I did my due diligence and found a provider listed on the BCBS website listed as in-network. I verified with insurance and the whole nine yards. However, when BCBS adjudicated the claim, it was processed as OON to my surprise. When I questioned why, I was told the provider used a different NPI that is OON. In all seriousness, how is a patient supposed to know what NPI a provider bills under? Do I have grounds to appeal the OON determination or should I ditch this provider and find someone else?

Hi everyone, my 77 year old dad is visiting me in May. It's his first time in the US. He has a COPD condition and we recently came to know from his doctor that he needs supplemental oxygen. He had to do a bunch of tests (spirometry, Hypoxic challenge) to qualify for it. The thing is once he is here and it's time To go back, the airline needs him to redo the tests that he's already done. I talked to INF and it looks like they only cover an onset of a pre existing condition. But, this counts as ongoing care. Can anyone recommend an insurance that will be helpful in this case? Thank you so much.

My husband and I are currently in the process of selling our home. The new owners are using a USDA loan. The first 4 weeks of the closing process were a breeze. Our home passed appraisal and we were told the buyers got their loan approval. The issues started last Thursday. We were supposed to close this past Friday, however I received a phone call from our realtor explaining that the buyers had not been notified that the needed to submit a copy of their W2. They had to go out on a Thursday night to H&R Block to get this final copy. Everything was submitted to USDA on Friday and we were told by the Title office that we were going to close today. It is now Tuesday and after a stressful weekend, we thought we were going to close today. I received an email from our realtor stating that the USDA system is down and we are having to extend closing once again , but this time they are not setting a date because it is unknown when that system will be back up and running. The title office claims that as soon as we get the approval, we will close but I am starting to get VERY frustrated that we are being lied to. Has anything like this happened to anyone??

Every six months I get a big envelope from Statefarm with all my car insurance details and prices. It also comes with a bunch of small booklets, think they are called "endorsements". Anyways the one I got said I would owe around $350 . It also says "This is not a bill". Now today I got my bill electronically. But it says I owe $450+. Unfortunately, I recycled the original paper bill that said I should owe $350. Was that $350 likely for some shorter duration? I did remove something from my insurance a few weeks ago so maybe they sent me some pro-rated amounts?

I am 20 years old and on my parents insurance. I got prescribed a medication under the impression that they would not be notified but my dad got a call about the prior authorization being approved and also a letter in the mail. Does anyone know how to change this/prevent this happening again in the future?

My ADHD prescription has all of sudden stopped being covered by BCBS TN. What’s the fastest way to contact them to resolve this? I have emailed, chat function not available, and I have now been on hold for 3 hours. Has this happened to anyone else? I’m currently at Walgreens don’t know if that matters. But again, it has been covered in the past. It’s not feasible to pay $100+ for a prescription every month nor do I want to.

So like the title says, I crashed my car in July. It was stated that I was at fault and geico covered every bill, except the ambulance one. The thing is, I didn't know there was an ambulance bill until a month ago, they said somehow the ambulance wasn't able to get the insurance or anything but I called GEICO and sent over the bill, and now they are saying they can't cover it and it has to be sent through my health insurance. I'm confused on that part because I thought if it was a vehicle accident then GEICO would cover it, but now they're saying otherwise. I'm just trying to understand the policies cuz I'm just confused right now. Edit: I live in NJ, and they said my coverage wasn't exhausted yet.

Hi all, I have an employer health insurance plan through my union and apparently a few months ago they had to abruptly change their mental health portion of my insurance plan. I am trying to get a therapist but my therapist says my insurance is not accepted because I am a part of a health concept plan but my employer who handles my insurance says I am not apart of the plan anymore and that I have anthem PPO. I’m in a constant loop of insurance saying one thing and my provider saying the other. The Union who handles my insurance tells me to tell the provider to call them but my provider uses a system to verify coverage. I’m not sure who to call or how to get this resolved. When I called anthem they transferred me to my union. When I called the union they said anthem handles that portion of the plan. I think I’ve been passed along every department now. Any advice would help.

My husband has a herniated disc and possibly arthritis, and we’ve been putting off going to the doctor because we’re confused and stressed about what our insurance (Cigna Wellfleet Student) will actually cover. We’re in Rhode Island. From what we can see, the MRI isn’t fully covered under our plan, and possibly other services aren’t either. A regular doctor visit would cost us about $50 out-of-pocket (not sure about the exact term), which isn’t awful, but feels kind of pointless if we can’t afford to get the necessary tests like MRIs anyway. What’s really throwing us off is that a friend of ours, another student with the *same exact plan*, broke their foot, went to the ER, got an MRI and whatever else was needed, and only ended up paying $100 for the ER visit. That’s it. We’re super confused. We’re also hesitant to call the insurance company because we’re scared they’ll be vague or misleading on purpose, or try to hide what’s actually covered to benefit themselves. We feel really stuck and just want to make the best decision for his health without going broke. Has anyone had experience with Cigna Wellfleet Student plans, especially in RI? Any advice on how to navigate this or what we can do to get clearer answers?

The accident occurred on 3/20 and was told they’re taking 100% fault. It all happened so fast, but I was on my way to work in the morning driving 45 in a 45 (it’s also dark and raining). I’m coming up to a 2-way crossroad where the guy’s road had a stop sign and mine didn’t. When I got close to the crossroad I see that he’s rolling up to the stop sign and I assume he’s stopping..because there’s a stop sign. Instead, he keeps rolling into the middle of the lane where I proceed to slam on my brakes and instinctively veer to the left to avoid him but I end up completely smashing the side of his car at 45 mph. I ended up missing that Thursday and Friday and returned to work on Monday since I was told I wouldn’t have to do much work. He ended up not even having a scratch while I have to go to the ER because I was so rattled and didn’t really know the extent of my injuries besides not being able to hear out of my left ear due to it ringing and sounding really muffled. I get a CT scan at the ER and was told that they couldn’t find anything major, so they sent me home with some muscle relaxers and a note for “light work no lifting” for work. A couple days later, I started feeling the extent of my injuries. Taking a deep breath, laughing, coughing, anything that expanded my rib cage or moved/put any pressure on my shoulder blade hurt really bad. My neck was stiff from the whiplash and I could crack my neck in ways I never had. My ear was still muffled with loud ringing and was very disorienting. This affected my sleep, work, daily activities like driving, working out, or even cleaning my apartment. It has been a week and a half since the accident and I’m still feeling all that pain. Albeit, not as significant and alarming as last week, but I still have a muffled left ear with some ringing, pain when my chest expands, shoulder blade pain, anxiety whenever I drive(which is a huge part of my job), sleeping issues, and as silly as this sounds, has destroyed my happiness. I got engaged the weekend before the accident and wanted the celebrate with friends the weekend after, but I wasn’t even able to leave our apartment to celebrate because of how much pain I was in. His insurance has offered me $2,500 for pain and suffering but I feel like that’s a slap in the face. I explained my situation to an attorney and he said it looks like they can make a decent case but said he couldn’t give me a number on how much he thought the case would be worth. So my questions are, can someone give me a ballpark estimate on how much I should negotiate for? & Do I need an attorney involved or is this a situation where I should fight the claim and negotiate myself? TL;DR I got in a high speed accident and his insurance is accepting 100% fault. I got out lucky but am still experiencing injuries like whiplash, some bruised ribs, shoulder blade pain, and muffled hearing. His insurance offered $2,500 and I don’t believe that’s enough for what I’ve gone through. How much could I counter offer for and should I get an attorney involved? Edit: I apologize, I did end up going to a primary care doctor last Friday but he told me the pain I experienced is common and went over the CT scan that the ER did and said “everything looks fine here”. I have an ear, nose, mouth appointment this Friday. Edit 2: I’m sorry if these seem like stupid questions, I’m just really young and don’t have any help outside of my mother.