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spaghettiwestern , (edited ) in My Health Insurance Company Is Trying To Kill Me

Name and shame - it does absolutely no good to post your experience without the insurance company name.

Health Net pulled constant bullshit with me. The company regularly refused payment on claims, saying they weren’t covered after previously paying for the same service under the plan. Health Net even went so far to refuse payment on a claim when they had provided prior approval for the appointment in writing. They would refuse payment on things that were clearly covered and I had to read them the policy to even get them to look at the denial. Health Net literally trashed prior authorization requests my doctor sent in and it took 4 months and personally faxing the request myself to get them to admit they were throwing the faxes away. The list goes on and on.

After major surgery I often spent 10+ hours per week on the phone with them because Health Net would deny so many claims. Getting rid of that crappy insurance company was a major relief.

buddascrayon ,

Not only that but the ACA rating system for plans is completely useless because the insurance companies invent brand new plans every single year so none of them ever have any kind of rating.

USSEthernet ,

Doesn’t matter, it’s all of them. My family has had United Healthcare, Cigna, and Anthem in the past 6 years and they’re all equally bad. We’ve had so many issues with coverage for both of my autistic children and mental health care.

The system is designed to screw you unless you have hours of time to question every bill. Luckily my wife doesn’t have a job so she can make all of these calls. In most cases we got everything resolved, but after my wife basically made this her daytime job calling about the bills and learning about how billing and coding works.

After our experience, I’m confident that no one knows what they are doing. It’s all guesswork. From the doctors, to their office billing people, to the insurance. It’s all fucked.

spaghettiwestern ,

Doesn’t matter, it’s all of them.

It’s the majority of them, but there are exceptions. I switched to Blue Shield (not Blue Cross or one of the combined companies in some states) and had almost zero problems. They paid my claims accurately the vast majority of the time and fixed the occasional problem with relatively little fuss. The Blue Shield reps also knew their stuff and I never once had to explain my policy to them.

Health Net is deliberately designed from the bottom up to refuse legitimate claims and to fight tooth and nail when customers demand they follow their own contract. IMO Health Net should be shut down.

…my wife basically made this her daytime job calling about the bills and learning about how billing and coding works.

I had to do the same, despite recovering from surgery. To make matters worse, after I hit the maximum out of pocket amount the medical centers continued to send bills showing I owed a balance. It took nearly a year and repeated escalation to their executive and legal departments to get them to provide refunds. Calls, faxes and certified letters were completely ignored.

Corporate America has become quasi-legal and well-funded organized crime.

USSEthernet ,

I had to do the same, despite recovering from surgery. To make matters worse, after I hit the maximum out of pocket amount the medical centers continued to send bills showing I owed a balance. It took nearly a year and repeated escalation to their executive and legal departments to get them to provide refunds. Calls, faxes and certified letters were completely ignored.

Yup, we always hit our deductible within about 2-3 months due to my kid’s therapy, yet we still get full bills from all of our providers even though we should be 90-100% covered at that point. You call the insurance, they say the provider billed it wrong, you call the provider’s office and they refuse that they did anything wrong and tell you to call your insurance. It’s a never ending cycle.

spaghettiwestern , (edited )

The worst of the medical centers that knowingly overcharged me was USC Keck in L.A. They completely ignored calls, emails, faxes and certified letters for nearly a year - never once responding to anything. The scumbags actually sent my account to collections despite my having a zero balance because they flatly refused to credit my overpayments. I’ve learned to refuse payment of any medical bill before making absolutely sure I owe the company what they are billing, and that can take months.

The thing that amazes me with all of these companies is they expect you and I to be right on top of our accounts, respond to letters and calls, and pay their bills within 30 days. This despite the fact they don’t give a fuck about doing the same. My attitude has become the same as theirs: “fuck 'em, let them wait”. I get sternly worded bills with red “Past Due” printed on them every month, ignore them completely and pay when I’m ready. There’s been no downside.

solsangraal , in My Health Insurance Company Is Trying To Kill Me

in most 1st world countries literally none of this ever happens.

insurance is the biggest scam of all fucking time. and we get to spend time arguing about gay books in the library

homesweethomeMrL OP ,

Don’t even think about asking about the extraterrestrials.

Uh, not . . that there are any, it . . that is, if there were any there would certainly be information that . . uh . . about, uh, that. Which there isn’t! Ha ha! Nope. Anyway. Let’s finish getting these taxpayer funded Ten Commandments installations put up, hand me that hammer will ya

CeeBee ,

in most 1st world countries

The US isn’t a 1st world country. It just cosplays as one.

ConstantPain ,

In lots of third world ones too. Here in Brazil there’s no such thing as “paying for ambulance” if you are in a health plan or using public health systems.

Asafum ,

we get to spend time arguing about gay books in the library

Congratulations! You’ve pointed to the exact reason why we’re stuck arguing about gay books! If right wingers didn’t have absolute bat shit social issues to bitch about they’d be joining us in bitching about the real issues we face!

Can’t have that! Propagandists, sing me a tune!

teodor_from_achewood , in My Health Insurance Company Is Trying To Kill Me

Before switching providers I had similar experiences, to the point where I’d start every call with “Please transfer me to a manager. You can help me by transferring me to a manager. No I need to be transferred to a manager. You’re not a manager so you can’t help me,” and so on and it was the only way to get whoever answered the phone to give me straight answers on the first try.

SquishyPandaDev , in My Health Insurance Company Is Trying To Kill Me
@SquishyPandaDev@yiffit.net avatar

Insurance is a scam. Get hospitality bill as self pay and tell them to go pound sand. Lo and behold they will quickly work out a reduced amount and a reasonable payment plan

YarHarSuperstar ,
@YarHarSuperstar@lemmy.world avatar

Unfortunately this isn’t an option for many folks, as they have insurance because there’s no way to afford the bills that they would be sending if one didn’t have insurance, even if a hefty discount was applied.

sunzu , in Novo Nordisk to build $4.1 billion North Carolina facility to boost output of Wegovy, Ozempic

Boomers got the money and the demand... smart move.

TheBigBrother , (edited ) in Julian Assange has reached a plea deal with the U.S., allowing him to go free

If Assange wasn’t in US territory when revealed classified information, why is he being judged by the US?

Was not the US should be judging the one/s who filtered the information and not who publish it?

zabadoh ,

US courts can still try him in absentia, i.e. if he’s not present in the courtroom.

If he’s in a country with an extradition treaty with the US, e.g. the UK, he can be extradited to the US for the trial or with a conviction.

FlowVoid ,

No, the SCOTUS has made clear that you cannot be tried in abstentia.

This case requires us to decide whether Federal Rule of Criminal Procedure 43 permits the trial in absentia of a defendant who absconds prior to trial and is absent at its beginning. We hold that it does not.

sunzu ,

u/@zabadoh explained how

the reason is that the US can exercise such authority in practice with any consequences.

a bigger concern here is his native government's limp dick response tbh

aint he from AU?

FlowVoid ,

the US can exercise such authority

Many countries have the authority to prosecute crimes that occur on their soil even if the perpetrator is outside the country. Including Assange’s native country.

The foreign interference crimes apply to conduct that occurs in Australia. So, if the perpetrator was in Australia at the time they engaged in interference, then prosecuting them would be relatively straightforward, provided there was sufficient evidence. If an offender is outside Australia at the time of the interference, they could still be charged with a crime.

sunzu ,

I don't understand the point you are trying to make?

AU is not prosecuting here

FlowVoid , (edited )

The point is that the US is not unusual in prosecuting people in other countries. Australia and others do the same thing.

sunzu ,

Who did AU prosecute like this?

Point I was making is that AU is failing to protect its citizen who is being harassed.... BTW ;)

FlowVoid , (edited )

Australia, like the US and other countries, does not generally shield suspected criminals from prosecution.

And that’s regardless of whether the person is actually guilty. Just ask Amanda Knox.

FlowVoid ,

Anyone involved in a crime committed on US soil can be charged with the crime.

Do you suppose hacking your computer should be legal provided the hacker is in Russia?

catloaf ,

If it’s legal in Russia, they should not extradite.

If I post this picture to VK from my home in the US, should I be extradited to Russia for it?

FlowVoid ,

You can certainly be charged in Russia.

Extradition is another matter.

TheBigBrother ,

Assange personally hacked the alleged computer in US soil? Cos as I see it he published classified information from outside the US so my question would be, you can be judged for publish classified information of the US even if you are not a US citizen? As far as I know the person/s accountable for the crime are ones who probably right now are working for the US govt…

sunzu ,

Original allegations suggested that russian operatives supplied wikileaks with the docs

TheBigBrother ,

So it should be a problem with Russia, no?

sunzu ,

I guess they committed the "crime" but how is US supposed to prosecute that with out looking limp dick?

FlowVoid ,

The US alleges that Assange was part of a conspiracy to hack computers in the US, ie he was not just a passive receiver, he was involved in planning the hack.

The superseding indictment alleges that Assange was complicit with Chelsea Manning, a former intelligence analyst in the U.S. Army, in unlawfully obtaining and disclosing classified documents related to the national defense. Specifically, the superseding indictment alleges that Assange conspired with Manning; obtained from Manning and aided and abetted her in obtaining classified information

sunzu ,

Damn, do we have ourselves a glowie here lol

FlowVoid ,

I didn’t say I think he is guilty. But the charges against him aren’t what everyone seems to think.

sunzu ,

Man... What is US trying to show here? That they can drum up fake charges on people?

We got it! Nobody doubted it. We are all quacking in fear!

It just looks pathetic at this point. Fuck it hound him some more! why do I give a fuck.

It just looks like a desperate exercise of coercive power!

FlowVoid ,

I don’t know what is going on here. On the one hand, I don’t trust Assange. On the other hand, I really don’t trust the Trump DoJ. Especially since they indicted Assange after the Obama DoJ concluded he hadn’t broken the law.

A trial would have been interesting.

Potatos_are_not_friends , in A Texas Democrat voted against rights for trans kids. This queer Black mom challenged her – and won

Good. I’m sick of Democrats being filled with left, center, and center right.

Toto , in Julian Assange has reached a plea deal with the U.S., allowing him to go free

deleted_by_author

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  • sunzu ,

    why so much downvote...

    This is right, right thing to do and the motive called out is likely true...

    If you disagree, please state your reasoning.

    protist ,

    Merrick Garland and his DOJ are absolutely not taking marching orders from the Whitehouse. Garland also doesn’t give two shits about politics. Dude’s rigidly ethical

    dogsnest , (edited )
    @dogsnest@lemmy.world avatar

    Lemmy dogpiles much more than reddit ever does. All one can do is upvote but it’s moot.

    Downvotes should max out at 5.

    eta:

    pud(proof)ding

    magnetosphere ,
    @magnetosphere@fedia.io avatar

    Unenforceable wish: no limit on downvotes, but people should have to EXPLAIN them. I often learn more from opposing opinions than from statements of agreement. If I say something unpopular, I want to know WHY it’s so widely disliked. Maybe I’m unaware of something important.

    NauticalNoodle ,

    I’m pretty sure that sometimes it’s a result of how the voter feels. Other times i’m not so convinced it’s humans voting.

    protist ,

    All this extended conversation about all the downvotes and not a single person responded to the reason I gave for downvoting right up there. Merrick Garland’s DOJ absolutely does not care about politics, and the implication that this guilty plea has to do with the Biden Admin wanting to influence the election in November is fictional.

    NauticalNoodle ,

    …because we weren’t responding to you?

    ccunning ,

    As of now 19 folks responded with upvotes. The lack of comments is because you nailed it and nothing else needed to be said.

    ccunning ,

    Forced troll feeding. Brilliant idea…

    magnetosphere , (edited )
    @magnetosphere@fedia.io avatar

    lol good point. I’m a goddam genius!

    Ironically, your reply is what I’m talking about. Tell me why I’m wrong! Point out what I missed!

    ccunning ,

    Just saw your edit…

    …but I did explain…

    …so I’m confused…

    magnetosphere ,
    @magnetosphere@fedia.io avatar

    It’s ironic because thoughtful criticism is helpful. The “tell me why I’m wrong” bit is a remark meant for others, not you.

    credo ,

    You’re right, the President should basically do nothing in the year before an election. Everything must be accomplished in the first three years, then we take a break.

    Edit: (Assuming POTUS was even involved)

    sunzu ,

    I guess a lot of people just got feelz about this one lol

    Ghostalmedia , in Police: Vandal spray paints ‘F--- Elon’ on 34 Tesla Cybertrucks in Fort Lauderdale
    @Ghostalmedia@lemmy.world avatar

    Dylan Maxwell did it.

    ininewcrow , in Julian Assange has reached a plea deal with the U.S., allowing him to go free
    @ininewcrow@lemmy.ca avatar

    Meanwhile, they have an orange beanbag presidential hopeful spilling the beans to the whoever around the world and he gets millions of dollars of support, literal legal immunity from anything and 1/3 of the country want him to become their Cheeto leader in Mountain Dew.

    disguy_ovahea ,

    That’s because that orange beanbag seated three associate justices of the Supreme Court, 54 judges for the courts of appeals, 174 district court judges, and three judges for the United States Court of International Trade.

    Even worse, citizens want to let him do it again.

    errer ,

    To be fair, Biden has seated almost as many judges in his term, so that has balanced out at the lower levels. With the very important exception of the Supreme Court.

    disguy_ovahea , (edited )

    There’s also the important point of Biden not committing crimes, like those that the commenter mentioned, and having those charges heard by one of his own appointed judges. Appeals from Trump’s other cases can potentially end up with one of his appointed appeals court judges, or ultimately be heard by the newly conservative Supreme Court, as you pointed out.

    I mentioned it because that’s the notable difference between Assange’s and Trump’s ability to live above the law.

    androogee ,
    LesserAbe ,

    Hey I like mountain dew

    Track_Shovel ,

    Please step into my secure toilet to see the nation’s secrets.

    I still can’t believe that fucking happened and people just go on ignoring it

    skuzz ,

    Hey, to the positive, less than 1/3 of the country. First, if you look at vote numbers versus total population in previous elections, as well factoring in as the total population including those that can’t vote for various reasons. Then, factor in that the party of shit nazis is disenfranchising remaining R voters at lightning speed, the party is massively in debt in some states and basically ceasing to exist, more of the insurrectionists continue to go to prison, the rest of the crazies end up doing something stupid and get arrested…

    Things are looking up as that fraction heads towards 1/4 and hopefully they’ll go back into their stinky rotting little hole where they belong. Their Russian troll daddies just make the presence look larger and more present than they really are.

    OsrsNeedsF2P , in Julian Assange has reached a plea deal with the U.S., allowing him to go free

    Legendary. That’s him cleared in Sweden, UK, and the US. Apparently they’re considering letting him return to Australia (his home country) as well. Godspeed, Assange!

    nondescripthandle ,

    Thats the catch, he has to fly home in a Boeing.

    crawancon ,

    haha oh

    fartsparkles ,

    A whole new meaning to defenestration.

    vaultdweller013 ,

    Im just imagining him being sucked out a window like a scene from Final Destination or something.

    protist ,

    “Cleared” is an interesting way to describe “pleaded guilty and sentenced to 62 months in prison.” Dude just already served 5 years.

    ryannathans ,

    With time already served

    protist ,

    Yes, that’s what I said

    slimarev92 ,

    lol he wasn’t “cleared” anywhere

    bolexforsoup , in Julian Assange has reached a plea deal with the U.S., allowing him to go free

    Now the right will hate Assange lol

    someguy3 , in Julian Assange has reached a plea deal with the U.S., allowing him to go free

    This seems like a big deal.

    YarHarSuperstar , in My Health Insurance Company Is Trying To Kill Me
    @YarHarSuperstar@lemmy.world avatar

    I get providers and insurance companies flagrantly violating ADA all the time with me and my housemate’s care. They don’t give a shit and nobody is holding them accountable if you don’t have money for a lawyer to threaten them officially.

    Drusas ,

    Do you mean HIPAA?

    YarHarSuperstar ,
    @YarHarSuperstar@lemmy.world avatar

    Well certainly that too. But I’m talking about the Americans with Disabilities Act.

    Taleya , in Police: Vandal spray paints ‘F--- Elon’ on 34 Tesla Cybertrucks in Fort Lauderdale

    30 cybertrucks, one owner? Fucking spiders georg here

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