance company to find ...
  A: Provider contracts require a physician to use in network labs. If your GYN used a non participating ...
Health Insurance Lab Test Cost Denied2/23/2011Linda Woolsteen
  Q: My doctor recently ordered a routine blood test as a part of a routine exam. I visited a lab in the ...
  A: I am assuming you have a PPO Plan and not a HMO like Kaiser. Ultimately, it is your responsibility ...
Recieve innetwork benifets for out of network doctor12/31/2010Linda Woolsteen
  Q: I was told by my Daughter's insurance (BC/BS PPO) to write a letter requesting in-network benefits ...
  A: The facility itself would either be in or out of network and would have nothing to do with the ...
Recieve innetwork benifets for out of network doctor12/30/2010Linda Woolsteen
  Q: I was told by my Daughter's insurance (BC/BS PPO) to write a letter requesting in-network benefits ...
  A: I would write on the top in big, bold, letters, "PREDETERMINATION" so it goes to the correct ...
misinformation10/8/2010Linda Woolsteen
  Q: My health insurance provider informed me that I need to change from an individual plan to a family ...
  A: Sorry for the delay. Additions of newborns was actually done by another department at our company ...
Michigan coverage of BCBSFL/Medicare8/21/2010Linda Woolsteen
  Q: I will call BCBSFL on Monday, but I've always gotten great answers from All Experts. My mother has ...
  A: Some of the PPO networks now are national meaning you are able to find providers (doctors, ...
Office visit charges3/17/2010Linda Woolsteen
  Q: Can a doctors office charge you for an office visit fee when all that you are getting done is ...
  A: It is kind of like when an appliance repairman comes out to your house. He usually charges you for ...
deductable for plan F2/20/2010Linda Woolsteen
  Q: I am about to buy a High Deductible Plan "F" medigap policy. The Deductible is $2000. Is that ...
  A: Sorry, I never really worked with Medicare, Medicaid, Medigap type policies. I like to follow the ...
dx code1/7/2010Linda Woolsteen
  Q: What ICD9 code should be used to bill for Liver Function Screening to evaluate patients liver ...
  A: Sorry, for the delay. Computer wasn't working very well. I am not a coder so I really cannot ...
COBRA for divorced spouses...12/20/2009Linda Woolsteen
  Q: I wondered if you know what rights a divorced spouse of a beneficiary under an employer paid ...
  A: Usually, under eligibility requirements of the policy it is stated An eligible Dependent is: the ...
Hep C11/9/2009Linda Woolsteen
  Q: I have a question. I was exposed to the hepatitis c virus.(I found that out 6 years ago). I test ...
  A: As far as I know, Hepatitis C is an automatic decline. I have not worked for a health insurance ...
Lapse in coverage ?10/28/2009Linda Woolsteen
  Q: I have Blue Cross of Ca. medical insurance and have had it for 25 years. I was recently late with my ...
  A: I apologize for the lateness of my reply. I had some medical issues of my own this past week and ...
quesiton about coverage and short term plan10/24/2009Linda Woolsteen
  Q: My husbands employer went backrupt in July 09. He lost his job. We believe his insurance through ...
  A: All I know is that the company I worked for would not accept a CCC from an Individual Policy for ...
quesiton about coverage and short term plan10/24/2009Linda Woolsteen
  Q: My husbands employer went backrupt in July 09. He lost his job. We believe his insurance through ...
  A: When you go from one plan to another, you want to obtain your CCC (Certificate of Creditable ...
Primary refuses to pay hospital bill9/12/2009Linda Woolsteen
  Q: I am covered by UnitedHealthcare federal employees health benefits program as my only primary health ...
  A: I sincerely apologize for not replying sooner. I was not able to log into the site for some reason. ...
use of medical card in different state7/13/2009Linda Woolsteen
  Q: my son is going to spend the rest of the summer with his father in virginia. i live in ohio and am ...
  A: All depends on what type of policy you or his father has that he is insured under. Do you have MMO ...
Out-of-Network Coverage6/29/2009Linda Woolsteen
  Q: I bought a high deductible plan from Aetna making sure it had maternity coverage and that my wife's ...
  A: well you sound like you understand quite a bit, your asking all the right questions... most people ...
Cobra6/25/2009Linda Woolsteen
  Q: I am in California. Went on Cobra Nov '06 and then Cal Cobra around May '08. It is due to expire on ...
  A: Sorry, I just know the basics of COBRA but don't feel I have enough information to answer this ...
notification of end of coverage5/5/2009Linda Woolsteen
  Q: I am recently divorced. My XH has kept me on his health insurance plan the past year. This year his ...
  A: I am not sure if I will be of any help on this one but I am going to advise of what my personal ...
plan denied lab tests as routine4/27/2009Linda Woolsteen
  Q: My daughter takes medication for eplipsey and sees her neurologist every six mos. He does a blood ...
  A: The doctor's office must have submitted the bill with a "v" code which is routine, as the diagnosis ...
Recession and Health Industry (2)3/26/2009Linda Woolsteen
  Q: Woolsteen, I am sorry to bother you again. I am very interested about what you wrote about the ...
  A: I don't think I can offer to much on the Long Term Care plans. I personally "think" and it is just ...
Recession and Health Industry3/25/2009Linda Woolsteen
  Q: my name is Baris. Would you please tell me about the problems that health industry faces because of ...
  A: Well I do not think I can subjectivly answer that question because I am no longer working in the ...
health insurance once divorced3/5/2009Linda Woolsteen
  Q: I've been divorced for approx 1 yr (12/07). For the past 8 yrs I have had health insurance through ...
  A: well the most likely went along & let you stay on because it is already a "Family" plan, just like ...
health insurnce coverage once divorced3/5/2009Gail Nowacky
  Q: I am recently divorced after 22 years of marriage (12/07) For the past 8+ years I have been covered ...
  A: You must meet the eligibility requirements of his health plan to be covered and if you don't meet ...
Health insurance9/23/2008Linda Woolsteen
  Q: My husband and I have been seeing a Dr. that is out of our network, in the past we were able to have ...
  A: sorry I do not have much experience with HMO's. When the providers contract with HMO's/PPO's it ...
catastrophic health insurance9/19/2008Linda Woolsteen
  Q: I have a 23 year old son in college who is no longer covered by our health insurance - United Health ...
  A: I tried to take a look at some of those policies through American College Student Assoc. But, it ...
Pregnancy W/personal health coverage.8/25/2008Linda Woolsteen
  Q: My husband and I are expecting a new baby. I personally have been searching for a better insurance ...
  A: Gosh, I have never seen an applicant be turned down for coverage due to pregnancy, at least the ...
lab work8/12/2008Linda Woolsteen
  Q: I need to have some blood work done, and have no insurance. I do have a prescription and have ...
  A: Sorry, I don't know of anything. I never really saw anything else than the normal labs used with ...
health insurance7/31/2008Linda Woolsteen
  Q: I just recently started a new job and am eligible for enrolling in the healthcare benefit plan. My ...
  A: Sorry, I don't think I am going to be of much help. I just found a Dental Policy that I think is ...
Insurance codes for hairloss7/15/2008Linda Woolsteen
  Q: Chemotherapy lupis,burns and all other hairloss codes. Thank you Gloria gigiaah@yahoo.com
  A: You probably want a coder for that. Usually, wigs, alopecia, hair loss are non-covered by most ...
health insurance-open enrollment -texas7/6/2008Linda Woolsteen
  Q: Myself and my husband are soon migrating to become permanent residents of Texas as beneficiary of ...
  A: so sorry for the delay. We had the 4th of July Holiday and then I had someone harrassing me from ...
Insurance7/6/2008Linda Woolsteen
  Q: Sorry for a longish question. Myself and wife are beneficiary of I-130 filed by our daughter who is ...
  A: Sorry for the delay. I though your question was actually the same as another I had & I thought you ...
MD office does not take my insurance6/24/2008Linda Woolsteen
  Q: Our insurance co. changed as of June 1. My 2 daughters saw the MD on June 2, gave the office their ...
  A: I am sorry, but yes, you are responsible. It is up to the Insured to make sure that their providers ...
Pre-existing condition and pregnancy5/25/2008Linda Woolsteen
  Q: I am a contract employee and I am not covered under any company benefits packages. I bought a ...
  A: Pregnancy cannot be considered as a Pre-Existing condition per Generally Most State laws. So, I ...
insurance denial3/31/2008Linda Woolsteen
  Q: my wife was pregnant with twins last year and was seeing a materno fetal medicine specialist in ...
  A: When you appealed, did you actually write on your letter "APPEAL DEPT"? Sometimes just a customer ...
health ins12/4/2007Linda Woolsteen
  Q: I currently have Anthem-Matthew Thorton Blue through the company that I work for. I've been at the ...
  A: Yes, you are correct, COBRA can be expensive. Sometimes all they have to offer you is a similar ...
Coding Liver Function Screening10/30/2007Linda Woolsteen
  Q: What ICD9 code should be used to bill for Liver Function Screening for patients on high risk ...
  A: I cannot advise what code to use. But, I can tell you that the way we (as an Insurance Company) ...
Lab Test Coverage Denied8/26/2007Linda Woolsteen
  Q: In January 2006 my oncologist ordered a lab test that was not covered under my insurance policy. At ...
  A: I apologize for not replying to your follow up. I had never seen or had one before on this site so ...

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Health Plan Administration

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Linda Woolsteen

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I can help you with questions about health insurance. If you feel your insurance company is mistreating you. Are they telling you they are checking eligibity, pre-existing, etc. Or you just don`t understand how your insurance works or don`t understand what a PPO is.. I can help you.

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One company I worked for I was the underwriter for the Academy of Medicine of Cleveland and the Ohio Bar Association. I was also a supervisor of our customer service department.

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