| Subject | Date Asked |
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| Old medical bills | 5/5/2009 |
Q: I'm getting doctor bills from 3 years ago I've never been late with my doctor bills. I don't have a ...
A: I am not sure I understand, have you already paid these bills? If yes,do you have a copy of the EOB ...
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| Breast Reduction | 4/17/2009 |
Q: Hey, I'm a 16 year old athlete, marching band member, and piano player with avid back problems due ...
A: It would help if you have a medical of the problms. Such as prior doctor visits to a doctor for the ...
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| How do I get My daughter's wheelchairs covered? | 1/26/2009 |
Q: I have Blue Cross Blue Shield HMO thru my husband's insurance. We live in Illinois and he works for ...
A: I am really sorry about your daughters condition. Unfortunately, I have never seen great coverage ...
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| HMO, PPO Payout | 1/23/2009 |
Q: What are the differences for reimbursement with HMO, and PPO for simple procedures that would be ...
A: It depends on the plan coverage that you have. The HMO has maybe nothing for you to pay or very ...
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| Preauthorization | 1/8/2009 |
Q: If insurance denies a claim for orthognathic surgery does that mean that they refuse to pay for any ...
A: It does most likely mean that would not cover any of the bills. However, maybe the provider they ...
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| Co-pays | 1/3/2009 |
Q: My wife and I are covered by my employer insurance as primary and medicare as secondary. We have a ...
A: I can't explain it. It is not right, I don't know why they don't do it right. You could try ...
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| emergency room billing | 4/17/2008 |
Q: We received a separate bill from an emergency room physician for $528. Our insurance co (blue ...
A: That is not unusual that the ER doc is not contracted with the insurance carrier and it doesn't seem ...
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| workmans comp vs private insurance | 4/11/2008 |
Q: I injured myself in the state of Mo. I found out through an MRI i have degenerative joint disease of ...
A: You have to tell the insurance upon enrollment if they ask. They will see the history in your ...
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| Out of Network Coverage | 3/25/2008 |
Q: My mother wants to have an operation done by a surgeon who accepts her insurance (UPMC); however, ...
A: That is very hard to do. The hospitals in the Network give the insurance a substantial discount and ...
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| Medicare related | 2/6/2008 |
Q: I am 50 and on SS Disability and my husband's employer provides my health insurance coverage. I am ...
A: When your husband retires he will lose his health coverage as an active employee. I have no idea ...
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| pre-existing in the state of Texas | 2/4/2008 |
Q: My employer recently changed insurance. The policies are individualized by employee, and rates apply ...
A: You are protected by a Federal Law called HIPAA. They are supposed to take into consideration the ...
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| emergency room denial | 1/31/2008 |
Q: i went to the ER due to a golf ball size pimple on my lower back. when i was finally seen by the ...
A: I would have to look at their coverage book to really figure it out, but they are probably ...
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| insurance overpayments | 1/28/2008 |
Q: Cherille, If a secondary carrier overpays on a claim we submitted, I understand that in Tennessee, ...
A: Did you adjust the charges to the amount that the insurance company allows? If so, the proper ...
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| deductible | 1/10/2008 |
Q: a couple years ago, my pediatrician's office told me they were collecting my entire deductible on ...
A: That is not the normal way that physician office's do it, but I guess it is their practice. When ...
|
| change health insurance | 12/17/2007 |
Q: I currently purchase my own health insurance and insure myself, my spouse and my daughter for $385 ...
A: How long have you had the prior insurance, if it is longer than the pre-x time on the new insurance, ...
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| 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: I think you should stick it out in your job until your follow up appointment. If you are fired, pay ...
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| DOUBLE INSURANCE | 11/6/2007 |
Q: I have medical coverage for myself and my wife under covered through UHC PPO plan which is through ...
A: The advantage to having dual coverage is that the insurance companies will coordinate benefits and ...
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| lap band | 10/26/2007 |
Q: My insurance (United Healthcare self funded through a Fortune 500 company) specifically excludes any ...
A: Generally when the design the policy coverage and specifically exclude a condition, there is no way ...
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| PPO Question | 10/3/2007 |
Q: Last October I had a procedure performed (Breast Reduction)which was pre-approved through my ...
A: Did you get a written response from UHC stating the dates that the doctor was in the plan? If yes, ...
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| Medicaid cancelled | 9/14/2007 |
Q: I was on HMO Medicaid while pregnant with my daughter and I delivered on March 6, 2007. I was told ...
A: I checked and the Federal Laws I was thinking of apply to "group insurance" and how they cover ...
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| Medicaid cancelled | 9/13/2007 |
Q: I was on HMO Medicaid while pregnant with my daughter and I delivered on March 6, 2007. I was told ...
A: Maybe you would need to reapply for the Medicaid. It sounds like you should be qualified. There ...
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| medicaid debt/lien | 9/11/2007 |
Q: Our now deceased, and long estranged, father told my sister that if she'd move from Alaska to ...
A: He probably never put the house in her name, right? Because if it was her house, I don't see how ...
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| hi | 8/25/2007 |
Q: "went to a doc in ny for initial visit doc drew blood and also gave b12 shot and total visti time ...
A: I do not think he should charge for work not done. I believe the payment from Medicare is based on ...
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| adjustments | 8/22/2007 |
Q: I AM NEW WITH MEDICAL BILLING AND OUR SYSTEM I SEE PATIENTS HAVE TWO INSURANCES, THEY ONLY BILLED ...
A: Like I said I am not familiar with this. If the agreement is that the doctor accepts Medicare, then ...
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| adjustments | 8/21/2007 |
Q: I AM NEW WITH MEDICAL BILLING AND OUR SYSTEM I SEE PATIENTS HAVE TWO INSURANCES, THEY ONLY BILLED ...
A: I am not sure of the situation with Medicare and Medicaid, I think what you are doing is correct (to ...
|
| No Insurance | 8/6/2007 |
Q: I have had 4 heart attacks. It has been about 11 years since my last heart attack. I have been ...
A: I am very sorry that you are having these problems. I do not have a good answer for you. But I ...
|
| hip replacement surgery coverage denied | 7/19/2007 |
Q: My aunt recently had hip replacement surgery. At the time of the surgery, the insurance company ...
A: She should also file an appeal with the insurance company if she has not already. She needs to get ...
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| Breast Reduction | 7/17/2007 |
Q: My mom and I have been trying sense I was 15 to get a breast reduction, I'm 5'1 i weight 145 an i am ...
A: You can appeal their decision and try again to get them to cover the surgery. Make sure that you ...
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| United Healthcare HMO | 5/31/2007 |
Q: I am considering a new job. I currently have Aetna PPO and always have had PPO plans. The new ...
A: The PPO that you are used to has a greater choice of providers that you can choose. The HMO will ...
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| health coverage | 1/4/2007 |
Q: Im hoping you can help. I am trying to find a GOOD health coverage plan. I am 52. I have done some ...
A: I think the answer is in easy to understand. You will have to pay out $5,000. of your own money for ...
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| Gap in- network | 11/9/2006 |
Q: My husband went to the er on sun for severe back pain. They gave him pain pills but did not do any ...
A: I am sorry, I really don't know the answer. Different states have different laws regulating HMO's ...
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| Benefit excluded | 9/21/2006 |
Q: I have a PPO (Statewide Cooperative Health Insurance Plan)which is managed throught empire blue ...
A: I am sorry that you have had such an experience. It is common that air ambulance is not covered, or ...
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| PPO/HMO Coordination of Benefits | 8/1/2006 |
Q: My wife has Blue Cross PPO with a high deductable. I have HealthNet HMO coverage for myself and my ...
A: I think she can just use the Health Net HMO. Maybe I am wrong, just try and make an appointment ...
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| deductable | 7/23/2006 |
Q: I went to the hospital for a procedure and when I registered I found out that because my deductable ...
A: Usually the routine well visits are under a special benefit and do not go to the deductible. You ...
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| HMO coverage out of network | 6/29/2006 |
Q: I have been suffering from a ruptured disc and out of work for over one year. I have been bounced ...
A: You can fight the HMO and request coverage. Present all of your medical history and information and ...
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| Pre-exiting conditions | 4/11/2005 |
Q: Cherille, I have been between jobs but hope to start work soon with a large corporation with good ...
A: if you have been with out coverage for over 62 or so days, the condition would be pre-existing if ...
|
| Dear Cherille Shelp,
According... | 3/27/2005 |
Q: According to my policy HI policy, they are supposed to pay 80% of my health insurance costs. But, ...
A: You need to read your plan booklet carefully. Are they covering usual, reasonable, and customary ...
|
| 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: Since it is just for yourself it would probably be individual insurance. Perhaps you could join an ...
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| HIPPA and HSA | 2/1/2005 |
Q: 1) Is it possible to combine a HIPPA plan with an HSA. 2) How high does the deductible have to be ...
A: All medical health plans are regulated by HIPAA. HIPAA guarentees that you will be able to get ...
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| HMO experience related | 1/26/2005 |
Q: Please define this and tell me the pros and cons to having this type of plan.
A: I don't quite understand the question. However, an HMO is a medical plan where you have to go to ...
|
| orthognathic surgery | 11/8/2004 |
Q: I just found out that I may need jaw surgery (set the mandible back) in order to correct my ...
A: I can not be sure how Blue Shield would think, but something that would seem medically necessary ...
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| Floridas health insurance | 11/1/2004 |
Q: I need to purchase a health insurance for my wife and my 10 year old son. We live in Orlando ...
A: I am sorry, I don't know about how to get good insurance at a reasonable cost. But, an HMO is a ...
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| HIPPA | 6/24/2004 |
Q: I am currently on COBRA and wish to switch to a new plan outside of my old employers insurance. I ...
A: Insurers are obligated to honor past coverage to apply toward pre-existing provisions and they need ...
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| disabled and being forced onto Medicare Part B by primary insurance | 5/21/2004 |
Q: My husband is disabled and has been covered for 12 years by his primary insurance company - ...
A: it sounds like you have enough troubles. You didn't mention when your husband last worked. There ...
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| insurance? | 3/4/2004 |
Q: I am in need of some advice. I will be starting a new job this month. I am a bit confused regarding ...
A: All of the HMO's are good companies to the best of my knowledge. Check the co-pays and deductibles ...
|
| exhausting lifetime Dollar amount | 3/1/2004 |
Q: I am a 61 year old male who had two heart valves repaired 8 Months ago in open heart surgery. At ...
A: First, you can file an appeal with the insurance company requesting review of your maximum benefits. ...
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| health insurance | 9/27/2003 |
Q: I am debating the question, "Should businesses provide employees with health insurance?" in my ...
A: I do not study economics, but here is my personal opinion. If more employers would sponsor the ...
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| Dental Insurance. | 5/30/2003 |
Q: I am a 30yr married professional based here in southern California. Right now I don't have either ...
A: 1. An HMO is a plan where you must go to specific providers. HMO coverage is usually the less ...
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