http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x3027621For those who guessed franksolich was attracted to this bonfire by the word "ear," you're right.
If it had been a nose ache or an eye ache or a tongue ache, I wouldn't have paid attention.
dweeb (1000+ posts) Tue Mar-18-08 01:44 PM
Original message
I'm sorry, but your earache is a pre-existing condition.
Last December I went to Eloy, AZ to go skydiving between Christmas and New Year's. Two days after Christmas I got an earache that wouldn't go away so I left earlier than I wanted to and returned to San Diego.
Basically, my left ear wouldn't 'clear.'
I tried Benedryl, Sudafed, Tylenol Cold & Sinus to try to get my ear to clear but nothing worked.
On January 17th I finally went to my doctor and he told me I had a eustation tube dysfunction. He gave me an anti-biotic and it cleared up after a week.
My insurance company is now refusing to pay the $45.15 bill for the doctor visit because they claim it was a pre-existing condition, even though I hadn't been to the doctor in 14 months prior to this.
I am tired of having to pay close to $200 a month for insurance only for the insurance company to deny paying the bill when it comes due.
So I'll be wasting another 3 or 4 hours today ****ing around with this ******* insurance company because there's not way in hell that I'll be paying for this doctor's visit.
Hmmm.
Going skydiving in an exclusive expensive resort area in this terrible Bush economy?
And then whining about $45?
One suspects, without knowing for sure, skydiving fees run a lot more than that; if somebody can afford skydiving, surely $45 is pocket-change.
Anyway.
Captain Angry (1000+ posts) Tue Mar-18-08 01:46 PM
Response to Original message
1. You just don't get it.
You have to go to the doctor when you're healthy. Because anything you have before you get there is preexisting. The only thing they'll cover is stuff you pick up while you're at the doctor's office.
Insurance company policymakers should be hunted for sport.
dweeb (1000+ posts) Tue Mar-18-08 01:49 PM
Response to Reply #1
2. I went through this shit last year when I was healthy.
The last visit I had previous to this one was for a regular blood test to check my cholesterol levels and blood sugars.
Because the previous year's blood test showed slightly elevated cholesterol levels, but not high enough to be treated, the insurance company refused to pay for the blood tests. My test results did show that my cholesterol levels dropped back into the healthy range by a combination of diet & exercise.
It took me close to 9 months of fighting with the insurance company before they finally paid the bill.
One gets the impression the dweebish primitive would argue with a waitress about a 2-cent discrepancy in the bar tab.
Captain Angry (1000+ posts) Tue Mar-18-08 01:52 PM
Response to Reply #2
5. We have got to get this process fixed.
Between this type of crap, and trying to translate taxes, we're wasting an amazing amount of time.
MADem (1000+ posts) Tue Mar-18-08 01:52 PM
Response to Reply #1
4. Insurance company policymakers should be hunted for sport.
What a wonderful idea.
Their enablers as well--wet and naked, through a mosquito-ridden terrain, with giant rubber band shooters and slingshots and sharp rocks.
leftofcool (1000+ posts) Tue Mar-18-08 01:53 PM
Response to Reply #4
7. and Cheney with a gun
sazemisery (1000+ posts) Tue Mar-18-08 01:50 PM
Response to Original message
3. You have had that eustation tube all your life so, of course, it is a preexisting condition.
These companies want only profit. You are not supposed to get sick and make them pay the bills. That hurts their bottom line!
Bastards.
Hmmmm.
One wonders how much of the Bostonian Drunkard's trust funds are tied up in insurance corporations.
dweeb (1000+ posts) Tue Mar-18-08 01:57 PM
Response to Reply #3
9. LOL
It's funny, but even as a kid I've never had ear problems.
And this company is incredibly myopic. This will cost them way more than $45.15 in wasted time and productivity for the worker(s) that I'm going to involve in getting them to pay this bill.
leftofcool (1000+ posts) Tue Mar-18-08 01:52 PM
Response to Original message
6. After the age of 50 everything is a preexisting condition. You pay only 200 a month for insurance? Ours is over 900.00 per month and will go up at retirement.
dweeb (1000+ posts) Tue Mar-18-08 01:56 PM
Response to Reply #6
8. I'll be 44 next week.
And that $200 a month is just for me, it's partially work-subsidized (and they're not paying much) and has a $2500 deductible for anything major.
Stuckinthebush (1000+ posts) Tue Mar-18-08 02:01 PM
Response to Original message
10. Listen to this one!
We pay almost $800 per month for Blue Cross Blue Shield family coverage. We have an HMO option at the University we work at, but opted for the BC/BS to avoid hassles. We are lucky in that we can afford it, but we aren't rich so it does take a chunk out of the paycheck.
A few weeks ago my wife started lactating. Not being pregnant, there is really only one explanation for this which is a pituitary tumor. My wife is a physician and diagnosed herself then went to her physician and they both agreed that this was the obvious cause. The next step is to have an MRI to locate a tumor and see what the size is, but first a routine blood hormone level was run. The level was lower than they would have thought, but the presence of lactation indicated an MRI.
Blue Cross denied coverage for the MRI because the hormone levels weren't high enough yet. So, in essence, she must wait for the tumor to get bigger in order to get an increased hormone level so she can get an MRI to verify a tumor exists.
Priceless.
Needless to say, I'll be canceling my very expensive health insurance for the HMO plan which, we found out, would have paid for the MRI without question.
I hate insurance companies.
franksolich scents a bouncy, in the bold comment above.
dweeb (1000+ posts) Tue Mar-18-08 02:04 PM
Response to Reply #10
12. Oh God.
That is incredibly horrifying.
I pray that your wife makes a full recovery.
Stuckinthebush (1000+ posts) Tue Mar-18-08 02:28 PM
Response to Reply #12
14. Thanks, dweeb
I'm sure she will. The pituitary condition is more common than one would imagine and the procedure is less risky than most operations near the brain.
I'm sorry to hear about your insurance nightmare.
We need single payer insurance in this country now more than ever. The insurance companies are getting worse and worse.
stellanoir (1000+ posts) Tue Mar-18-08 02:02 PM
Response to Original message
11. What a pain.
I had chronic ear infections for many years and I thought the bacteria had built condominiums in my eustation tubes and used bottles and bottles of Otic solution.
They were recurrent for a long time and really painful.
I used to take the high speed express elevator in the IDS tower in Minneapolis just to alleviate the pressure.
I finally got permanent relief by using Mullein oil topically (available at health food stores) and a singular 20 minute acupuncture treatment.
It worked for me and you may want to consider the doing the same.
Hope you feel better very soon.
HMO's are total scam artists. BTW
You know, that's really weird, in the bold comment above.
Anybody around here remember when HMOs (Health Maintenance Organizations) were a Great Liberal Cause?
The first HMO here in Nebraska was founded by a bunch of McGoverniks during the mid-1970s.
One wonders what's up with that.
Tracer (1000+ posts) Tue Mar-18-08 02:06 PM
Response to Original message
13. Sorry about your insurance problems, but ...
... it's "eustachian tube".
Brigid (1000+ posts) Tue Mar-18-08 02:34 PM
Response to Original message
15. I used to work for a large health insurance company.
Stories like the ones you all are telling here are why I no longer work there. I just couldn't take it anymore.
Sadly, when I saw "Sicko," it really didn't tell me anything new.
Yes, insurance company policymakers should be hunted for sport. They are the lowest form of life.
Primitives aren't a form of life?
Oh my. One learns something new every day.
damntexdem (1000+ posts) Tue Mar-18-08 03:02 PM
Response to Original message
16. If you get sick, it's obviously an pre-existing condition -- you have a body that it susciptible to illness.
Likewise with injury.
Until we outlaw "pre-exising condition" exceptions in health insurance, we will all suffer from nonsense like this.
uppityperson (1000+ posts) Tue Mar-18-08 03:13 PM
Response to Original message
18. Ideas and question
I am a health care provider, small business, do my own medical billing. Not an absolute expert, but it is what I do and have done for many yrs.
Question first, can you tell us which ins company it is?
Ideas: Some ins co's routinely deny many bills on the first time through. Resubmit it, or have doctor's office resubmit it, with chart notes saying not pre-existing. This is a game they play, if they can get you so frustrated you pay, they don't have to and make more money and, after all, that is what they are in business for. Making money. Keep it civil (hard to do), keep repeating, work your way up the ladder. It is a pain because it is wasting your time and your money. Oh yes, good to do it all by mail.
If it comes down to it, see if your state has an Insurance Commisioner (we do in WA) as they often act as advocates between ins so and people.
I had a co who denied my prenatal visits (think one of the BC/BS ones) 20 yrs ago as they never received any of my bills. I ended up having to mail them in "receipt requested" for them to get them. Odd, eh?
Now I'm dealing with what should have been billed as a routine office visit got put in the system as an ER visit.
Best of luck and yes, it is frustrating. Their time is worth money and yours isn't. Hope your ear feels better too.
