How Much Time Did You Spend Fighting Health Insurer Denials of Claims?

I'm interested in hearing from people who have personally filed health insurance claims (or helped clients do so) for which the insurance company should have paid at least some money. I'm especially curious about Anthem or Cigna.

Did they deny any part of the claims? If so, how many hours were spent appealing the decision and going to arbitration? Did the insured person have to drive to a distant place to participate in the arbitration hearing?

Please tell us all about your experience. It would be useful to know how much effort is involved in trying to actually use health insurance.
 
Had a case with BCBS Gold plan in AR where the insurance was not picking up their entire part. Got the detailed bill from the hospital and sent it to BCBS and went over with the client and insurance rep and got it taken care of in a couple hours of work time. Took about a week to ten days to get resolved.
 
I'm interested in hearing from people who have personally filed health insurance claims (or helped clients do so) for which the insurance company should have paid at least some money. I'm especially curious about Anthem or Cigna.

Did they deny any part of the claims? If so, how many hours were spent appealing the decision and going to arbitration? Did the insured person have to drive to a distant place to participate in the arbitration hearing?

Please tell us all about your experience. It would be useful to know how much effort is involved in trying to actually use health insurance.

Most issues we see are just stupid errors.. It can take many months start to finish and a few 20 minute phone calls to the carrier. It takes months because it takes a while to reprocess claims and check on everything. Your success is largely dependent on how well you understand the plan yourself. Our bcbs reps have no clue and they need to be told the benefits and have it explained to them. Most are just call center reps and have no clue how the plans operate. Even worse when the reps are outsourced to another country.
 
Code blue .................

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I came across a forum where people involved with medical billing attempt to help each other. Its chaotic. Lots of new codes...lots of questions.. but very few replies, because no one knows the answers.

Medical Billing Forum: https://www.aapc.com/memberarea/forums/billing-reimbursement/?

It seems that health insurers are blamed too frequently (and easily) when a bill is not paid properly. The Affordable Care Act is raising hell in all corners of the medical industry.
 
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Carriers are easy targets. Always have been even before Obamacare. Not saying carriers are perfect, they aren't. But all the change you can believe in because of Obamacare has made things worse, not better.
 
I'm helping a client fight one now with Blue C

They said they couldn't identify the patient??

With another insurer I had one where the doctors office didn't code the procedure properly so that the carrier could process the claim
So the client calls the agent as always when they have a problem
 
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