Recent Posts
Topic: RE: I'M APPROVED!!!!
Thanks. Trust me it will go by so fast. Good luck with everything. If you ever need motivation or someone to talk to...I'm only a click away.
Topic: RE: I'M APPROVED!!!!
Congratulations! That's great news. I'm in the very beginning stages of getting this surgery. I can't wait until I can get up here and say: I'M APPROVED
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! Topic: RE: meeting high deductible
I just wanted to thank you for your insight. If you find out any more info please write!
Topic: I'M APPROVED!!!!
I just received a call today....I'm approved. I meeting with my doctor on Thursday to schedule my surgery date. I am so excited. I know this is meant to be because everything has been smooth sailing.
Topic: Tricare Prime Approval - North Region
Hi, My name is Tampa and I received my approval today after two business days! I just wanted to say Tricare rocks and I am grateful that they approved me without a hassle. I'm scheduled to have my RNY at Inova Hospital in Fairfax at the end of March. Although it's right around the corner and I have a lot to do in a few weeks I'm glad because the other option was May. So clear a big spot for me on the losers bench...I'm kinda hippy right now......but that too will past!! Yeah
Topic: RE: meeting high deductible
True, but how do they know if you have met your deductible or not on the day of service if you don't tell them? Not saying you are wrong, just saying that's how mine works. I had to go to urgent care on Jan 3, and they took my card and didn't ask for a dime, and it says right on there "patient responsibility: 20% after deductible". My bill came in the mail about a month later.
Topic: RE: meeting high deductible
It's actually up to each provider as to when they bill you. Some providers will ask for the money up front. A participating provider with BCBS will know how much the BCBS approved amount is. If they know you have not met your deductible, they may make you pay at the time of service. This is their right.
Topic: RE: BCBSM appeal question???
You have 2 years from the date of service. The appeal process in on your EOB from BCBSM. Why did they deny it. What was your BMI and co-morbidities.
Topic: RE: meeting high deductible
This is how my insurance works too. thankfully I don't have nearly that high a deductible, mine is $1,500, then I pay 20% after that for the next $1,500, then the rest is paid at 100%.
With my insurance, and I believe most work this way, the clinic/hospital will take your card and copy it, and you pay nothing on the date of service. They will bill your insurance, insurance will reply to the clinic and you that the balance has been applied to your deductible and that the whole balance is "patient responsibility", up to the point your deductible is satisfied. After that they pay at thier rate (80%, 100% or whatever). But ALL charges are at the insurance companies negotiated rates, so it is a benefit to you, even with the high deductible.
With my insurance, and I believe most work this way, the clinic/hospital will take your card and copy it, and you pay nothing on the date of service. They will bill your insurance, insurance will reply to the clinic and you that the balance has been applied to your deductible and that the whole balance is "patient responsibility", up to the point your deductible is satisfied. After that they pay at thier rate (80%, 100% or whatever). But ALL charges are at the insurance companies negotiated rates, so it is a benefit to you, even with the high deductible.
Topic: RE: meeting high deductible
Thanks for the quick response. That makes a lot of sense. So in your hypothetical situation that you mentioned will I have to pay that $75 at the time of service, or is that what the insurance will bill me?

it's never too late