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United Healthcare - Appeal: UH Erroneous Determination as Out-of-Network (when provide is in-network)
Hi all - I was wondering what the likelihood that my Appeal that I finally sent in will be successful or if I'm just going to continue getting the runaround from United Healthcare. At this stage is it worth doing anything else (or do I have to wait until the Appeal plays out?)
Some details...
The claim that I filed with United Healthcare had all the correct, relevant, and necessary information including the in-network Tax ID, the Practice’s pertinent information, the doctor’s name, itemized receipts (two – one paid with FSA and one paid with credit card), and other pertinent claim-related information.
United Healthcare processed the claim as out-of-network, but the Practice is in network, which made me receive +/- $3,000 less in reimbursement than I should have (due to that money going to an out-of-network deductible).
I have called United Healthcare more than 15 times now across 3 months to see what else is needed and to fix the wrongly coded EOB and I’m always told that United Healthcare made a processing error and will fix it – but it never happens months and months later.
The EOB erroneously states that this was an out of network event, but everything was in-network, and I have coverage for the procedure on my plan.
Once again, every time I have called United Healthcare, they have told me that I’m right, that they are ‘backing out’ of the old claim and will fix it, and every time nothing has been fixed. I just called earlier this week, and the 15th advocate I spoke with (after taking 20 minutes to look over all the times I called and notes) said I was 100% absolutely correct, I should have received an EOB saying it was in-network, and the determination was wrong, but folks keep coding it – inexplicably – as out of network.
She encouraged me to appeal....which I just did.
Expectations of what may come next? Thank you.
the at-fault driver's insurance - How to File a Small Claims Case for Mini-Tort in Michigan?
I was involved in a car accident in Michigan, and the at-fault driver’s insurance denied my mini-tort claim because they don’t have mini tort coverage. I still have out-of-pocket repair costs ($1,000), and I want to file a small court claims case against the at-fault driver.
I have the **police report**, repair estimates, and insurance denial letter as evidence.
**My questions** ❓
1. **How do I file a small court claims lawsuit in Michigan?.**
2. **What court do I file in—where the accident happened or where the driver lives?.**
3. **How do I serve the at-fault driver properly?.**
4. **What happens if they ignore the lawsuit or refuse to pay after a judgment?.**
5. **Has anyone successfully won a mini-tort case in small claims court?.**
Any advice or experience would be really helpful! Thank you!
Progressive - What to do about car insurance
Hey everyone! HOME HEALTH NURSES/WORKERS INPUT NEEDED
So I haven’t been offered the job yet but I have a second round (!!!) interview on Monday :) this job requires a lot of driving, with mileage reimbursement. They said I would sometimes have to drive patients to and from doctors appointments and/or school (I’m a nurse, I would be a field case manager) and I’m just curious if any of you have been in this scenario. For car insurance do/did you apply for ride share option just in case?
I am debating switching ins. companies anywho, my quote from Progressive is really high.. apparently in my state (NJ) they hiked it up just in general and a few months ago I got into an accident that I’m 100% not at fault for.
Healthy Paws Pet Insurance - Healthy paws pet insurance
Is it even legal for Healthy Paws pet insurance to increase premiums at almost 200% in CA? This is outrageously high!! Anyone experiencing the same?
#healthypawspetinsurance
warranty company - Warranty claim made before expiration date, do they have to honor it?
Location: Texas
On mid February of this year our truck randomly started being noisy, we immediately took it to a shop, they told us the issue and that if it had a warranty we would be fine. It did have a warranty and we immediately contacted them and dropped off the truck in a certified shop. The shop then dealt with the warranty and the claim was officially filed on March 5th (we were told this by the warranty company) today we call for an update and get told they can no longer do anything since the warranty expired on March 30th.
We think they purposely let time run out. Has anyone dealt with something similar?
Fred Loya Insurance - Fred loya insurance has been ignoring me for 3 weeks
My car was totaled at the beginning of July, it was the other drivers fault and she has Fred loya. I have been completely out of a car for 3 weeks and I can’t get through to anyone. I don’t know what to do.
The car isn’t worth a lot, it’s a 2005 Subaru Outback, but in my area (Colorado ) I should get at least $4,000 for it, they offered me $2,200 and after I sent a bunch of comparables over they’ve been ignoring me.
I have 2 jobs and I go back to school next month, I need a car.
Any advice on how to get them to pay attention to me? I’m pretty poor so getting a lawyer feels out of the question, but I’m also getting desperate.
Thank you in advance
charter bus' insurance company - Witness ghosting me. Any recourse?
Hi, my parked car was scratched up on the side by a charter bus a couple months ago. A witness left a note with their number stating that they can send me the license plate photo. They seemed very willing to help and agreeable to making a statement if needed. I had opened a claim with the bus’ insurance company and sent the agent text screenshots of the correspondence with the witness. Weeks later the agent informed me they couldn’t get in touch with the witness and issued a denial because of that.
I texted the witness and asked if they could follow up with the agent and was met with no answer twice a couple weeks apart. Is there any other form of proof that I could present to strengthen my case? Thanks in advance!
renter's insurance - Mold in apartment, not sure what to do next
Location: Washington State
I’m dealing with a housing situation that has gotten increasingly serious, and I could use advice on whether I have a legal case and what my next steps should be. I don’t qualify for free legal aid, but I also can’t afford to hire a lawyer outright. I’ve already spoken with the Tenants Union of Washington State, who suggested I update my complaint with the city’s code enforcement office on Monday because the situation has escalated significantly since I first reported it. They also mentioned I might be entitled to compensation that my landlord isn’t disclosing (either intentionally or not). I’m wondering if I should wait to hear from code enforcement again or if I need to start pursuing legal representation now.
My story begins at the start of the new year. On January 6, I submitted a service request because the floor in my entryway was visibly warped and I was having trouble closing my front door. On January 8, maintenance came out, removed the weather stripping from the bottom of the door, and marked the request as complete even though no inspection was done and the root issue wasn’t addressed. At that point, I figured I had at least documented the damage in case they tried to blame me later, but I had no idea how bad things were about to get.
On March 26, I submitted another repair request because there was now visible water damage and possible mold along the baseboards next to my front door, along with the floorboards becoming even more warped. In my bathroom, there was a significant colony of black, furry mold that had grown between the wall and a small stepstool I had propped up against it. I had also noticed that there were "blisters" in the paint on the walls in the hallway leading up to my apartment where water had obviously started to pool. Maintenance showed up the next day, told me they would "call someone," and once again closed the ticket without fixing or really even looking at anything. On March 29, I went into the leasing office to speak with someone in person because I felt like the issue was not being addressed properly and I wanted some answers. I explained the problem to the leasing agent and he asked me to send him an email describing the issue (which I did) and that I should open yet another repair request for the issue (which I also did.)
On April 1, the maintenance person showed up again. This time, he brought a pipe wrench and literally tried to hammer down the warped floorboards (no joke). Then he sprayed two sprays of mold inhibitor on the wall next to the front door “just in case.” That afternoon, I was told that a water restoration company would be out the next day to inspect the unit.
The water restoration company came first thing on April 2, while I was still in bed. They found significant moisture behind the walls and suspected the presence of mold. The property manager came by a few minutes before noon, took photos, and informed me that my apartment was currently uninhabitable. He told me to file a claim with my renter’s insurance for a hotel. I work from home and was in the middle of my work day when he told me that the water restoration company would be arriving shortly to start dismantling my bathroom to start looking for the cause of the leak. I ended up making a claim with my renter's insurance (even though I believe property management is responsible for the cost of temporary housing) but without a statement of cause, my insurance wouldn't help me find a place to stay so I had to make arrangements on my own for myself and my dog. I'm currently staying in a hotel down the street from my apartment building that is being charged to my credit card.
On April 3, the leasing manager called me to inform me that my apartment is unlivable and they have no timeline for repairs, so I have the option to either break my lease with no penalty or move into another unit (with them paying the moving costs). I asked him to send the offer via email because I needed a written record of the offer before I would even consider anything. He sent me an email the next day (April 4) briefly outlining my two options: either I transfer to another one-bedroom unit in the building at my current rental rate, or I break my lease with no penalties. That’s it. He didn't even include the offer to cover moving expenses to the new unit.
I'm stuck in a frustrating situation with no real solutions. My renter's insurance isn’t covering my hotel costs because they won’t pay without a statement of cause, which I still don’t have. Even if they do cover it, I’ll still be out $250 because of my deductible. I expect the property management company to take responsibility for that since the damage was caused by their neglect. The options they’ve offered don’t even begin to address the full scope of the inconvenience and stress I’m dealing with. There’s no mention of covering the moving costs, or even offering rent relief for the time I’ve been displaced. Neither of these options account for the impact this situation has had on me and my dog.
What should I be doing next? I’ve already filed a complaint with the city’s code enforcement office and plan to follow up on Monday, but I’m not sure if I should be waiting for them or moving ahead with other options, including legal advice. I know I can’t afford to hire a lawyer outright, but I also feel like I’m being jerked around by the property management company and my renter's insurance. Any advice on what steps I should take next?
homeowners insurance company - T-Lock shingles
My homeowners insurance company called me and told me I need to replace my roof and get rid of the t-lock shingles or they will drop me. Is it right for them to do that? The roof is in good condition doesn’t leak or anything. They are basically forcing me to get a good roof redone. Is there something I can do to have them help pay to where I’m not replacing on my own?
Empower - New Employer 401k Options
I just started a new job and received the Empower 401k fund options below. All of these funds appear to have high expense ratios (most around 1%) and overall don’t seem to be that great.
I’m considering rolling over my old 401k to this new plan or an IRA. My old plan is valued at approximately $500k invested in passive total market index funds. I’m 40 married no kids.
While I won’t be able to do the backdoor Roth IRA if I rollover my old plan to an IRA, I feel like the funds available at fidelity are superior to these.
I’m just looking for another opinion on this before I make any decision.
Thank you!
American Century One Choice In Ret ARTAX - 1.01%
American Century One Choice 2025 ARWAX - 1.03%
American Century One Choice 2030 ARCMX
American Century One Choice 2035 ARYAX
American Century One Choice 2040 ARDMX
American Century One Choice 2045 AROAX
American Century One Choice 2050 ARFMX
American Century One Choice 2055 AREMX - 1.14%
Virtus NFJ International Value AFJAX - 1.3%
American Funds EuroPacific Gr R3 RERCX - 1.12%
Invesco Balanced-Risk Alle R5 ABRIX - 1.08%
Invesco Developing Markets Y ODVYX
MassMutual Global Svc. MGFYX - 1.13%
Invesco Real Estate Y IARYX - 1%
MFS Utilities R3 MMUHX - 1.02%
PIMCO Commodity Real Ret Strat PCRAX2 - 1.45%
Columbia Small Cap Index NMSAX - .45%
Franklin Small Cap Value Fund FRVLX - .97%
Invesco Discovery ODIYX - .79%
MassMutual Mid Cap Growth Service.. MEFYX - .86%
Virtus Ceredex Mid-Cap Value Equity I SMVTX - 1.02%
BlackRock Equity Dividend MSDVX - .97%
MassMutual Blue Chip Growth Service.MBCYX - .85%
MM S&P 500 Index Adm MIEYX - .49%
Loomis Sayles Strategic Income Fund Y NEZYX - .67%
MFS Government Securities R3 MFGHX - .76%
Invesco International Bond OIBYX - 79%
Infl-Prot and Inc (MassMutual) MIPYX - .69%
Capital Preservation Account CGPJQ0
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