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Quest - Doctor billing insurance for treatment weeks before appointment without notifying patient
At the end of 2024 my wife visited an allergist to try and get a handle on her allergies. A boat load of testing later and she needs allergy injections for her horrific environmental allergies to attempt to get control of them. Everything is good with this allergist at this point. It’s the end of December 2024 and the allergist informs her at her appointment at the end of the next month (January 2025) she will owe $1500 to start her year long series of injections. We have a HDHP with HSA so we totally understand that cost because the deductible resets.
Well life punched us hard over the next month and my wife has ramped up her attempts to find a new job because she is so unhappy at her current one. Given everything going on and the fact that she isn’t sure if she will continue to have the same insurance or access to the same provider to complete the allergy injections if she gets a new job, she decided now isn’t a good time to start the allergy injections. So she cancelled her appointment 48 hours prior to the scheduled appointment.
This provider did not give her any kind of verbal, written, mimed, carrier pigeon, etc policy related to appointments, billing, and/or payment policies for the practice. Nothing. So at the beginning of February 2025 she received a bill from Quest for the bloodwork she had done in December 2024. Two of the bajillion tests requested by this provider were not covered and it was going to cost us almost $700 out of pocket (whole separate issue we’re handling). She couldn’t find an EOB so I told her to log onto the portal to see if she could download it. Well she logs onto the portal and there are $2,000 worth of claims submitted from this allergist in mid January 2025. They were not the claims related to her appointments in December 2024 and they were submitted two weeks before she cancelled her first allergy injection appointment.
To make a long story short, the allergist prepped the injection two weeks before my wife’s first allergy injection over the course of 3 days and submitted the claim to insurance for it. The doctor’s office is saying she is responsible for the bill and I’m saying that sounds like fraud for billing for treatment she never received and was prepared without any kind of contract or informed consent to give her the opportunity to prevent this from happening. My wife has spoken with 2 different insurance reps and one was like yeah you’re responsible and the other said I’m referring you to our fraud department. The doctor is entirely unhelpful and has refused to communicate with her on 1. Why there is no practice policy to avoid this situation and 2. How long that injection mixed up in good for and 3. What happens if she stops doing the injections after one appointment.
What do we need to know about this? Is this fraud? Should we push to not be responsible for this cost? Did my wife make a mistake somewhere in understanding how allergists operate and missed what is the obvious to the field she should have cancelled her appointment at minimum two weeks before it was scheduled?
Progressive - Is there a time limit for claim payouts?
Got into an accident last September and filed a claim back then when it happened. Since then I’ve been scraping together the money for the (1k) deductible. Now i’m worried progressive won’t pay out because I took too long. Is that a thing or do they still need to pay out for it??
State Farm - Ohio roof damage
I live in Ohio and have State Farm for my homeowners policy. My roof was damaged by wind end of September 2024 and siding was torn off my house. I also have water damage inside my home. I had a contractor out and State Farm had their contractor out to assess damage. I have a $6k deductible and State Farm deemed it was repairable. Payout is $4k but I appealed because of the matching code in Ohio and I don’t agree the roofing repairs will match my current roof. In the meantime, another storm passed through and now shingles are flying off my house. I am 20 years in on a 30 year shingle. State Farm wants me to file a new claim, and a new $6k deductible. I believe they should have covered it from the beginning. Now what do I do?
Insurance Commission of WA - Regrading loss of salary
Location: perth wa
Last year my partner got rear ended in march 2024 while they were on the way to work. Got admitted in Fiona stanly for three days to do test and scans and lodged the claim with insurance commission of wa . They kept asking documents and stuff for 4-5 months yesterday (after 1 year going back and forth)got payed $787 from insurance commission as one of payment as a loss of salary while they are still not capable to be back to work. Is it worth proceeding it with legal ways to get compensation for the loss of salary. Salary was $950 average a week.
Thank you
Country-Wide Insurance - Country-Wide Insurance lowballing and delaying my claim – need advice (NY)
State Farm - $399 for two cars and renters…am I getting screwed?
I’m in Illinois and have a pickup truck and a minivan. I also rent a house from my in-laws. I have State Farm for my policies and they have been going up and up and up the last few years. My coverages are standard and I have no claims or tickets on record.
US Health Group - health insurance agent did my application wrong, what do I do?
I’m a 19F college student in Maryland and need a PPO plan because my school is in DC. I aged out of Medicaid, and since Maryland’s enrollment period is closed, I can’t reapply until November-January.
I contacted a health insurance agent, but they mistakenly listed me as male on the application. When US Health Group called to verify my info, they corrected the error, and my quote jumped from 140 to 160/month. I am a broke college student with no job.
The agent is trying to "fix" it and get us back to the original quote, but I’m worried this mistake of his will bite me in the ass when I'm older as he is now playing with the deductible in case of a life threatening emergency (before it was 8k I'd have to pay out of pocket and now its +20k).
I don't know what to do as I've never had to deal with insurance! Should I switch agents, as the gender was a mistake? Please help!
Trupanion - Does trupanion lie about rate increases?
They advertise they never raise rates due to age. I got insurance when my dog was a puppy and in the two years ive had her the rates raised annually from $40 to $50 and now $60. It sure seems like they raise rates based on age, unless you are telling me that vet care has increaed by 50 percent in my city in the last two years.
Even in the very email they sent about the rate increase, they said "Trupanion is unique in that we never increase your monthly cost because you’ve submitted an invoice or because your pet ages. "
Cigna - Seen by different doctor than I scheduled appointment with -- owe $1000
Hi All,
I'm hoping you can help me review my options and come up with a plan for a recent unexpected (and I believe inaccurate) medical bill. I get annual cleanings and other routine dental care (e.g. 1 set of x-rays a year) for free under my dental plan. I have just recently gotten off of my parent's insurance and onto my own plan so I made sure to double and triple check both on my insurance provider (Cigna)'s website and on Zocdoc that I was booking an in-network appointment. At my appointment, however, I was seen by a different dentist than the one I booked with who ended up being an out-of-network dentist. I was surprised by a $400 bill from Cigna, which should have been $0, several weeks later. A fruitless chat with a Cigna rep led to them reprocessing my claim, even though I knew it wouldn't do any good since the information submitted by the dental office showed that I was seen by the out-of-network dentist. A week ago the claim was processed and my bill went up to nearly $1000 because they say the facility is out of network. It is not, and I have a screenshot from Cigna's website showing it isn't.
Anyway, I'm feeling a bit lost about how to proceed. I know about the No Surprises act but am not totally sure how I would go about using it to my advantage here -- I do have the original emails showing that I booked my appointment with a different provider than the one who saw me, but am not sure how I can communicate this to the right people. Any advice about next steps would be very much appreciated! TIA for helping me figure out how to move through this.
EDIT: In my 20s, live in NY State, insured through employer.
Allstate - Ditch Allstate for amica in GA?Questions….other companies?
No claims in 12 years with Allstate. Hear their home claims are a nightmare. Hear good things about Amica.
Carry homeowners, 2 autos, and an umbrella.
Would cut my auto insurance half but double my homeowners leading to a wash prior to the amica dividend payment.
Couple questions:
What do you use to calculate your replacement cost for a house?
Do you make any changes to that calculation if the policy has an overage waiver? My Allstate is 20% and the quoted amica is 30%.
Any reason to carry additional structures if I don’t have a fence or our buildings?
Any others to look into for insurance? With amicas rates in auto, it could make sense to break out my homeowners if we don’t choose to bundle.
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