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ASPCA - AKC pre-existing conditions confusion
I have 2 rescues.
Dog 1 we got at birth and found out she has auto immune hepatitis and will need medication for life. We had to pay $4,000 to find this out.
Dog 2 is of unknown age and he was a stray so we had no knowledge of his health. We since found out he has IVDD and degenerative valve disease. So he will need ultrasounds 2 x year plus medication eventually. ASPCA has not paid a cent after a year. They chalk everything up to pre-existing conditions.
I feel like I’m not understanding the AKC clause that says they pay for pre-existing conditions after 365 days. I’m not happy at all with ASPCA’s customer service and the rates were comparable at the time I signed them up last year. I’m sure if I get a new quote before my ASPCA plan renew, AKC will ask about pre-existing conditions and quote premiums accordingly.
I tried looking for the info on their website but it seems so vague and I don’t know where else to get further clarification.
Cigna - OON claim reimbursement with provider who is sole proprietor
My wife has started seeing a new therapist who she seems to really like.
The therapist is out of network for our insurance (Cigna) and I think does only self-pay, but issues a superbill at the end of the month that we can submit for reimbursement. This superbill contains her NPI number but not her TIN.
I have submitted claims with these superbills to Cigna but they have been denied due to lacking a TIN. After seeing the denials I googled and found that this provider is a sole proprietor therefore her TIN is actually her SSN, and that it is a relatively common practice for solo therapists to be structured this way instead of through an LLC.
If she declines to provide a TIN to our insurance company is our only recourse finding a different provider? I’m not going to ask my wife to switch but just want to understand the lay of the land.
State Farm - Does anybody know or have had an awful experience with State Farm?
Does anybody know or have had a awful experience with State Farm? They have kept my car at a body shop. It was a front end collision. They fixed all the outside of the car. Even things that did not need to be replaced. When went to pick it up it was not drivable. We told them at the time of the crash that they stability. Track went out. They refused to fix that. They told me to have it towed to my dealership. And guess what? I can’t get a hold of their roadside assistance. And every time I call they act like they don’t even know Like there is no claim! How can that be? They still have my vehicle at the shop.
Progressive - Progressive already has my wage verification, but keeps calling my employer for more information? I don't know why but it sounds sus.
My hip was broken in 3 spots after a pedestrian vs vehicle accident. I'm working with an attorney who has been talking with Progressive (the driver's insurance). They asked for information regarding my employment to verify wages. I have two jobs. 1 WFH, the other is more physical. I was able to return to the WFH job quickly thanks to a lot of pain meds. Anyway, my employer filled out the paperwork they needed, I sent it to my attorney who passed it over to Progressive. They still called my WFH job, needing to speak with my employer. Why? What more do they need to verify? Is this normal?
PENNIE - PENNIE (Pa) questions
I was laid off effective 3/31. (Thanks, Trump and Musk.)
I filled out the application with PENNIE on 3/31. Got approved and told I have 60 days to select a plan. I called PA/PENNIE then. I didn't have my COBRA info yet so couldn't make an informed decision.
I just logged back on to PENNIE and while it still says "you have 52 days to choose a plan," the effective date is coming up as May 1st, not retro to April 1st (like how COBRA works).
I've called and the rep is not well-informed. The last time I called, another rep said "yes you can choose later and it goes retroactive."
unknown - Insurance Help
Hey all,
Ran across something weird today. I was notified by my son’s pediatrician office that his provider was not covered under our insurance plan. We have been going to this provider without issue and picked this provider based on the fact that when we searched him on our insurance website, it listed him as in network. I contacted my insurance company, and they reported to me that on initial search based on NPI, he was a covered provider.
I called the billing office back and they said to give the insurance company the tax ID to search. I did this, and my insurance said the tax ID was not covered, but when the tax ID and NPI were provided, it was listed as covered.
My insurance called the billing department, and they told my insurance that they do not accept my insurance plan, only certain policies under my insurance provider, but not my specific plan.
The medical office told me they would be resubmitting the prior claims since they should not have been processed as “in network” and that I would be responsible for payment since it’s out of network.
I can’t make any sense of this. All prior claims from the visits were processed and covered by my insurance, but now the medical office is claiming that they have always been out of network? Why would they have been billing my insurance if they were in fact out of network? Any help or insight would be helpful!
Healthy Paws - Avoid healthy paws
Current policy holder for two animals since 2018. Aside from the constant increase in premiums… now that I’ve begun filing claims they are questioning the breed of the dog and threatening to double my premiums if I don’t validate a large mix breed vs a mix pit bull.
Disgusted.
Aetna - Can a doctor be within an insurance network and no longer be licensed?
I believe that a Psychiatry doctor within my Aetna Network is no longer licensed or have an active license in Texas. He has a NPI and Medicare number and part of multiple insurance networks. But, I cannot find an active license for Texas and Aetna actually says that they do not verify if a doctor is still licensed?? This is not good! Would you assume that a doctor is active if he's a part of a network?
BCBS Anthem - Just got rejected approval from BCBS Anthem for surgery. Appeal likelihood?
I’m in shambles. A surgery out of network I was approved actually late last year is somehow now denied in network now? And the record of approval is nowhere to be found?? Literally saw it three weeks ago.
I want to make sure this appeal hits the ball out of the park with all necessary info but it’s such an uphill mountain and I was so happy for a month and a half excitedly waiting for my surgery next month.
Please help.
RentalCover - RentalCover rental car insurance - no response
I bought a car rental through Kayak/Priceline in November and was offered rental insurance through RentalCover. Purchased the rental insurance and got a policy. During the trip I caused some damage to the bumper and it had to be replaced so I started a claim with RentalCover, but it's been sitting at the status "under assessment" for over two months.
The rental company has a claim specialist asking me for an update every week. I've tried contacting RentalCover multiple times through email, chat, and the contact form but I've never heard back for an update on what's going on. They have no phone number available to speak with a person.
I'm not sure what to do. I'm afraid the rental company will demand payment, but the rental insurance is completely unresponsive. Do I just keep waiting? Get a lawyer? Try to claim with my normal insurance?
Edit: the accident occured in Colorado.
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