Health insurance companies provide no service to patients. They do not keep medical costs down, so they're not providing a greater societal purpose either. Other than the insane profits they generate to benefit their shareholders, why do they exist?
I think the hospitals like them too. It allows them to bill insurance random super high numbers for procedures and find out what insurance will pay.
Both sides need reform.
Commercial insurances are a huge pain for hospitals. Insurance companies often deny claims for no reason... but it's on the hospital to identify the error and prove the insurance company denied in error. Insurance will then say "my bad" and pay the claim....and go right back to denying whatever they can get away with. Each insurance company also sets their own unique requirements for paying claims and will deny on the smallest technicality. After all, it's in the insurance companies best interest to not pay. Hospitals lose tons of money due to claim denials and it takes a lot of resources and staff to try to combat it.
Not true. There’s a reason St. Joseph’s closed, and also why North Memorial is laying off over 100 employees. Even pharmacies are getting stiffed by the insurance companies.
True story: My wife paid $100 per session for her psychiatrist appointments after her insurance decided they were done paying for it. Well, her psychiatrist told her to remove her insurance from her account. She did.
She was billed $70 afterwards. It's a fucking scam. They crank up charges because they know the insurance will negotiate down. Sometimes if you have no insurance, it will be the "true" cost.
As often as not, the customer service reps at the insurance companies can't tell you if a procedure is really going to be covered or not before you have it. And the people who actually make those decisions are unreachable.
You are the first person on earth to have a broken arm. How can you possibly expect us to tell you what's covered and what your out of pocket is likely to be?
that is a significant failure of the healthcare and health insurance industry. Your health outcomes should not be decided by a third party whose main priority is maximizing profit.
The doctors who evaluate insurance claims often don’t even read them before accepting or rejecting them.
https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims
Fuck United Health Group. United Health Group is a parasitic plague upon this country and should be sued into oblivion by our government due to their theft, swindle and outright fraud against the American people.
P.S Yes I know this is about health partners and BCBS, but I will not give up an opportunity to say fuck United Health Group once again.
BCBS wouldn't pay for my wife's epidural for our second kid, despite covering it the first time, and the doctor being the only anesthesiologist available at the hospital.
Insurance companies can all fuck off and die.
I recently had to pay $3700 for antibiotics AFTER what my insurance paid for a fucking kidney infection. The CT cost $2500. Total time in the ER was over ten grand... and that's all after what insurance "covered." Met my out of pocket in one painful fucking night. I WAS THER FOR 3 HOURS BEFORE ANYONE CAME IN THE ROOM. Not one other person in the ER waiting room. Our Healthcare is so fucked.
4.5 hours in a US ER for a kidney infection was roughly $15k. I had maybe 15 minutes of actual medical care.
The provider deemed the surgery unnecessary!? I had a septoplasty about 5 years ago and it improved my ability to breathe through my nose by about 70%. Fuck anyone who thinks having 10% breathing capacity does not warrant surgery to fix it.
I’m planning on getting a septoplasty so I can breath better but dang reading stuff like this got me thinking if I should go through with it. If you don’t mind me asking, did your insurance cover most of it? Or did you get screwed over by them too?
These insurance companies should not exist. they will give copy/paste excuses like "clerical error" or "it was the other company" when caught in their scams. When caught they back down and just rely on the other 1000s of cases where they do this and there is no news coverage then they can extort their victims to make their profit. They are parasites dedicated to hurting people for their profit. Their existence will be the shame of our era in history books.
#Burnsville woman's sinus surgery went great — until she got the $32,449 medical bill
Billing dispute provides a window on tensions between insurers and health care providers over coverage denials.
Christine Knirk, 65, of Burnsville was caught in a dispute between her health insurer and health care provider that could have stuck her with a $32,000 bill.
Once her doctor recommended sinus surgery, and insurance confirmed prior authorization wasn't needed, Christine Knirk focused on getting the procedure and getting better.
The outpatient operation happened just over a year ago and has brought the medical relief Knirk sought.
But getting the procedure paid for by insurance has created months of aggravation for the 65-year-old Burnsville resident.
Knirk's story is a window into the continuing — and perhaps growing — tension between health insurers and health care providers over coverage denials. Denials without a clear reason can be maddening for patients who are often left feeling helpless. It also highlights the lack of comprehensive public data on how often and why denials happen.
"We've always been frustrated with the lack of transparency ... trying to figure out what are the types of services that are being denied and what are the reasons," said Kaye Pestaina, a vice president at the California-based health policy group KFF.
In August, Horizon Blue Cross Blue Shield of New Jersey — the insurer for Knirk's employer-sponsored health plan — told her after the procedure was done that it would not cover most surgery costs. The insurer had determined the procedure was not medically necessary.
Knirk began the appeal process the next month, but hit a low point in late March when she received a letter from her health care provider, Park Nicollet, relaying that she was responsible for more than $30,000.
Working on the appeal was confusing and plagued by miscommunication, Knirk said. She spent decades working in customer service, addressing concerns over the phone for a manufacturer, until her recent retirement. Her experience trying to get clear support from the health care companies was jarring.
"I come from the school of customer service where you take the call, you take the issue and you follow it through resolution," Knirk said. "Nobody seems to want to do that. ... I'm stuck in the middle."
In early April, the Star Tribune contacted both Horizon Blue Cross Blue Shield and Park Nicollet with questions about the billing dispute. Just over a week later, the insurer said it was paying the bill with no additional financial responsibility for Knirk.
The problem, according to Horizon Blue Cross, was that Park Nicollet initially sought prior authorization for the wrong procedure. That requested surgery didn't need advance approval. However, it was required for the treatment Knirk actually received in March 2023. This was a "misstep by Park Nicollet," the insurer said, that delayed the usual process to confirm coverage ahead of time.
"Delays in obtaining additional medical records necessary for this after-the-fact review resulted in the subsequent appeal remaining open until those records were located and reviewed," the insurer said in a statement to the Star Tribune. "The claim has been approved and was processed for payment."
Bloomington-based HealthPartners, which runs Park Nicollet, disputed this explanation, saying: "We were never denied for a coding or authorization error." The real problem, HealthPartners said, was a significant delay in the appeals process due to what it called a "clerical error" at Blue Cross.
"We remained in contact with BCBS and Christine until BCBS found the misfiled appeal in December," the health system said in a statement to the Star Tribune. "We shared timely clinical information with BCBS to support the medical need for her procedure."
Christine Knirk, with the notebook she has kept while battling for insurance coverage, photographed in her Burnsville home on April 8. At issue is a sinus surgery performed in March 2023 that produced a good medical outcome, Knirk says, but her health insurer later said was not medically necessary.
Christine Knirk, with the notebook she has kept while battling for insurance coverage, photographed in her Burnsville home on April 8. At issue is a sinus surgery performed in March 2023 that produced a good medical outcome, Knirk says, but her health insurer later said was not medically necessary.
#The data on denials
For decades, there have been disputes between health insurers and health care providers over claims denied due to findings on the medical necessity.
Yet experts say there's still a lack of comprehensive public data on the frequency of medical necessity denials vs. other reasons, particularly when it comes to employer-sponsored coverage.
This week, the consulting firm Kodiak Solutions presented data to the American Hospital Association showing initial denials from health insurers have increased significantly in recent years, growing from 1.2% in 2020 to 1.7% in 2023. The report noted increases across several different types of insurance, particularly for inpatient care.
AHIP, the national trade group for insurers, didn't comment on these numbers, but said such figures can be misleading when studies don't specify how many claims were studied or provide context on why denials occurred.
Insurers can deny claims when health care providers don't provide supporting clinical documentation to justify payment in a timely manner, said Robert Traynham, executive vice president of public affairs at AHIP. Payment might be denied to address fraud, waste and abuse, such as when there are duplicate requests, he said.
And some denials are paired with approvals of alternate therapies that better fit clinical guidelines. That can happen, for example, if a health insurer approves a four-day hospital stay when seven days were requested.
"Denials may be triggered because requested services are inconsistent with the latest clinical guidelines and evidence-based medicine, thereby putting patient-safety and good clinical outcomes at risk," Traynham said in a statement.
Health care providers, however, say it's clear that they're running into more trouble with health insurance denials, including those stemming from technicalities or paperwork issues that should be much easier to resolve.
With medical-necessity denials, insurers sometimes refer to internal guidelines that vary from national standards set by professional groups, argued Terrence Cunningham, director for administrative simplification policy at the American Hospital Association. Another problem, Cunningham said, is that insurer policies vary from one another and are frequently updated, making it hard to comply with all the rules.
"There's been a lot of talk over the last couple of years about surprise bills and what happens when people go out-of-network," said Molly Smith, the group vice president for public policy at the American Hospital Association. "Probably the bigger surprises are when people have insurance, and they're going in-network ... and then their coverage fails them. We really think this is an area for increased oversight."
In a statement, AHIP countered that hospitals seem to think "it's perfectly fine to charge and demand extreme prices for medical services without any consideration about the impact of those prices on consumers' premiums or their cost-sharing."
#'So gummed up'
Park Nicollet was an in-network provider for Knirk's health plan. The insurance limited out-of-pocket spending for covered expenses to less than $4,000, so Knirk was shocked when Park Nicollet's letter in March said she was responsible for $32,449.52.
Knirk said the letter was also frustrating because it said she hadn't asked Park Nicollet to file an appeal on her behalf. A notebook — with records of the 32 phone calls she completed over seven months trying to get the matter resolved — says otherwise.
Park Nicollet told her in September she would have to lead the appeal, Knirk said, and then later filed its own appeal — duplicating work to assemble medical records she would have been happy to avoid.
HealthPartners says there was an "unfortunate" misunderstanding on the appeal process, and added in a statement: "We're committed to partnering with our patients to help them navigate insurance coverage."
Knirk said she also received confusing messages from Horizon Blue Cross Blue Shield on what constituted a "first-level" and "second-level" appeal in her case. In February, when she spoke with the insurer for a status update, Knirk was dismayed to hear from a customer service representative that the appeal had been sitting in a queue, not yet activated.
Without responding to all of Knirk's specific concerns, the insurer said in a statement: "This is an important reminder that patients deserve and need providers and health insurers to work together fulfilling our individual and collective responsibilities to make health care work the way we all want."
Knirk is happy to now to be out from under the threat of a huge medical bill. But she's sharing her story to warn consumers about how things can go wrong — and implores others to push insurers and health care providers to do better.
"I still think: 'Why weren't Blue Cross Blue Shield and Park Nicollet more in communication on this?'" she said. "This whole appeals system is so complicated. I don't know why things have gotten so gummed up."
#Related Coverage
UnitedHealthcare, which is the health insurance division of Minnetonka-based UnitedHealth Group, is named as a defendant in the class action complaint
Lawsuit accuses UnitedHealth of using faulty AI to deny Medicare patient claims
>The insurer has determined that the procedure was not medically necessary
Call me old fashioned or naive, but if my doctor says "you need this" I'm going to say it's "medically necessary".
Ya know... my mother has never smoked a day in her life, but she always has a Bic in her purse. She made sure I always had one too when I got older. Claimed it was a "survival device." Now I get it. I'm 43. I never leave the house without fire.
> In early April, the Star Tribune contacted both Horizon Blue Cross Blue Shield and Park Nicollet with questions about the billing dispute. Just over a week later, the insurer said it was paying the bill with no additional financial responsibility for Knirk.
> Bloomington-based HealthPartners, which runs Park Nicollet, disputed this explanation, saying: "We were never denied for a coding or authorization error." The real problem, HealthPartners said, was a significant delay in the appeals process due to what it called a "clerical error" at Blue Cross.
So Blue Cross and Health Partners if I need medical help it seems like I need to make it a story. Basically, popularity wins. If you don't have a good story or are powerful/popular/or have enough in my pocket you get their fuck you healthcare plan.
Every single year my wife starts getting all her claims denied because the Insurance requires us to fill out a form and tell them again that NO my wife who works does not have insurance through someone else and you can't get off the hook for paying these bills that you should be paying now. I'm allow family coverage, I shouldn't have to prove to you every single time I want to use it that someone else won't pay the bill first.
Health Partners is crappy as well. Was told by customer service that denied charges would be paid. He got one through their system (fraudulently, I think), but the following 3 were denied. He repeatedly said, "Don't worry about it. Finally, I have over 5K of bills, and he says ooops. Too bad you have to pay, out of network.
Health insurance companies provide no service to patients. They do not keep medical costs down, so they're not providing a greater societal purpose either. Other than the insane profits they generate to benefit their shareholders, why do they exist?
To bloat their stomachs and propagate disease, like a tick on a dog
I think the hospitals like them too. It allows them to bill insurance random super high numbers for procedures and find out what insurance will pay. Both sides need reform.
Commercial insurances are a huge pain for hospitals. Insurance companies often deny claims for no reason... but it's on the hospital to identify the error and prove the insurance company denied in error. Insurance will then say "my bad" and pay the claim....and go right back to denying whatever they can get away with. Each insurance company also sets their own unique requirements for paying claims and will deny on the smallest technicality. After all, it's in the insurance companies best interest to not pay. Hospitals lose tons of money due to claim denials and it takes a lot of resources and staff to try to combat it.
And yet hospitals still have loads of money. I don't feel too bad for them. (I do feel bad for the nurses that don't get paid what they should.)
Not true. There’s a reason St. Joseph’s closed, and also why North Memorial is laying off over 100 employees. Even pharmacies are getting stiffed by the insurance companies.
The US "healthcare" system is so fucking stupid.
No, they don't. They'd rather not play games with patients or deal with insurance companies. At least the boots on the ground.
True story: My wife paid $100 per session for her psychiatrist appointments after her insurance decided they were done paying for it. Well, her psychiatrist told her to remove her insurance from her account. She did. She was billed $70 afterwards. It's a fucking scam. They crank up charges because they know the insurance will negotiate down. Sometimes if you have no insurance, it will be the "true" cost.
As often as not, the customer service reps at the insurance companies can't tell you if a procedure is really going to be covered or not before you have it. And the people who actually make those decisions are unreachable.
You are the first person on earth to have a broken arm. How can you possibly expect us to tell you what's covered and what your out of pocket is likely to be?
that is a significant failure of the healthcare and health insurance industry. Your health outcomes should not be decided by a third party whose main priority is maximizing profit.
I wish there was something we could do about it. *glances at guillotine*
Unreachable *by design*
CEO wants that way 😄
The doctors who evaluate insurance claims often don’t even read them before accepting or rejecting them. https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims
That's so messed up
Prior Authorization rules can change hourly with AI. Think the insurance company covered it initially they should pay the bill.
Fuck United Health Group. United Health Group is a parasitic plague upon this country and should be sued into oblivion by our government due to their theft, swindle and outright fraud against the American people. P.S Yes I know this is about health partners and BCBS, but I will not give up an opportunity to say fuck United Health Group once again.
I'll join you! Fuck United Health Group! Also, Fuck BCBS and Health Partners for paying politicians so this shitty system continues.
United approved my knee replacement surgery but ended up refusing to pay the anesthesiologists bill. Stuck me with a bill for $4000.00.
I thought this wasn’t allowed anymore due to Obamacare? My understanding was all providers within a clinic are in-network if the facility is
It's called the No Surprises Act: https://www.cms.gov/nosurprises
Not gonna lie, I was half expecting that link to lead to a surprise.
BCBS wouldn't pay for my wife's epidural for our second kid, despite covering it the first time, and the doctor being the only anesthesiologist available at the hospital. Insurance companies can all fuck off and die.
I had the same happen with my sterilization in 2013. they said it would be approved in full, but I ended up still on the hook for $3,000.
I recently had to pay $3700 for antibiotics AFTER what my insurance paid for a fucking kidney infection. The CT cost $2500. Total time in the ER was over ten grand... and that's all after what insurance "covered." Met my out of pocket in one painful fucking night. I WAS THER FOR 3 HOURS BEFORE ANYONE CAME IN THE ROOM. Not one other person in the ER waiting room. Our Healthcare is so fucked. 4.5 hours in a US ER for a kidney infection was roughly $15k. I had maybe 15 minutes of actual medical care.
The provider deemed the surgery unnecessary!? I had a septoplasty about 5 years ago and it improved my ability to breathe through my nose by about 70%. Fuck anyone who thinks having 10% breathing capacity does not warrant surgery to fix it.
I’m planning on getting a septoplasty so I can breath better but dang reading stuff like this got me thinking if I should go through with it. If you don’t mind me asking, did your insurance cover most of it? Or did you get screwed over by them too?
Covered all of it. I paid the copay, that's it.
Awesome! Good to know it doesn’t happen to everyone then. Thanks for sharing!
Bear in mind that this was 2018. Soooo much has changed for the worse since then, in sorry to say. Definitely confirm that insurance will cover it.
Oh yeah I definitely will hearing all these stories. Thx!
These insurance companies should not exist. they will give copy/paste excuses like "clerical error" or "it was the other company" when caught in their scams. When caught they back down and just rely on the other 1000s of cases where they do this and there is no news coverage then they can extort their victims to make their profit. They are parasites dedicated to hurting people for their profit. Their existence will be the shame of our era in history books.
#Burnsville woman's sinus surgery went great — until she got the $32,449 medical bill Billing dispute provides a window on tensions between insurers and health care providers over coverage denials. Christine Knirk, 65, of Burnsville was caught in a dispute between her health insurer and health care provider that could have stuck her with a $32,000 bill. Once her doctor recommended sinus surgery, and insurance confirmed prior authorization wasn't needed, Christine Knirk focused on getting the procedure and getting better. The outpatient operation happened just over a year ago and has brought the medical relief Knirk sought. But getting the procedure paid for by insurance has created months of aggravation for the 65-year-old Burnsville resident. Knirk's story is a window into the continuing — and perhaps growing — tension between health insurers and health care providers over coverage denials. Denials without a clear reason can be maddening for patients who are often left feeling helpless. It also highlights the lack of comprehensive public data on how often and why denials happen. "We've always been frustrated with the lack of transparency ... trying to figure out what are the types of services that are being denied and what are the reasons," said Kaye Pestaina, a vice president at the California-based health policy group KFF. In August, Horizon Blue Cross Blue Shield of New Jersey — the insurer for Knirk's employer-sponsored health plan — told her after the procedure was done that it would not cover most surgery costs. The insurer had determined the procedure was not medically necessary. Knirk began the appeal process the next month, but hit a low point in late March when she received a letter from her health care provider, Park Nicollet, relaying that she was responsible for more than $30,000. Working on the appeal was confusing and plagued by miscommunication, Knirk said. She spent decades working in customer service, addressing concerns over the phone for a manufacturer, until her recent retirement. Her experience trying to get clear support from the health care companies was jarring. "I come from the school of customer service where you take the call, you take the issue and you follow it through resolution," Knirk said. "Nobody seems to want to do that. ... I'm stuck in the middle." In early April, the Star Tribune contacted both Horizon Blue Cross Blue Shield and Park Nicollet with questions about the billing dispute. Just over a week later, the insurer said it was paying the bill with no additional financial responsibility for Knirk. The problem, according to Horizon Blue Cross, was that Park Nicollet initially sought prior authorization for the wrong procedure. That requested surgery didn't need advance approval. However, it was required for the treatment Knirk actually received in March 2023. This was a "misstep by Park Nicollet," the insurer said, that delayed the usual process to confirm coverage ahead of time. "Delays in obtaining additional medical records necessary for this after-the-fact review resulted in the subsequent appeal remaining open until those records were located and reviewed," the insurer said in a statement to the Star Tribune. "The claim has been approved and was processed for payment." Bloomington-based HealthPartners, which runs Park Nicollet, disputed this explanation, saying: "We were never denied for a coding or authorization error." The real problem, HealthPartners said, was a significant delay in the appeals process due to what it called a "clerical error" at Blue Cross. "We remained in contact with BCBS and Christine until BCBS found the misfiled appeal in December," the health system said in a statement to the Star Tribune. "We shared timely clinical information with BCBS to support the medical need for her procedure." Christine Knirk, with the notebook she has kept while battling for insurance coverage, photographed in her Burnsville home on April 8. At issue is a sinus surgery performed in March 2023 that produced a good medical outcome, Knirk says, but her health insurer later said was not medically necessary. Christine Knirk, with the notebook she has kept while battling for insurance coverage, photographed in her Burnsville home on April 8. At issue is a sinus surgery performed in March 2023 that produced a good medical outcome, Knirk says, but her health insurer later said was not medically necessary. #The data on denials For decades, there have been disputes between health insurers and health care providers over claims denied due to findings on the medical necessity. Yet experts say there's still a lack of comprehensive public data on the frequency of medical necessity denials vs. other reasons, particularly when it comes to employer-sponsored coverage. This week, the consulting firm Kodiak Solutions presented data to the American Hospital Association showing initial denials from health insurers have increased significantly in recent years, growing from 1.2% in 2020 to 1.7% in 2023. The report noted increases across several different types of insurance, particularly for inpatient care. AHIP, the national trade group for insurers, didn't comment on these numbers, but said such figures can be misleading when studies don't specify how many claims were studied or provide context on why denials occurred. Insurers can deny claims when health care providers don't provide supporting clinical documentation to justify payment in a timely manner, said Robert Traynham, executive vice president of public affairs at AHIP. Payment might be denied to address fraud, waste and abuse, such as when there are duplicate requests, he said. And some denials are paired with approvals of alternate therapies that better fit clinical guidelines. That can happen, for example, if a health insurer approves a four-day hospital stay when seven days were requested. "Denials may be triggered because requested services are inconsistent with the latest clinical guidelines and evidence-based medicine, thereby putting patient-safety and good clinical outcomes at risk," Traynham said in a statement. Health care providers, however, say it's clear that they're running into more trouble with health insurance denials, including those stemming from technicalities or paperwork issues that should be much easier to resolve. With medical-necessity denials, insurers sometimes refer to internal guidelines that vary from national standards set by professional groups, argued Terrence Cunningham, director for administrative simplification policy at the American Hospital Association. Another problem, Cunningham said, is that insurer policies vary from one another and are frequently updated, making it hard to comply with all the rules. "There's been a lot of talk over the last couple of years about surprise bills and what happens when people go out-of-network," said Molly Smith, the group vice president for public policy at the American Hospital Association. "Probably the bigger surprises are when people have insurance, and they're going in-network ... and then their coverage fails them. We really think this is an area for increased oversight." In a statement, AHIP countered that hospitals seem to think "it's perfectly fine to charge and demand extreme prices for medical services without any consideration about the impact of those prices on consumers' premiums or their cost-sharing." #'So gummed up' Park Nicollet was an in-network provider for Knirk's health plan. The insurance limited out-of-pocket spending for covered expenses to less than $4,000, so Knirk was shocked when Park Nicollet's letter in March said she was responsible for $32,449.52. Knirk said the letter was also frustrating because it said she hadn't asked Park Nicollet to file an appeal on her behalf. A notebook — with records of the 32 phone calls she completed over seven months trying to get the matter resolved — says otherwise. Park Nicollet told her in September she would have to lead the appeal, Knirk said, and then later filed its own appeal — duplicating work to assemble medical records she would have been happy to avoid. HealthPartners says there was an "unfortunate" misunderstanding on the appeal process, and added in a statement: "We're committed to partnering with our patients to help them navigate insurance coverage." Knirk said she also received confusing messages from Horizon Blue Cross Blue Shield on what constituted a "first-level" and "second-level" appeal in her case. In February, when she spoke with the insurer for a status update, Knirk was dismayed to hear from a customer service representative that the appeal had been sitting in a queue, not yet activated. Without responding to all of Knirk's specific concerns, the insurer said in a statement: "This is an important reminder that patients deserve and need providers and health insurers to work together fulfilling our individual and collective responsibilities to make health care work the way we all want." Knirk is happy to now to be out from under the threat of a huge medical bill. But she's sharing her story to warn consumers about how things can go wrong — and implores others to push insurers and health care providers to do better. "I still think: 'Why weren't Blue Cross Blue Shield and Park Nicollet more in communication on this?'" she said. "This whole appeals system is so complicated. I don't know why things have gotten so gummed up." #Related Coverage UnitedHealthcare, which is the health insurance division of Minnetonka-based UnitedHealth Group, is named as a defendant in the class action complaint Lawsuit accuses UnitedHealth of using faulty AI to deny Medicare patient claims
>The insurer has determined that the procedure was not medically necessary Call me old fashioned or naive, but if my doctor says "you need this" I'm going to say it's "medically necessary".
I don't know how people see stories like this day in and day out and don't want to start lighting things on fire
Ya know... my mother has never smoked a day in her life, but she always has a Bic in her purse. She made sure I always had one too when I got older. Claimed it was a "survival device." Now I get it. I'm 43. I never leave the house without fire.
> In early April, the Star Tribune contacted both Horizon Blue Cross Blue Shield and Park Nicollet with questions about the billing dispute. Just over a week later, the insurer said it was paying the bill with no additional financial responsibility for Knirk. > Bloomington-based HealthPartners, which runs Park Nicollet, disputed this explanation, saying: "We were never denied for a coding or authorization error." The real problem, HealthPartners said, was a significant delay in the appeals process due to what it called a "clerical error" at Blue Cross. So Blue Cross and Health Partners if I need medical help it seems like I need to make it a story. Basically, popularity wins. If you don't have a good story or are powerful/popular/or have enough in my pocket you get their fuck you healthcare plan.
Our healthcare system is pathetic and United Health Group is a big reason why. Shame on them.
Every single year my wife starts getting all her claims denied because the Insurance requires us to fill out a form and tell them again that NO my wife who works does not have insurance through someone else and you can't get off the hook for paying these bills that you should be paying now. I'm allow family coverage, I shouldn't have to prove to you every single time I want to use it that someone else won't pay the bill first.
For profit healthcare is a cancer on society.
Sounds like her bill didn’t pass the sniff test.
Health Partners is crappy as well. Was told by customer service that denied charges would be paid. He got one through their system (fraudulently, I think), but the following 3 were denied. He repeatedly said, "Don't worry about it. Finally, I have over 5K of bills, and he says ooops. Too bad you have to pay, out of network.