this post was submitted on 21 Sep 2024
472 points (95.6% liked)
Asklemmy
43942 readers
514 users here now
A loosely moderated place to ask open-ended questions
If your post meets the following criteria, it's welcome here!
- Open-ended question
- Not offensive: at this point, we do not have the bandwidth to moderate overtly political discussions. Assume best intent and be excellent to each other.
- Not regarding using or support for Lemmy: context, see the list of support communities and tools for finding communities below
- Not ad nauseam inducing: please make sure it is a question that would be new to most members
- An actual topic of discussion
Looking for support?
Looking for a community?
- Lemmyverse: community search
- sub.rehab: maps old subreddits to fediverse options, marks official as such
- [email protected]: a community for finding communities
~Icon~ ~by~ ~@Double_[email protected]~
founded 5 years ago
MODERATORS
you are viewing a single comment's thread
view the rest of the comments
view the rest of the comments
I don't know what's covered under US "healthcare", and I think it also depends on your age. Probably should talk to your doctor and ask them. Maybe a bunch of blood tests, dental work, cancer screenings, prostate check, colonoscopy, and upper endoscopy.
I work in American healthcare. Your doctor is actually one of the worst people to ask about coverage.
Unfortunately, the only solid way to be 100% sure of coverage is to call your insurance company and make them guarantee your planned procedures in writing. Every doctors office has a department to deal with insurance—after you talk to the insurance company you will want to talk to the insurance department at the doctors office and give them the written statement from the insurance company.
After your procedures, your bill will be processed by a medical coder at the doctors office, and a clearing house coder who gets things ready for your insurance company, before it potentially gets double checked again by coders who actually work for the insurance company. Those people will not have any clue about the arrangement made prior to your procedure, and this is the series of steps where something might happen that would cause your insurance company to not pay.
If you did your due diligence and got everything in writing beforehand, then the insurance company will kick the bill back to the doctor, at which point it will be reviewed by a payment specialist who will be able to see and use the written commitment to force the insurance company to process the bill.
This whole process takes anywhere from weeks to months, so you may not know there is a problem until a while after your appointment.
Welcome to American healthcare. Good luck getting whatever you can.
Unfortunately, dental is typically separate from health care in the US. (It's stupid).
This isn't always the case, technically. Dental can be considered for normal health insurance if it's directly impacting your health (like an emergency surgery). That being said, your insurance may fight the shit out of this and will still most likely require you to list your dental insurance as the primary for billing.