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Health Plan Administration/Questions Answered by Expert Linda Woolsteen
| Subject | Date Asked |
| Health Insurance Lab Test Cost Denied | 2/23/2011 |
| 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 doctor | 12/31/2010 |
| 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 doctor | 12/30/2010 |
| 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 ... | |
| misinformation | 10/8/2010 |
| 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/Medicare | 8/21/2010 |
| 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 charges | 3/17/2010 |
| 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 F | 2/20/2010 |
| 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 code | 1/7/2010 |
| 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... | 12/20/2009 |
| 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 C | 11/9/2009 |
| 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 ? | 10/28/2009 |
| 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 plan | 10/24/2009 |
| 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 plan | 10/24/2009 |
| 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 bill | 9/12/2009 |
| 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 state | 7/13/2009 |
| 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 Coverage | 6/29/2009 |
| 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 ... | |
| Cobra | 6/25/2009 |
| 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 coverage | 5/5/2009 |
| 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 routine | 4/27/2009 |
| 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) | 3/26/2009 |
| 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 Industry | 3/25/2009 |
| 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 divorced | 3/5/2009 |
| 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 insurance | 9/23/2008 |
| 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 insurance | 9/19/2008 |
| 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. | 8/25/2008 |
| 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 work | 8/12/2008 |
| 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 insurance | 7/31/2008 |
| 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 hairloss | 7/15/2008 |
| 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 -texas | 7/6/2008 |
| 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 ... | |
| Insurance | 7/6/2008 |
| 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 insurance | 6/24/2008 |
| 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 pregnancy | 5/25/2008 |
| 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 denial | 3/31/2008 |
| 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 ins | 12/4/2007 |
| 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 Screening | 10/30/2007 |
| 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 Denied | 8/26/2007 |
| 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 ... | |
| Lab Test Coverage Denied | 8/26/2007 |
| Q: In January 2006 my oncologist ordered a lab test that was not covered under my insurance policy. At ... A: I do not know Texas Law and I am not a lawyer so I cannot advise of any legal advise. Have you ... | |
| Blue Cross refusing to insure due to existing prescription | 7/19/2007 |
| Q: I recently changed employers. At my previous employer we had Blue Cross HMO coverage for the whole ... A: I just went through the exact same thing myself. I use to have migraines for the last 20 yrs and ... | |
| Health Insurance Coding | 5/18/2007 |
| Q: My wife recently went in for her annual gyno exam. About a month later, we recieved a letter from ... A: Well, there are a couple of things here. HIV test? was this for her employer? Meaning her job ... | |
| Help | 4/5/2005 |
| Q: Pennington, I turn 25 this month and although I am still in graduate school I am about to lose ... A: sorry for the delay. For some reason, I did not get an email that there was a question here for me. ... | |
| health insurance | 3/21/2005 |
| Q: I do small business in California for my own, no employee, I like to know what is the lowest cost ... A: Hey, I sincerely I apologize for not answering sooner. For some reason I do not remember seeing ... | |
| Blue Shield of California plans | 1/20/2005 |
| Q: I need to know if there is value lost or benefits given up if I change from an older plan, ... A: Im not quite sure you meant to ask me this question because I dont know what these plans are that ... | |
| pretax heathcare spending account | 11/19/2004 |
| Q: I am considering signing up for my company's plan that allows me to put money (pre tax) into a ... A: We offer a HSA plan where I work as well. However, we are instructed not to get into the Savings ... | |
| waiting period | 10/22/2004 |
| Q: if a cancer policy has a 30 day waiting period is a person covered on the thirth day? policy dated ... A: Your question had a typo in it, I am assuming you meant the 30th day... I really could not answer ... | |
| Health Insurance | 7/15/2004 |
| Q: I am currently on my husband's health insurance. We are thinking about having a baby and at the ... A: I have to advise that no benefits are ever guaranteed. However, pregnancy cannot be considered a ... | |
| Health insurance | 8/14/2003 |
| Q: My 70 year old Dad is visiting from Africa. He has some medical problems but no insurance. The only ... A: your just looking for health insurance for the 3 weeks that he is here? Or for him to apply while ... | |
| Health Insurance | 6/19/2003 |
| Q: My company is changing our health insurance provider. Should I have to answer all the questions ... A: If you have to prove insurability, then yes, you have to answer the health questions. While I am ... | |
| third party liability | 3/15/2002 |
| Q: my health plan is refusing to pay a claim due to my injury (broken Arm) happened while i was moving ... A: While at your repair facility? By that you mean jus where you usually take your car? or you own the ... | |
| Health insurance claim coding | 9/7/2001 |
| Q: Can you tell me if there is standardization in health insurance claim codes. For instance, my claim ... A: no there is no standardization for denial codes used by insurance companies. Your explanation of ... | |
Health Plan Administration
Answers by Expert:
Linda Woolsteen
Top Expert on this page
Expertise
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.
Experience
Past/Present clients
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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