RL Peeves

[Rinel]

Being told to do the wrong thing by bosses, explaining that it is the wrong thing, and being told that I am wrong and that I should do it their way. Despite multiple people with decades of experience in the field telling me that I’m doing it the right way.

Oh well. Not my name on the documents the courts will be reading.

[Pavel]

Fucking. Hayfever.

[junipersky]

Last night I went to the district’s big Halloween thing. It was fun.

Tonight I went to husband’s work Halloween thing.

Both were enjoyable.

Now I don’t want to people for a long long long time.

[mietze]

I have been so depleted from 3 weeks of horrible smoke and then an upper respiratory infection that my short term prednisone prescription doesn’t make my high and hyperactive for the first three days. I don’t even have insomnia. I crash out hard after being functional and out of bed for awhile.

I miss rp. I miss volunteering. I miss work (though did pull an 8 hour for the first time this week). But at least I can sleep and the weather is cool and rainy and glorious and eventually maybe I can get on top of thus fatigue. But if its been noticed on my games I’m not around too much that’s why.

[Solstice]

I bought insurance through my employer the last open enrollment period because I needed mental health support, and the plan my partner pays for (Kaiser) has good healthcare but lousy mental health support - so I’ve kept using my partner’s plan as my primary medical facility while getting standard checkups and such at the Kaiser Medical Center, using the Kaiser insurance, and using my own healthcare for mental health appointments. Thought it was an expensive workaround, but ultimately a smart thing for my mental health.

Last month, I had a surgery performed at the Kaiser Medical Center (Estimated to cost me ~$800-1500 because I’m in network), presented my Kaiser Insurance, and today I received a bill for my surgery.

At the insurer I’d just signed up for, which covers nothing.

$11,340.

So, today I learned that if you’re double-insured, it doesn’t matter what card you provide. They just pick whatever’s considered “primary”, and since this policy is in my name only, it’s my “Primary” and my partner’s is “Secondary.”

Like most of you, I don’t have 11 grand laying around, so I’ve been in desperate phone calls to figure out if that’s what I actually owe, or if the Primary will bill the Secondary, and who I owe what, but it’s all “pending” and won’t clear for 10-15 days. I’m sick to my stomach with worry, and loathing every last part of the healthcare system. We’re paying for two insurances and ended up with the worst elements of both.

Be very careful about being double-insured. It can, apparently, fuck the everloving hell out of you.

[Pavel]

@Solstice That’s… fucking bonkers.

“Yeah you gave us your Visa card, but you usually use your Amex, so we’re billing that instead.” What the fuck?

[GF]

@Solstice I feel like the estimate provided to you ought to be considered binding somehow. Would you have had the surgery there if they’d told you the surgery would be twelve thousand dollars instead of eight hundred?

[TNP]

Not just to @Solstice but everyone…

I’m in medical billing. And yes, if you have multiple insurances, they talk to each other and figure out which is primary, which is secondary, tertiary, etc. The insurance in your own name is always primary over the one in someone else’s name. There might be exceptions but I haven’t run into them.

Don’t panic too much. Whatever you owe after the primary insurance processes the claim gets filed to the secondary. If they didn’t pay anything, it’s likely either because the doctors/facility was out of network (and you have no out of network benefits) or you have a high deductible. Whoever the bill is from should now be sending it to your secondary with a copy of the primary EOB showing what you owe.

Without knowing what your policy states, it’s impossible to accurately predict but if you were pretty sure they’d pick up most or all of it to begin with, they still should.

eta: To clarify, the primary doesn’t bill the secondary. The doctor/facility the claim is from bills the primary, gets the results, then bills the secondary, then bills you.

[Morphine]

The hospital or facility may have a financial assistance program to help you. This link is what I found with a quick google search. https://about.kaiserpermanente.org/community-health/communities-we-serve/northwest-community/ensuring-health-access/subsidized-care-and-coverage0/medical-financial-assistance-program

I work adjacent to medical billing (I screen people for eligibility for financial assistance programs similar to the above) – and I’ve only just made it past my 90 day probationary period (benefits on Monday, yay!) so I am no expert on this – but I believe that when you have a primary and a secondary insurance, the facility bills the primary first, the primary decides what it will pay, what it won’t, and what is the patient’s responsibility, and either writes a check to the facility or goes ‘nah’. Then the facility passes on whatever is left to the next responsible party, which in this case should be your secondary insurance. Only after the secondary has been billed and responded should you be considered for whatever is left.

All of which takes time, and yes, in the meantime you’re getting statements and bills and there’s five figures on there and it’s really stressful and overwhelming. I’m sorry that you’re going through that, and I’m sorry that people with insurance still have to apply for financial assistance at all, but I hope that isn’t just ‘explaining’ stuff that you already know, and will help you a bit.

Oh phew yes, I’m right, thanks TNP.

[TNP]

@Morphine said in RL Peeves:

Oh phew yes, I’m right, thanks TNP.

Yes indeed. Oh, and to add another point…

I don’t know how other states do it but in New York, everyone bills separately. So there will be a bill from the surgeon, a bill from the anesthesiologist, a bill from the pathologist if it was needed, and a bill from the facility. It can get very confusing and difficult to keep track of. So if your state is the same, just be aware.

[Solstice]

@TNP @Morphine

This is immensely comforting, and I super appreciate it. No one I spoke to on my various phone calls was able to really give me any sort of explanation that approached this level of clarity, and that led me to blind panic.

Sounds like I need to hurry up and wait.

[TNP]

@Solstice You’re welcome.

Oh, more info for everyone.

So. Which is primary and secondary etc is called coordination of benefits. And sometimes it gets screwed up. When you add or drop an insurance company when you have multiple ones, you have to inform the other insurance that you no longer have the one you got rid of. Otherwise they think you still have it.

So if you ever cancel your own insurance, let Kaiser know immediately otherwise they’ll continue to think they’re secondary and won’t pay. This applies to any and all insurances, including Medicare and Medicaid.

[SpaceKhomeini]

@Solstice

As an aside —

Just in general, fuck Kaiser.

They fucked me harder than anyone has been fucked by a Kaiser since Belgium.

[Pavel]

@SpaceKhomeini said in RL Peeves:

They fucked me harder than anyone has been fucked by a Kaiser since Belgium.

[Arkandel]

I don’t want to care about the US midterms. I’m not even American nor do I live there.

But the stuff I read on the interwebs pisses me off, more so because it’s a race at all and without even the outcome at this point. So while I’d rather shrug it off I must admit I do care after all, which also annoys me.

[crawfish]

@Arkandel I voted early this morning and the polls are PACKED, unexpectedly so I guess because there were a lot of startled faces.

[Arkandel]

@crawfish I hope things turn out well.

But I was so sure Brits would do the obviously right thing with Brexit, too, and that went down super well too.

[Testament]

@Arkandel said in RL Peeves:

I don’t want to care about the US midterms. I’m not even American nor do I live there.

But the stuff I read on the interwebs pisses me off, more so because it’s a race at all and without even the outcome at this point. So while I’d rather shrug it off I must admit I do care after all, which also annoys me.

Don’t get on Twitter. I’m fairly certain that is the major reason that has explained my current emotional and mental state at the moment is because I’ve read a lot of hateful things.

I’ll stop now before someone thwaps me for veering too political.

[Wizz]

@Arkandel said in RL Peeves:

@crawfish I hope things turn out well.

Don’t mean this to be dismissive to your feelings or good intentions at all, but…oof, at this point, give us another decade like this one (or dare I say even another five years) and I legitimately don’t think this country will look the same on maps anymore.

I’ve never considered becoming an expat so seriously, and I really wish it was easier/cheaper.

[Testament]

@Wizz said in RL Peeves:

@Arkandel said in RL Peeves:

@crawfish I hope things turn out well.

Don’t mean this to be dismissive to your feelings or good intentions at all, but…oof, at this point, give us another decade like this one (or dare I say even another five years) and I legitimately don’t think this country will look the same on maps anymore.

I’ve never considered becoming an expat so seriously, and I really wish it was easier/cheaper.

I recommend Costa Rica. That’s where I’m trying to get in five years.