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The Water Cooler
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Medical Insurance Frustration
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<blockquote data-quote="Davs2601" data-source="post: 2593789" data-attributes="member: 6772"><p>We are currently having issues with our two medical insurances and I need some advice on who to talk with.</p><p></p><p>We have two health insurance policies Wife = Health Choice, Me = Blue Cross Blue Shield Fed</p><p></p><p>Son had tubes put in on May 2nd and we received a bill for $700. The primary (HC) paid $900 then BCBC paid in $200 to bring it up to their max allowable ($1100) for the procedure. BCBS says this is correct and the surgery center is saying they are wrong and should pay the full amount up to $1100 which would cover the balance of $700</p><p></p><p>I have had lengthy discussions with them both and I'm not getting anywhere, but one of them appears to be lying about the situation. One of two things should happen, the surgery center accepts the $1100 max allowable charge regardless of 1 or 2 insurance policies or BCBS should cough up more $. I have them as a full blow secondary insurance and not a supplemental insurance. I pay my premiums so that they cover XX% of procedures.</p><p></p><p>My daughter had tubes put in in 2009 = No Charge to us</p><p>My wife gave birth to my son in 2013 = No Charge to us</p><p></p><p>Not sure what has changed since I am still using a provider that is "In Network"</p><p></p><p>Any advice or know who I should talk with?? If I owe Ill pay my debt, I just feel this is being processed improperly and the two sides can get on the same page.</p></blockquote><p></p>
[QUOTE="Davs2601, post: 2593789, member: 6772"] We are currently having issues with our two medical insurances and I need some advice on who to talk with. We have two health insurance policies Wife = Health Choice, Me = Blue Cross Blue Shield Fed Son had tubes put in on May 2nd and we received a bill for $700. The primary (HC) paid $900 then BCBC paid in $200 to bring it up to their max allowable ($1100) for the procedure. BCBS says this is correct and the surgery center is saying they are wrong and should pay the full amount up to $1100 which would cover the balance of $700 I have had lengthy discussions with them both and I'm not getting anywhere, but one of them appears to be lying about the situation. One of two things should happen, the surgery center accepts the $1100 max allowable charge regardless of 1 or 2 insurance policies or BCBS should cough up more $. I have them as a full blow secondary insurance and not a supplemental insurance. I pay my premiums so that they cover XX% of procedures. My daughter had tubes put in in 2009 = No Charge to us My wife gave birth to my son in 2013 = No Charge to us Not sure what has changed since I am still using a provider that is "In Network" Any advice or know who I should talk with?? If I owe Ill pay my debt, I just feel this is being processed improperly and the two sides can get on the same page. [/QUOTE]
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