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RL Peeves

Scheduled Pinned Locked Moved No Escape from Reality
974 Posts 85 Posters 277.4k Views
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  • T
    TNP @Solstice
    last edited by TNP 29 Oct 2022, 17:07

    Not just to @Solstice but everyone…

    I’m in medical billing. And yes, if you have multiple insurances, they talk to each other and figure out which is primary, which is secondary, tertiary, etc. The insurance in your own name is always primary over the one in someone else’s name. There might be exceptions but I haven’t run into them.

    Don’t panic too much. Whatever you owe after the primary insurance processes the claim gets filed to the secondary. If they didn’t pay anything, it’s likely either because the doctors/facility was out of network (and you have no out of network benefits) or you have a high deductible. Whoever the bill is from should now be sending it to your secondary with a copy of the primary EOB showing what you owe.

    Without knowing what your policy states, it’s impossible to accurately predict but if you were pretty sure they’d pick up most or all of it to begin with, they still should.

    eta: To clarify, the primary doesn’t bill the secondary. The doctor/facility the claim is from bills the primary, gets the results, then bills the secondary, then bills you.

    S 1 Reply Last reply 29 Oct 2022, 17:22 Reply Quote 5
    • M
      Morphine
      last edited by 29 Oct 2022, 17:10

      The hospital or facility may have a financial assistance program to help you. This link is what I found with a quick google search. https://about.kaiserpermanente.org/community-health/communities-we-serve/northwest-community/ensuring-health-access/subsidized-care-and-coverage0/medical-financial-assistance-program

      I work adjacent to medical billing (I screen people for eligibility for financial assistance programs similar to the above) – and I’ve only just made it past my 90 day probationary period (benefits on Monday, yay!) so I am no expert on this – but I believe that when you have a primary and a secondary insurance, the facility bills the primary first, the primary decides what it will pay, what it won’t, and what is the patient’s responsibility, and either writes a check to the facility or goes ‘nah’. Then the facility passes on whatever is left to the next responsible party, which in this case should be your secondary insurance. Only after the secondary has been billed and responded should you be considered for whatever is left.

      All of which takes time, and yes, in the meantime you’re getting statements and bills and there’s five figures on there and it’s really stressful and overwhelming. I’m sorry that you’re going through that, and I’m sorry that people with insurance still have to apply for financial assistance at all, but I hope that isn’t just ‘explaining’ stuff that you already know, and will help you a bit.

      Oh phew yes, I’m right, thanks TNP.

      T 1 Reply Last reply 29 Oct 2022, 17:16 Reply Quote 2
      • T
        TNP @Morphine
        last edited by 29 Oct 2022, 17:16

        @Morphine said in RL Peeves:

        Oh phew yes, I’m right, thanks TNP.

        Yes indeed. Oh, and to add another point…

        I don’t know how other states do it but in New York, everyone bills separately. So there will be a bill from the surgeon, a bill from the anesthesiologist, a bill from the pathologist if it was needed, and a bill from the facility. It can get very confusing and difficult to keep track of. So if your state is the same, just be aware.

        1 Reply Last reply Reply Quote 2
        • S
          Solstice @TNP
          last edited by Solstice 29 Oct 2022, 17:22

          @TNP @Morphine

          This is immensely comforting, and I super appreciate it. No one I spoke to on my various phone calls was able to really give me any sort of explanation that approached this level of clarity, and that led me to blind panic.

          Sounds like I need to hurry up and wait.

          T 1 Reply Last reply 29 Oct 2022, 17:27 Reply Quote 1
          • T
            TNP @Solstice
            last edited by 29 Oct 2022, 17:27

            @Solstice You’re welcome.

            Oh, more info for everyone.

            So. Which is primary and secondary etc is called coordination of benefits. And sometimes it gets screwed up. When you add or drop an insurance company when you have multiple ones, you have to inform the other insurance that you no longer have the one you got rid of. Otherwise they think you still have it.

            So if you ever cancel your own insurance, let Kaiser know immediately otherwise they’ll continue to think they’re secondary and won’t pay. This applies to any and all insurances, including Medicare and Medicaid.

            1 Reply Last reply Reply Quote 3
            • S
              SpaceKhomeini @Solstice
              last edited by 29 Oct 2022, 19:38

              @Solstice

              As an aside —

              Just in general, fuck Kaiser.

              They fucked me harder than anyone has been fucked by a Kaiser since Belgium.

              I woke up feeling so good, I think I’d better call in sick/ I need a personal trainer to help me hold my drink
              I plan to be spontaneous next time we meet/I’m putting off procrastinating until next week
              I’ll get onto it when I give a shit

              P 1 Reply Last reply 30 Oct 2022, 03:29 Reply Quote 2
              • P
                Pavel @SpaceKhomeini
                last edited by 30 Oct 2022, 03:29

                @SpaceKhomeini said in RL Peeves:

                They fucked me harder than anyone has been fucked by a Kaiser since Belgium.

                that reference

                He/Him. Opinions and views are solely my own unless specifically stated otherwise.
                BE AN ADULT

                1 Reply Last reply Reply Quote 3
                • A
                  Arkandel @helvetica
                  last edited by 3 Nov 2022, 15:27

                  I don’t want to care about the US midterms. I’m not even American nor do I live there.

                  But the stuff I read on the interwebs pisses me off, more so because it’s a race at all and without even the outcome at this point. So while I’d rather shrug it off I must admit I do care after all, which also annoys me.

                  C T 2 Replies Last reply 3 Nov 2022, 15:38 Reply Quote 2
                  • C
                    crawfish @Arkandel
                    last edited by 3 Nov 2022, 15:38

                    @Arkandel I voted early this morning and the polls are PACKED, unexpectedly so I guess because there were a lot of startled faces.

                    I draw things! http://www.mahaldoodles.com

                    A 1 Reply Last reply 3 Nov 2022, 15:44 Reply Quote 2
                    • A
                      Arkandel @crawfish
                      last edited by 3 Nov 2022, 15:44

                      @crawfish I hope things turn out well.

                      But I was so sure Brits would do the obviously right thing with Brexit, too, and that went down super well too. 🙂

                      W 1 Reply Last reply 3 Nov 2022, 17:36 Reply Quote 3
                      • T
                        Testament @Arkandel
                        last edited by 3 Nov 2022, 15:53

                        @Arkandel said in RL Peeves:

                        I don’t want to care about the US midterms. I’m not even American nor do I live there.

                        But the stuff I read on the interwebs pisses me off, more so because it’s a race at all and without even the outcome at this point. So while I’d rather shrug it off I must admit I do care after all, which also annoys me.

                        Don’t get on Twitter. I’m fairly certain that is the major reason that has explained my current emotional and mental state at the moment is because I’ve read a lot of hateful things.

                        I’ll stop now before someone thwaps me for veering too political.

                        I don't know what I'm doing. Poke at Seven Nations sevennations.aresmush.com port 2021

                        S S 2 Replies Last reply 3 Nov 2022, 19:52 Reply Quote 2
                        • W
                          Wizz @Arkandel
                          last edited by 3 Nov 2022, 17:36

                          @Arkandel said in RL Peeves:

                          @crawfish I hope things turn out well.

                          Don’t mean this to be dismissive to your feelings or good intentions at all, but…oof, at this point, give us another decade like this one (or dare I say even another five years) and I legitimately don’t think this country will look the same on maps anymore. 😬

                          I’ve never considered becoming an expat so seriously, and I really wish it was easier/cheaper.

                          T 1 Reply Last reply 3 Nov 2022, 17:54 Reply Quote 2
                          • T
                            Testament @Wizz
                            last edited by 3 Nov 2022, 17:54

                            @Wizz said in RL Peeves:

                            @Arkandel said in RL Peeves:

                            @crawfish I hope things turn out well.

                            Don’t mean this to be dismissive to your feelings or good intentions at all, but…oof, at this point, give us another decade like this one (or dare I say even another five years) and I legitimately don’t think this country will look the same on maps anymore. 😬

                            I’ve never considered becoming an expat so seriously, and I really wish it was easier/cheaper.

                            I recommend Costa Rica. That’s where I’m trying to get in five years.

                            I don't know what I'm doing. Poke at Seven Nations sevennations.aresmush.com port 2021

                            A 1 Reply Last reply 3 Nov 2022, 18:55 Reply Quote 1
                            • A
                              Arkandel @Testament
                              last edited by 3 Nov 2022, 18:55

                              Come to Canada for the snow and the freezing cold, stay for the Raptors and poutine options!

                              1 Reply Last reply Reply Quote 4
                              • S
                                Sammich @Testament
                                last edited by 3 Nov 2022, 19:52

                                @Testament said in RL Peeves:

                                Don’t get on Twitter.

                                Just good advice in general. Especially for mental health.

                                C 1 Reply Last reply 3 Nov 2022, 20:16 Reply Quote 2
                                • C
                                  crawfish @Sammich
                                  last edited by 3 Nov 2022, 20:16

                                  @Sammich I joined recently for business things and well I suppose I got there too late.

                                  I draw things! http://www.mahaldoodles.com

                                  1 Reply Last reply Reply Quote 0
                                  • J
                                    junipersky Administrators
                                    last edited by 3 Nov 2022, 20:59

                                    I have completely lost my voice. (I think from the mother of all sinus infections.) This means that when I do try to speak it comes out as the quietest of whispers.

                                    Then everyone who is trying to speak to me speaks in a whisper, and then I can’t hear them!

                                    I swear, I’d speak in a normal tone of voice if I could!

                                    (Upside, the 5th grader who volunteered to be my ‘voice’ got a kick out of it.)

                                    1 Reply Last reply Reply Quote 2
                                    • G
                                      GF
                                      last edited by 4 Nov 2022, 15:21

                                      It’s November 4 in the northern hemisphere and it’s so hot my computer’s fan keeps kicking on to cool the machine down.

                                      1 Reply Last reply Reply Quote 0
                                      • S
                                        Sammich
                                        last edited by 4 Nov 2022, 23:23

                                        Fireworks. Ugh. Why can the public still buy them?

                                        K 1 Reply Last reply 4 Nov 2022, 23:49 Reply Quote 2
                                        • K
                                          KarmaBum @Sammich
                                          last edited by 4 Nov 2022, 23:49

                                          @Sammich said in RL Peeves:

                                          Why can the public still buy them?

                                          Cuz they’re fun as shit!!!

                                          Why can’t we have more of them?!

                                          On Dragon Wings · https://pern.gaslightswitch.com · pern.gaslightswitch.com port 4201

                                          1 Reply Last reply Reply Quote 1
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