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?

I got an advertisement from my insurance, UHC sent to my email about a program called Real Appeal. The title said “Reach your weight loss goals now, at no additional cost” so I signed up and made an account. It looks like UHC denied the claim and I now owe $162.23. I set up a Teledoc appointment but missed it before looking at my claims (my mistake I know). I missed the appointment and haven’t rescheduled. I’d link the email given but not sure how.

I have a high deductible UnitedHealthcare plan through work and my primary care doc referred me to a local radiology clinic for a mammogram and ultrasound for a lump in my armpit (everything turned out okay). I got the bill the other day and almost choked, $635! I called UH and they said since it was billed as diagnostic and they don't offer any discounts, they only paid about $50 and I paid the rest, essentially it barely mattered that I had insurance. I am 35 so they aren't covered yet as preventative. Should I appeal this? It's so much money after being laid off for 7 months before.

My pet insure Nationwide discontinued our pet policy. My dog a 4 year old Labrador has preexisting allergies. Trying to find the best pet insurance. Any ideas? Our vet does not use Pet Assure. Update: Nationwide reinstated my policy but only at 50%. I will take it since my dog has allergies.

So a few years ago Freedom Mortgage bought my Mortgage from Veterans United. I qualified for a VA rate adjustment at some point down the road and they were very helpful to set up a payment system where I am paying money every two weeks shaving years off the amortization schedule. The problem arose when we had water damage to my house during a storm. After getting the insurance figured out, there was mold involved which made things tricky, I had a large check which was going to be used to pay the final contractors to put the house back together. The check was sent to me, I signed it and sent it to Freedom because it was large enough to require the involvement of the mortgage company. The problem arose when they kept moving the goalposts and demanding more paperwork, more inspections, and more reports. After nearly two months of providing them with everything they finally cut a check, for less than the originally cited amount. I was told the amount was less because they withheld money which had already been paid. They said if I wanted more money I could either give them an itemized list, down to the nails, of every penny I am asking for or get an inspection at my expense to confirm the work hasn't started. Freedom is holding my money hostage and making every step of this process impossible. I cannot stress enough to get as far away from this company as possible. The only reason I am still with them is my 2.25% APR. The scariest part is their inability to tell me what they are going to do with the extra money once we are done.

I live in Colorado and was in an accident where the other driver admitted fault. Their insurance company (Progressive) accepted full liability, paid for the repairs, and told me I could file a diminished value claim once repairs were completed. I filed the claim with an independent appraisal from a DV business that valued my loss at about $4,000. Now, Progressive is denying it, saying I’m “not eligible” because I’m keeping the vehicle and not selling or trading it right now. Their email says: > “As you are keeping the vehicle and not trading it in or selling it, there is no way to measure diminished value as you’ve not lost anything.” This is a 2024 Hyundai Kona with ~11,000 miles, accident-free before the crash. My understanding is that Colorado law allows diminished value claims in third‑party accidents regardless of whether you actually sell the vehicle—it’s based on the market value difference before vs. after the accident. Do they actually have legal grounds to deny me just because I’m keeping the car? Has anyone in Colorado fought and won this?

Hi all, I have two 4-year old cats on Healthy Paws pet insurance. I've seen the recent posts here regarding horrendous premium increases with HP, and am wondering if I should try to switch companies before my cats get older. My cats are healthy and I've never made any claims. My premium is currently about $80 for both cats (and yes, it did go up a good bit this year). I live in California (yikes). My major concern is that one of my cats has a history of struvite crystals in the urine. He's never had a blockage, a UTI, or any urinary problems - it was an incidental finding on pre-op labs before a dental cleaning. He's been on prescription food since then and the crystals have cleared up. But I know this would be considered a pre-existing condition if I tried to change pet insurance companies. My question is, how broad might this exclusion be? Would I potentially never get covered for anything urine or kidney-related if the insurance company tried to blame it on the history of crystals? And if there's a risk of that happening should I stick it out with HP (maybe the premium increases won't be as bad for cats?), or still try to switch? I do not have access to an employer-sponsored MetLife plan covering pre-existing conditions. I've read some companies might cover certain pre-existing conditions if they have been treated and symptom-free for over 12 months, would that potentially include my cat's history of crystals? Appreciate any opinions or advice. Thanks!

Pets Best insurance premium increased 50% last month. Premium initially doubled when I moved from SC to NC 3 yrs ago then this additional 50%. Current coverage; - accident/illness - Unlimited, 90% reimbursement, $250 deductible. -No well care. Annual premiums are only about $20 less than annual WellCare visit charge. Ran a new quote online from same company. It is 50% of new premium (so less than premium before last month’s increase). Makes no sense. 1 dog - Doxy long-hair - 5 yrs old. Insurance with Pets Best since I got him at 6-8 weeks old. He’s generally healthy but I carry insurance because of typical issues a doxy can develop as they age. The only vet visits he’s had outside of well care: (1) Urgent care visit & call to poison control in 2022 after he got into medication (claim was made and they paid around $50). (2) An out of town visit to vet when he had Gastro issues (throwing up/diarrhea) and wasn’t eating. Cause unknown. Given a round of antibiotics and no more issues. This vet isn’t on his records and I didn’t file a claim since it was under my deductible. My questions: (1) Outside of taking a chance that something happens during the waiting period of a new policy, is there any reason I shouldn’t apply for a new policy to get the lower premium? (2) Will the prior poison visit be considered existing condition if there is another event? He was fine and hadn’t ingested anything harmful. They just watched him for a couple hours. (3) Is the insurance company likely to pick up the out of town gastro visit and consider any future gastro issues an existing condition since I didn’t claim? Thanks in advance for input.

I was stopped at a traffic signal when another car coming from the opposite direction had his tire come of and hit my car. His insurance is declining to pay saying that it should be covered by my insurance comprehensive coverage. His insurance is liberty and mine is progressive. Just does not sound fair to me. Total damages of 5 k. I do have a 500 comprehensive coverage, its the principle of things. How do I go about it? UPDATE I had the other party call the insurance. The insurance just called and accepted it was their fault and promises to cover everything. They asked to go ahead and book an appointment with the body shop, which I just did for next week. Justice was served , thanks largely to the other driver being honest and standing for it. god bless America. Its about 20 days work and probably will be able to work out a rental car too in the mean time.

Edit: It looks like this was my deductible. It looks like I didn't fully understand how things were billed before/after my deductible was met. Thanks for the help everyone! I recently received a bill for $275 from an in-home sleep study. When looking at my EOB it says that the ammount billed was $450 and Cigna negotiated a $175 cost reduction, however under "What Cigna Plan Paid" the amount is listed as $0. Also, the provider network status is listed as "IN NETWORK". I was operating under the assumption that this at home sleep test would fall under the other lab work from an independent lab category and would be billed at 15%. Not sure if this is necessary info, but I am located in California. My questions are: 1. Does anyone know what an in-home sleep study would be classified as when it comes to how it is billed? 2. Is it possible to contest this with Cigna to get them to cover more? 3. Is it possible to negotiate this bill with Virtuox in the event that Cigna will not budge?