In reply to mtn:
That's the whole desirable "undecided vote" both parties are always going after.
Nickelback has a chance to steal that vote...
In reply to mtn:
That's the whole desirable "undecided vote" both parties are always going after.
Nickelback has a chance to steal that vote...
Appleseed wrote:
Have you ever actually tried to watch that show? It is 30 minutes of that with people screaming, 8 minutes of screaming to where you can't hear that, 4 minutes of introductions/lead ins. and 18 minutes of local ambulance chaser commercials.
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/01/10/graph-of-the-day-congress-is-less-popular-than-lice-colonoscopies-and-nickelback/
I'm thinking that now's a really bad time to be a PhD student in a lab which no longer has long-term funding. They're not reviewing grants, a backlog is building, and our grant renewal is in that pile...
Swank Force One wrote:slefain wrote:Stop right there. If you were having problems related to "usual and customary," which is also known as "Contracted Rates," then you weren't going to an "In Network" or to use your term, "Approved" provider. It's one or the other. The end. Which was it? In Network providers CANNOT charge you the difference between billed charge and contracted rates. If that was happening, you had an issue with your provider, not the insurance company. In network providers AGREE to the "usual and customary/contracted" rates when they sign their contract with the insurance company. This is not special to BCBS, this is how health insurance works, period. And again... BCBS will not bill you for anything but premiums. They don't administer health care, they cannot and will not bill you for services that someone else rendered. It's not their problem, nor do they even truly care if you pay your providers or not. The only possible exception here would be if Subrogation was involved, which could be the case if your car insurance paid out any medical costs. BCBS is typically a "Pay and Pursue" company. They get medical claims for accidents, they pay them. Subrogation department will handle what happens if BCBS AND your car insurance both pay the same bill. I'm assuming Subrogation wasn't involved because you didn't mention if your car insurance paid any bills, and that'd be a pretty important key to the story that you probably wouldn't have left out. I'm truly sorry that you had to go through your accident and apparently everything afterwards was a total pain in the ass, but inaccuracies serve no purpose but to perpetuate the shell game. As for Curmudgeon, i remember the other thread quite clearly. Yes, he had some E36 M3ty things happen concerning multiple waiting periods. Mostly because he didn't purchase COBRA between policies. This happened multiple times. The information is given to you when an employer-funded health insurance plan ends, and explains that one of the biggest benefits of COBRA is ensuring that there's no break in coverage, therefor preventing another waiting period from happening. NOTE: Like i've said many many times before, i don't agree with waiting periods or pre-existing in general. However, the hoops were put in place. They're E36 M3ty hoops. Expensive hoops. The hoops aren't secret. Not jumping through them can screw you. I can understand being mad about it the first time if you didn't read your COBRA packet. I can't understand being mad about it the 2nd or 3rd time. Either way, it's going away, so that's progress! Now nobody will have to deal with it anymore, and the rest of us won't have to hear about it.Curmudgeon wrote:I am shocked, SHOCKED that BCBS treated you like that. Oh, wait, no I'm not because that is how they treated ME. I paid my premiums for six years and when I finally needed to get patched back up they fought me on every single charge. I had to resubmit doctors bills multiple times, or have them re-coded so they wouldn't be rejected. I went to their approved doctors every single time but I guess it didn't matter. I swear I was going to reach through the phone and punch the next person who said the words "usual and customary" to me. For those who don't know that is the amount that an insurance companies feels it should pay for a procedure, which may be WAY different from what you are charged. The difference between the two is now your problem. So now you have to call the doctor and get them to re-code the bill to something that the insurance company will pay or lower the price. Sometimes the doctor just re-submits the same bill which is now magically accepted, where the original bill was not. It was a good thing I was on medical leave for two months relearning to walk or else I'd never been able to deal with the stupidity of the whole billing situation. Then when it was all over is when the threatening phone calls came in asking when I was going to pay them back. This was not some debt collection agency, the phone was answered by BCBS staff. The "bills" were mailed from BCBS but nowhere on them was there a due date, just a long statement of services and a huge number at the bottom in bold. Screw BCBS.alfadriver wrote:I'm the one who bitched about BCBS of SC (one of those so-called non profits) holding a HUGE surplus while denying claims for my daughter's asthma meds claiming her eligibility had ended. Which was complete bullE36 M3 because they had been accepting my money for a year and a half. When it comes down to a tug of war between my kid's health and the shareholders, the shareholders can go berkeley themselves. EDIT: These are the same shiny happy people who finally paid for her meds after I raised hell and wrote a blistering letter to the local newspaper. I then change employers, get another policy with the same company and coverage of her asthma is denied for six months as a 'preexisting condition'. Yeah, I've heard all the arguments for that. They are bullE36 M3 designed to maximize profit at the expense of the policy holder and all I have to say is: if the ACA was good for one thing it was getting rid of that goddamn preexisting condition thing.Bobzilla wrote: yeS! Let's grow the gov't even MORE! That will fix it. I've never seen a gov't agency completely overstep it's bounds, come in at 4 times the cost and fix absolutely nothing before. Look, you want complete gov't oversight, move to Europe. LEave us the berkeley alone.So you are ok with a healthcare company denying you some basic service so that they shareholders profit more? We are not talkign about an OEM radiator, but giving you the most up to date heart opreartion.
Last time I will post in this thread about that situation because the whole thing STILL makes my blood boil: the denied claim for her meds was after I had been employed and covered, along with her, for over a year. It had not a damn thng to do with COBRA.
It was merely bullE36 M3 and stonewalling on the part of BCBS to fatten that surplus up a bit more and put bonuses averaging $100k in the pockets of the shiny happy people running the place.
Done. Out of here. In a large deviation from my usual libertarian leanings, I'm actually glad the ACA is going to help schmucks like me squeeze the insurance companies' balls.
Wow what a great 16 days. Fantastic work all around guys. Can't wait till we go through this again in January.
DoctorBlade wrote: we won't, don't worry. the gop will surrender then too.
If the ACA debacle continues into next year, don't bet on it.
In reply to Curmudgeon:
We had bcbs for a year at my company, and everyone who used their insurance got denied the first time, every time, no matter how big or small tier claim was. Approved doctors, dentists, surgeries, all denied the first time for basically arbitrary reasons. One lady's daughters annual dental visit was denied because it had only been like 360 days since her last annual. Most that I heard of we're paid after they resubmitted the claim with no changes, just had to jump through hoops in hopes you'd just go away.
oldsaw wrote:DoctorBlade wrote: we won't, don't worry. the gop will surrender then too.If the ACA debacle continues into next year, don't bet on it.
I don't actually think anyone can organize anything in Washington anymore. It is the land of the "nobody wins because we have to ensure the other side loses big" deal. Nuclear option politics is here to stay for some time.
The whole situation is so screwed up that this article makes sense. http://m.washingtonpost.com/blogs/wonkblog/wp/2013/10/16/if-ted-cruz-didnt-exist-democrats-would-have-to-invent-him/?tid=pm_business_pop
I'm beside myself with the idiocy I am seeing.
That worked out about how I figured it would. I'll just leave this here that someone said in 2006:
“The fact that we are here today to debate raising America’s debt limit is a sign of leadership failure,” “Increasing America’s debt weakens us domestically and internationally. Leadership means that ‘the buck stops here.’ Instead, Washington is shifting the burden of bad choices today onto the backs of our children and grandchildren. America has a debt problem and a failure of leadership. Americans deserve better. I therefore intend to oppose the effort to increase America’s debt limit.”
The outcome was predetermined, as it always is. This morning it was announced that many Republicans in the House voted to pass the resolution but a higher percentage voted against it. How's that for 'have your cake and eat it too'? Bastards.
Let's see.... the dems gave up NO concessions and the republicans gave ALL the concessions. Those dam R's and their inability to negotiate. It's all their fault.......
Strizzo wrote: In reply to Curmudgeon: We had bcbs for a year at my company, and everyone who used their insurance got denied the first time, every time, no matter how big or small tier claim was. Approved doctors, dentists, surgeries, all denied the first time for basically arbitrary reasons. One lady's daughters annual dental visit was denied because it had only been like 360 days since her last annual. Most that I heard of we're paid after they resubmitted the claim with no changes, just had to jump through hoops in hopes you'd just go away.
Routine dental visits often go on a rotating 365 day cycle. When i say "often," i mean maybe 30% of policies.
Bummer that your employer felt the need to impose such a policy on you guys.
Bobzilla wrote: Let's see.... the dems gave up NO concessions and the republicans gave ALL the concessions. Those dam R's and their inability to negotiate. It's all their fault.......
This wasnt an appropriate platform to negoiate on! A law is a law, there are appropriate ways to repeal it if you want. No enough votes to repeal it, tough E36 M3, that's the way it works. Holding government funding and credit hostage is not an acceptable solution, I would be saying the same exact thing for the other party if they started it. And it is very justified to not negoiate when a group threatens to let the government default, it legitimzes the tactic for other radical groups in the future. And the republicans didn't give up anything, they had nothing on the line. Nothing has changed in the 16days except our government looks even more like a joke to the rest of the world.
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