Q. I have heard that the health insurance companies make mistakes all the time, but because people don't know how to read the statements consumers are regularly overcharged and don't know it. What questions can I ask my doctor to ensure that treatment will be covered-I heard that the wording a doctor uses can determine if the ins. co. will cover the treatment or not.
A. Insurance companies provide a plan document that explains what they will cover. Most people look at what their copays are, but few read into the limitations and exclusions. What the doctor says (via medical records and ICD-9 & CPT coding) DOES determine whether the insurance company will cover the service, but the physician (or his staff) is legally obligated to code for the exact service provided.
For example, if your insurance company does not cover a routine eye exam per plan exclusions, and the doctor codes the visit as a routine exam, your claim is DENIED. If the doctor codes the visit as something was medically wrong with your eyes, it might be covered. But, it would be unethical to change a diagnosis just so your insurance company would pay if you were really only there for a routine exam.
Bottom line ... understand what your insurance company will cover, and be prepared to follow the rules.
PS, it isn't your doctor's job to know what your insurance pays for, it is yours.
For example, if your insurance company does not cover a routine eye exam per plan exclusions, and the doctor codes the visit as a routine exam, your claim is DENIED. If the doctor codes the visit as something was medically wrong with your eyes, it might be covered. But, it would be unethical to change a diagnosis just so your insurance company would pay if you were really only there for a routine exam.
Bottom line ... understand what your insurance company will cover, and be prepared to follow the rules.
PS, it isn't your doctor's job to know what your insurance pays for, it is yours.
What is the best way to settle debt with car insurance companies? Should I get a lawyer? ?
Q. I recently got in a car accident and my insurance company did not cover the extent of the accident. The insurance company is calling and asking for an outrageous amount. I s there a way I can negotiate a lower price and or payment plan?
The outrageous amount is 15 grand and the poor person I hit owns a Mercedes.
The outrageous amount is 15 grand and the poor person I hit owns a Mercedes.
A. lol, yeh right.
the reason the insurance wants you paying for it is so they dont have to.
the fact that youre even asking this question should answer it for you, get a lawyer.
the reason the insurance wants you paying for it is so they dont have to.
the fact that youre even asking this question should answer it for you, get a lawyer.
What are good questions to ask when hiring a new employee?
Q. I am hiring a new employee for a busy insurance company. What are some important questions to ask in an interview?
A. ask why they are looking for a different job,check and make sure they are not job hoppers.Are they willing to do the work you require.Good luck.Good workers are hard to find now days people just don't have job respect they use to have.
Who/ What are insurance companies backed/insured by?
Q. Do insurance companies have an program similar to banks FDIC, or are there insurance companies that solely insure other insurance companies. I ask for the question of what happens in a natural disaster situation when an insurance company cannot afford to repay/replace the damaged/lost property of its customers, or when an insurance company fails - Gov't bailout, FEMA?
A. A carrier admitted to your state, is backed by your state insolvency fund. The state insurance commissioner looks at the money they have set aside, and tells them how many policies, wiht how much coverage, they can write, for that amount of reserve (capacity).
Additionally, in cases like natural disasters, insurance companies ALSO buy "reinsurance" - kinda like big insurance policies with "reinsurance" companies, so they don't get wiped out.
They don't NEED government bailouts, because they're so heavily regulated, it doesn't happen very much at all that they "go under", and when they do, the policies have plenty of time to nonrenew, and any unpaid claims get paid by the state insolvency fund.
FEMA runs the National Flood Insurance Program - the ONLY way to buy flood insurance (for the most part).
Additionally, in cases like natural disasters, insurance companies ALSO buy "reinsurance" - kinda like big insurance policies with "reinsurance" companies, so they don't get wiped out.
They don't NEED government bailouts, because they're so heavily regulated, it doesn't happen very much at all that they "go under", and when they do, the policies have plenty of time to nonrenew, and any unpaid claims get paid by the state insolvency fund.
FEMA runs the National Flood Insurance Program - the ONLY way to buy flood insurance (for the most part).
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