USA PA Highmark BCBS - Out of Network charge when facility In Network? Insurance |
- USA PA Highmark BCBS - Out of Network charge when facility In Network?
- Shady Body Shop and Shady Insurance
- Liability for teaching online?
- Eligiblity for subsidized health care now that I'm married?
- Driving Car Out of State Consistently
- Aftermarket parts for theft
- My friend drives my car and gets in an accident. Whos insurance pays?
- Two settlement amounts for stolen car. How can this be negotiated?
- Getting insured with an expired license, since I can't renew at the moment?
- Advice for a pain and suffering settlement
- Insurance Question Regarding Totaled Vehicle
- CA / Santa Clara County HOA + Water Leak
- SOS TRAVEL INSURANCE
- Commercial auto policy or not?
- Am I covered under CDW (Collision Damage Waiver) if the insurance company pays for the rental but I use my credit card for the deposit?
- Should I enroll in Aflac? Are they trust worthy?
- Dutch artist/designer visiting (building)-site in Virginia, looking to understand insurance needed
- My car was damaged by a distracted driver, where do I go from here?
- Ideal life insurance for a 24 y/o male who takes care of a single parent
- Travelers vs. State Farm
- Single-car accident i was involved in happened hours ago, will my rates increase heavily?
- Home insurance up $400.00 last 3 years?
- Long term disability coverage question
- How can corporate and commercial business benefit from premium finance during Covid-19?
| USA PA Highmark BCBS - Out of Network charge when facility In Network? Posted: 01 May 2020 04:25 AM PDT Hi All, My wife and I have been going around and around with the insurance provider and companies for a few months and are looking for advice as to how to proceed. My wife and I are expecting our first child. Her OB suggested a couple of genetic screening tests and gave procedure codes to see if they were covered with our insurance. Wife called and ensured that the test selection we wanted was covered, which it was. She then called and asked if the facility she was going to was in network, which it was. We specifically drove almost an hour away to make this accommodation on a Saturday. Bloodwork was drawn for the test. Flash forward 3 months, we get a bill for the whole test from the testing facility (which was not the same as the one we cleared) for the whole amount (~$8k). We called the facility we took the test at who said that since it was a Saturday, they had to send it out for processing since their lab was closed for the weekend, which we did not authorize. We then received an EOB from our healthcare provider which said it was an uncovered out of network charge and sent a check for their coinsurance. Wife called and provider stated that, even though the test was covered, because it was an out of network facility, we're stuck with the bill. We could file an appeal since it wasnt our choice and we did our due diligence. The call center rep seemed to think it was a slam dunk appeal since they had full documentation of us calling in to preauthorize, they could see we went to a covered facility, etc. We received a letter a month later saying the appeal was denied since the test was performed by an out of network facility, but they talked with the testing facility and they would accept the coinsurance check as payment in full. Wife called the testing facility and explained, they stated to send over the check from healthcare provider and they would process and we would owe nothing. I asked for this in writing, which they said they couldnt do due to not allowing email correspondence for legal reasons. We sent the check, which they cashed. We then received another bill from them saying we owe ~$2k after payment from insurance due to additional coinsurance and uncovered line items. Called facility again and they said that the check hadn't fully processed and it would in March and we'd receive a statement saying we owe $0 in April. Yesterday we received the same bill as before ~$2k and that the amount was over 120 days past due. Where do we go from here? The whole system seems like a sham from us doing everything in our power to ensure it was right, to appeal getting denied, to the facility attempting to shakedown us for the rest of the cash. More importantly - how can I avoid this next time? [link] [comments]  |
| Shady Body Shop and Shady Insurance Posted: 01 May 2020 08:59 AM PDT Edit: Louisiana, US My '85 Corvette was in an accident a year ago, and has sat at a body shop for that whole time outside in their back. I was ran off the road by a lady who didn't have the right of way cutting me off. She admitted fault. I had an insurance card from her but it was expired. So completely out of the blue an adjuster agent calls me and her insurance knows what happened and got in contact with me. They wanted to total the car even though we gave them an appraisal of what it was truly worth. They wanted to total the $8000 for only $3000 in damages and repair. We got them to budge and we were under the idea the car was now being worked on and that the insurance gave the go ahead. This was October of last year, the accident happened in May 2019. Through that whole time the car was rained on, beat on by the sun, and through severe hail storms (just my luck). Everytime I would ask them about the progress of the car and they would give an excuse, "paint booth broke", and finally my dad went by yesterday, "frame jig is broke". But we knew they were all operational. Cars were going in and out of the shop everyday. Everytime I came by to check, there were always a whole new set of cars. Finally we decided ebough was enough and took the car home. The only thing they did was pull the hood latch, take off the air filter on the engine, and put primer on the new hood I gave them. Here's the damage done: I built the engine by myself two years ago with a new fuel tank and everything. Now there's 1 year old gas in the fuel system causing the engine to not run, not water tight sealed on weatherstripping, tires were left deflated and there's cracking in the sidewall, crack in the glass, paint bubbling and cracks, and the digital dash is now sunburnt and not able to be read. I really need help here because I'm totally at a loss for words, this is my grandpa's car, it can't be totalled whatsoever. When I talked to my insurance (State Farm), they said they have no contact with the other insurance and they have no records of the claim number except for the fact the body shop called insurance once in January [link] [comments]  |
| Liability for teaching online? Posted: 01 May 2020 05:38 AM PDT I'm a pole fitness instructor who wants to start doing online group classes and private lessons. My boss at the studio I work for emphasized that if we (instructors) are teaching from our homes we need our own liability insurance since we're not covered by her policy at home. I'm afraid my policy may be denied since it's pole dance and not the usual personal training or yoga. Does anyone have knowledge about if this is even worth it? Does having a consent waiver help me at all? It's a pretty thorough waiver that I created for all clients who want lessons outside of the studio. Any advice is appreciated! [link] [comments]  |
| Eligiblity for subsidized health care now that I'm married? Posted: 01 May 2020 05:27 AM PDT I've been using marketplace healthcare for the past couple years but recently got married. My wife is under 26 so she has been staying on her parents health insurance but now that we are married I know that triggers a status update on healthcare.gov. My understanding is that if I have the option to get coverage from her employer I have to take that. Two things though, one, it's twice the price if I did and two, she would have to get on that plan just so I could get on it. It's not offered to family unless she is on it. So, my question is does this count as the example saying coverage is not technically available to me? At least not until she decides to get on the work coverage after turning 26? I did the numbers and we'd be paying $350 extra per month for less quality coverage. She doesn't make a ton of money anyway especially now under these circumstances, that loss of income would sting a lot. [link] [comments]  |
| Driving Car Out of State Consistently Posted: 01 May 2020 08:03 AM PDT My parents are purchasing a car for me (they will be legal owners) that I will be driving out of state (where I reside). As long as I am on their policy, does it pose any potential risk to have me be driving their car out of state? Hope that makes sense. Thanks. [link] [comments]  |
| Posted: 01 May 2020 07:17 AM PDT So my wheels and tires were stolen and I do have coverage for that. I went to the dealership to get a quote for the oem parts and the insurance wants to pay for all aftermarket parts. Do I have to settle for aftermarket parts? My vehicle is a 2019. I'm in Texas [link] [comments]  |
| My friend drives my car and gets in an accident. Whos insurance pays? Posted: 30 Apr 2020 09:32 AM PDT If my friend is driving my car and gets in an accident and is at-fault and we both have our own insurance. Whos company will cover the damage mine or his? And how would it effect my rates if it is under mine if he causes the accident? EDIT: new jersey is the state [link] [comments]  |
| Two settlement amounts for stolen car. How can this be negotiated? Posted: 30 Apr 2020 07:08 PM PDT I have replacement value coverage on the stolen car, and insurance presented me with two amounts:
I don't want to miss out on the higher payout but I also want the freedom to downgrade. How can I negotiate to improve my situation? Thank you for reading! [link] [comments]  |
| Getting insured with an expired license, since I can't renew at the moment? Posted: 30 Apr 2020 10:48 PM PDT I had a DUI in 2017, and haven't had a chance to get last few things taken care of. My license has expired and I can't take the permit test I need to in order to get it again. I NEED a car very soon, as the situation with my roommate and I has changed and I have NO other means to get back to work in a week or so (taxi, biking, Uber, etc is NOT feasible). I do want to have insurance before I start driving a car I'm buying this week. What companies can insure me without a license? I'm 100% aware of the repercussions of "driving without a license". I can't do what I need to do at the moment to get it valid. I want to make sure I have insurance in case something happens, as in a worst case scenario I'm still covered. As soon as offices resume normal services I'm getting it taken care of. [link] [comments]  |
| Advice for a pain and suffering settlement Posted: 01 May 2020 02:32 AM PDT Last year I was in an accident and visited several family physicians and got differing answers as to what could be going on. After the soreness faded from the accident I started to notice a persistent pain in the muscle of my left shoulder / upper back. In the process, I took 2 x-rays of different areas and they both came back negative. During this time the pain got worse and in addition to the soreness the muscle was noticeably inflamed. I eventually did physical therapy which at first didn't help much, but then they started incorporating dry needling and that brought much relief, but it was only for a few days. Eventually, I went to a pm&r physician who did trigger point injections and again I had much relief, but it only lasted about 5 weeks. I was later told that I likely have myofasical pain syndrome and will need these injections monthly. The thing is you can't really diagnosis this besides the patient describing the symptoms and then the physician feeling for inflammation and tenderness. Therefore, I'm guessing the insurance didn't take the diagnosis into consideration, because they only offered $500. Even if it weren't for the diagnosis I wouldn't be okay with this, because out of pocket I've paid $1500 for treatment (co-pay / deductible). My medical bills were much more than that, but thankfully insurance covered that. Also, the injections are about $280, but I only pay $60. I'm hoping to always have insurance, so hopefully it'll never be $280 out of pocket, but even the $60 is a lot for me right now and the amount they offered doesn't even cover a year. I've never settled anything like this before, so is this amount fair for a situation like this or should I try to negotiate more? If I should negotiate how much should I request? I was hoping for closer to $4,400 to cover what I've already paid out of pocket, and then to cover 4 years of treatment until I can at least graduate and be in a more comfortable position to pay this out of pocket. I'm thankful that they're even offering me anything, but I'm hoping for more, because the pain this brings me is very disruptive and I'd like to know that I'll be able to afford treatment. [link] [comments]  |
| Insurance Question Regarding Totaled Vehicle Posted: 30 Apr 2020 03:33 PM PDT Here are the basics: About two months ago, I was driving down the road and a bucket fell off of a dump truck and hit the front of my vehicle. I filed a claim. No big deal, received a check for the damage. In the mean time, while waiting to go get the work done (coronavirus issues and trying to avoid using a rental car) a hail storm comes through and totals out my vehicle. My question is, what do I do with the check that I got for the damage prior to the storm? I've never been in this situation before. [link] [comments]  |
| CA / Santa Clara County HOA + Water Leak Posted: 30 Apr 2020 10:47 PM PDT Hi folks, Thanks for taking a read. Need a bit of advice. (cross post from legal) Here's the situation (CA / Santa Clara County).
I guess this boils down to the following questions.
Thank you [link] [comments]  |
| Posted: 30 Apr 2020 05:38 PM PDT Long story short I had travel plans to San Fransisco to celebrate finishing breast cancer treatment right when SF shutdown for covid. Of course my still immunocompromised self wasn't going and still hasn't gone anywhere. I've sent them a copy of my medical records but my travel insurance is claiming since I'm not in active treatment my claim isn't covered. I sent my doctor the letter they're requesting for an appeal but doc office is completely overwhelmed and my request is rightfully going ignored. I also lost my job and now my high interest credit card is incurring interest that is making my stomach roll. I've been going back and forth with Aon for about 6weeks now and I need this resolved. What are my options? [link] [comments]  |
| Commercial auto policy or not? Posted: 30 Apr 2020 03:22 PM PDT Hello, My situation is as follows: Professionally licensed Engineer Do I need to have commercial insurance coverage for my vehicle? Would the equipment not be insured via the company and therefore not need to be insured through my vehicle policy? I have asked so many people this question. My insurance broker: commercial policy required. My colleague: commercial not required. My company: currently unknown. TD representative: Commercial required. TD representative #2: commercial not required. Can anyone offer any guidance on if this is a commercial situation or not? Thank you! [link] [comments]  |
| Posted: 30 Apr 2020 08:33 PM PDT Was involved in an accident that resulted in my vehicle being deemed a total loss by the at-fault party's insurance company. Fast forward a few days later, I get put into a rental and I decline their insurance. Couple days later I end up causing some undercarriage damage to the rental due to my own negligence and I end up paying for the repairs to the rental out of pocket and never informed the rental car company. The bill to repair the car wasn't cheap but they never found out about it and the car really was repaired (it drove fine afterwards). I was curious if I was covered under the CDW by my credit card company (Chase Freedom Unlimited CC) if all I paid was the deposit and a refueling fee? Am I eligible to be reimbursed by my CC under the CDW if all I paid was the deposit/refueling fee and the insurance company paid 100% of the rental or am I out of luck? Any responses would be greatly appreciated! Thanks [link] [comments]  |
| Should I enroll in Aflac? Are they trust worthy? Posted: 30 Apr 2020 04:35 PM PDT So I dirtbike a lot, and of course insurance does not cover everything, so I would like to get an additional insurance in case I break a bone, need xrays, or perhaps MRIs etc. I was wondering if Aflac would be for me? Say I think I have a broken bone, ligament or something and insurance covers 60%, would aflac cover the rest? How about for random sickness? surgery for say a biopsy or something or cancer; can they enroll everything into one? thanks for the heads up! [link] [comments]  |
| Dutch artist/designer visiting (building)-site in Virginia, looking to understand insurance needed Posted: 30 Apr 2020 12:09 PM PDT For the completion of a project in Virginia, my colleague and I will have a site-visit during the installation and tuning of our artwork. We likely won't do any physical labor (I don't think our visa would allow this anyway) but will advise on the installation on and off for about a week. We have been informed that we are to have all the right insurances for such site-visit and in preparation of our next meeting I'm trying to get a picture of what that might entail, where to get such and what we should expect to pay. [link] [comments]  |
| My car was damaged by a distracted driver, where do I go from here? Posted: 30 Apr 2020 06:00 PM PDT Yesterday afternoon (Minnesota) a car hit my 2014 Honda Civic that was parked on the street in front of my house. I came out to leave and saw my car up the curb in the grass with the other driver nearby trying to move his car out of the roadway. Neither car was drivable (crushed wheel/corner on each), both had to be towed. I called the police and the driver said he looked down at his ringing phone and hit my car. It hit my car in the back corner and my car looks totaled... the damage is extensive. I have filed a claim with his insurance, and the agent from there said he would have someone out to examine my car at the auto body shop it was towed to tomorrow. In the meantime, they have set me up with a rental from Enterprise. Where do I go from here? I guess my worry is they will declare my car totaled and value it at a number lower than it truly is worth. I'm not sure how this all works. My car is a 6 years old. I purchased it brand new from the dealership and had it totally paid off. I'm quite upset and worried. Any tips/advice welcome. Thank you. [link] [comments]  |
| Ideal life insurance for a 24 y/o male who takes care of a single parent Posted: 30 Apr 2020 05:03 PM PDT What would be the best type of life insurance policy to get for me(24M) who takes care of my single father who has dementia? If anything were to happen to me he would be left to my 2 younger siblings who aren't really equipped to take care of him given their age and experience. Taking care of him is not the easiest thing but I think I am a little more capable of handling and managing him since I already work in the medical field. I would be getting life insurance in the future for whenever I start a family so I figured I should start now to be safe so I can make things easier on my siblings in case something happens to me. Edit:FL-USA, I am single, healthy, non-smoker, and don't do any crazy things since I am busy taking care of my Dad all the time if that helps. [link] [comments]  |
| Posted: 30 Apr 2020 11:04 AM PDT We're looking at bundling our car insurance with our new house insurance. Right now, we have car and renters insurance through State Farm, and we've never had a problem with them. In fact, our current representative is pretty great and helped save us a little money. However, we had someone run rates with other companies, and we found that Travelers is HALF as much as State Farm currently is. Has anyone had trouble with Travelers? I'm not sure which company to go with as I'm afraid to have a ton of trouble filing a claim. Edit:: thanks everyone! We're swapping over. I appreciate your replies! [link] [comments]  |
| Single-car accident i was involved in happened hours ago, will my rates increase heavily? Posted: 30 Apr 2020 04:39 PM PDT This happened at around 4pm EST In marion Township, PA. I (18M) was driving in the rain, i put cruise control on(as the road is notorious for deer) came around a bend. The back end of my truck swung out from behind me, causing me to hit a telephone pole with my rear going around 40mph (speed limit was 45). I completely sheared the pole (which was replaced less than 2 hours later) and hit a Y road sign that was in front of the pole. The officer that wrote up the report said that '[I] did nothing wrong'. However, i am afraid my insurance rates will heavily spike, as the officer said Penn Power( the company that manages the poles where the accident happened) would sue Erie Insurance (my insurance) to get the funds for the pole replacement. i was going the limit and wasnt breaking any travel violations. Will this make my rates spike, and if so, about how much? [link] [comments]  |
| Home insurance up $400.00 last 3 years? Posted: 30 Apr 2020 10:14 AM PDT Hi, I would appreciate any advice. I am helping my mom with some budgeting since she is retiring and I reviewed her home insurance for the last couple years. https://imgur.com/a/mgyRQAyhttps://imgur.com/LaJ6PP6 This is what her policy states is covered. She does not live in a large home and used to pay around 500 a year on home insurance. It has now gone up to 1000.00 starting this year. Her home has actually devalued quite a bit in the past years and I am worried they are adding unnecessary coverage. She has not once made a claim in 20 years. I am worried to change the policy and move to another company as she needs a new roof due to hail damage and we need to make her first claim. Any advice would be greatly appreciated. medical is 1000 each and 300,000 personal liability. what is dwelling extension? Will lowering personal property help? [link] [comments]  |
| Long term disability coverage question Posted: 30 Apr 2020 09:09 AM PDT I currently own a LTD policy that pays 60% of income up to 67 years old. Can I buy a supplemental LTD policy that increases my income percentage above 60% or is 60% the maximum you can collect despite stacking policies? [link] [comments]  |
| How can corporate and commercial business benefit from premium finance during Covid-19? Posted: 30 Apr 2020 09:05 AM PDT What's premium finances' greatest solution for the client or businesses in today's Covid-19 climate? [link] [comments]  |
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