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health insurance denial of claims
Posted by Jenknut on 12/12/2001
WASHINGTON -- My 10 yr old son has a seizure disorder and has recently begun to have nocturnal seizures.As research shows , 1/3 of all people with seizure disorders have some form of sleep apnea.His neurologist sent him to have a sleep apnea test done and it did come back negetive.Now our insurance has denied the claims for about $3000.00 . They are telling us that its not a covered benefit.The doctor faed the insurance company some records showing that my son had a DIAGNOSTIC test done and that he has never been TREATED for sleep apnea.Here is what my benefit book states......Pg.24 , Treatment of or related to sleep disorders , except as specified under covered medical equipment and supplies.......Pg (Covered services) diagnostic , x-ray and lab services.They have sent these claims to their review department and they still deny them. The bills now have late fees and collection charges not to mention they are affecting my credit now.

To help keep me as a potential future customer, I would like the following:

I would like the insurance company to pay the claims , the late fees , the collection charges and right a letter accepting responsibility for the collections to help me get it off of my credit report.I think I am also due some kind of compansation for my time spent making the phone calls (sitting on hold for endless periods of time and arguing my case) and my stess not knowing how to pay these bills so the neurologist will keep treating my son for his regular needed visits.

At the very least I would like a response from your company regarding this incident. Thank you for your time.
     
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Posted by Anonymous on 2002-02-27:
You do not have an insurance company. Your employer is self-funding the benefit. AmeriBen Solutions is not denying your claim, your SPD is. AmeriBen CANNOT create an exception, only your employer can.
Posted by Anonymous on 2002-03-15:
I also cotacted the employer and was told that it needed to be worked out with ameriben. after 3 appeals it went to the employer who also denies it.the company(employer)has been sold to a larger company and they are still denying it and have not even provided us with any benefit books.because of the size of this company , I really didnt expect them to do things the way they are.
Posted by HaroldSays on 2006-10-29:
I would like to know more about your situation as I encountered a similar problem and I was able to get it resolved positively and satisfactorily for the person. If you are legally entitled to the benefit then you should receive it. Do not let them get away with this. Another thing, you must be certain that your doctor wrote the right Insurance Payment Code for his billing. If he did not bill it properly, the company will not pay the claim either. If I can help you further, let me know. Harold, HaroldSays.
Posted by ken on 2013-06-11:
Ameriben will primarily deny the claim, and be defended by Anonymous comments....
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StarEmpty StarEmpty StarEmpty StarEmpty Star
Verizon Wireless Poor Customer Service And Rip Off
Posted by Lonleyy21 on 06/26/2012
FT. LAUDERDALE, FLORIDA -- Recently I ordered 2 iPhones on June 10, 2012. I called the next day to cancel this service, never received those phones and was returned to their warehouse.

I received a first bill of $304.00 for a service that I never received, plus another bill for $159.00, which I don't know why. I contacted them and waited 56 minutes to get to a representative and the call was dropped.

I've been waiting for a refund for the phone I never received and they tell me every day when I call, that I will receive my refund in 24 hours, which I never received yet.

I will not recommend this company to anyone, plus their prices are high.......................

.....................DO NOT BUY ANY PHONE FROM VERIZON WIRELESS.............
     
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Posted by MRM on 2012-06-27:
Wow, how can they charge you when you never had the phone? Outrageous indeed.
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StarStarStarStarEmpty Star
Bad
Posted by Jkbeventplanner on 06/21/2012
CALIFORNIA -- Since June 10, 2012 I am not able to text or open up my emails and half of the times can not place a call using my cell. I understand that boosTmobile is going 4G but that shouldn't affect the services for the 3G phones. If the company can't do both then return back to what has made the number 1 at the rate that I affordable in this economy. They should acknowledge it is a problem to it's client and offer a deal or discount instead of bad service.
     
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How can I get in touch with families on last Saturdays show?
Posted by Sunray93 on 04/02/2012
Hi I was wondering if it is possible to get in touch with someone who did any reporting on the families from the show on 20/20 last Saturday from "my Extreme Affliction" I would like to help these families and somehow send a letter or email to them. I understand their personal contact info may not be possible to obtain without their permission. I really believe that I have info that could help these families if I just had the opportunity to get it to them.

Please help!
Thank you!
     
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Posted by madconsumer on 2012-04-02:
due to security reasons, ABC cannot give out contact information. you would be able to perhaps locate the families by doing a web search.

lastly, you can email ABC, and if they feel your query is genuine, they can contact the families for you.
Posted by dan gordon on 2012-04-02:
I'd send the ltr to ABC and ask them to forward it on
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Start a segment on consumer protection
Posted by Thegame2567 on 01/25/2002
Please consider starting a segment on consumer protections from companies that screw its customers over again and again. There is no accountibility from corporate america and consumers are being screwed over!

Thank you for taking the time to read this.
     
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Posted by Chel on 2006-08-07:
RIGHT ON!!!!!!!!!! Corporate America doesn't give a darn about consumers! They take our money and that's all they care about. I had to fight like the dickens to resolve some really expensive shoddy products and service...all by big companies. One example is in regards to Speedee Oil Change (their Livermore, CA chain). The idiots poured motor oil in my brake system, causing the brakes to fail me completely...at 65mph in morning traffic!!! A cement median stopped me. I battled the owner and ended up taking him to small claims court. We mediated the ordeal and he agreed to pay the enormous repair fees. Yet, the owner didn't fulfill his obligation...and I was screwed because the court refuses involvement following mediated cases. So, I visited his hell-hole in person, called daily and bugged him to the point he wanted me out of his life...and he finally reimbursed me. Granted...this process was a loooong 15 months long and was a complete nightmare!

Absolutely, us consumers need protection so the big (and small as well) companies don't away with all crap they pull!
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spam
Posted by on 12/01/2001
PHILA., PENNSYLVANIA -- Somehow it seems I have gotten on every email list in the world. I get tons of unwanted email, and their instructions to be removed are usually fraudulent. Either I get a message that there is no such address or the mailbox is full. Or once my request to be removed from some mail concerning insurance resulted in pornographic pictures appearing on my computer screen. I have reported this to various carriers, all of whom seem unable to do anything about it. Who are these companies, how do they get our addresses, and why can't anyone stop the spam?

To help keep me as a potential future customer, I would like the following:

See above

At the very least I would like a response from your company regarding this incident. Thank you for your time.
     
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Posted by Anonymous on 2001-12-02:
I too receive at least 20 spams a day! It makes me very angry!!
Posted by Anonymous on 2001-12-03:
The problem with tyring to get off these mailing lists is if you do what they say to get off, i.e. "reply" to address below requesting to be removed, that only lets them know that there actually is a person at this address, and you will then start getting even MORE spam!!! I know, because it happened to me, and my computer tech support person here where I work advised me to NEVER try the reply method of getting these annoying advertisers out of your mailbox. The best way is to just ignore them, delete them as you get them, and they will eventually stop sending, altho usually you just keeping getting on new lists, unfortunately!!
Posted by Anonymous on 2002-01-28:
Most Mail Services (ie.Outlook Express) provide a means of blocking e-mail from unwanted senders....USE IT !
Posted by Anonymous on 2002-05-15:
Software is readily available to stop it...reach into your pocket, blow the dust off your wallet and purchase some!
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unjustic
Posted by on 11/08/2001
hi i was lock up for no reason wife sad i hit her i did not lock up n have to take class before court. is this right.

like to talk to someone on this.

Thank you for taking the time to read this.
     
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Posted by Anonymous on 2001-11-24:
Ummmmm...... Do you speak English much?? Get a tutor.
Posted by Anonymous on 2004-04-18:
Ooooooookkkkkkkkkkkaaaaaaaaaayyyyyyyyyyy....let'slearn how to speak & write in English, then try typing that again.
Posted by afrpennycentury on 2004-04-18:
Yes. You should take a class. You should take many classes. Education is very important.

When you have personal legal problems, you need to get in touch with legal aid. I dare say your teacher in anger management might be able to help you. A National News Magazine will not have any interest in your domestic violence situation, unless it is COMPLETELY UNIQUE and FASCINATING. That means more interesting to other people than anything they've seen that day. You are just not the only guy who ever hit his wife. I doubt the government will be much help to you in teaching you basic communication and relationship skills, but good luck. Also: DO NOT HIT PEOPLE. IT IS WRONG, EVEN IF YOU ARE MAD.
Posted by firstrateconsumer on 2006-10-16:
Use your time in jail learning how to read and write you illiterate slob.
Posted by velvatnrbt on 2007-03-29:
The people above should not have commented on this person's language skills. The written expression skills are very indicative of a moderate to severe hearing loss. The high frequency speech sounds such as in the /ed/ left out of words, the /s/, /th/, /ch/ sounds are all high frequency speech sounds. If you cannot hear them it is quite common for Deaf culture to omit them.
Obviously, the people who commented have no more than a high school degree. Hey, leave the diagnosis to the profressionals.
Posted by URWrong! on 2007-03-31:
Velvatnrbt: How immature of you. You resort to claiming that other commenters have no more than a high school degree. Real professionals don't stereotype people.

Unless you know the commenters personally, leave your assumptions out of it.
Posted by Starlord on 2007-05-22:
velva,
Please keep your amateur diagnoses to yourself. I have had hearing problems since I was a baby, and a cold destroyed the nerves in my right ear, rendering me totally deaf in that ear. When I was in law enforcement and security, I wanted my training to be as realistic as possible, so I did not use hearing protection. As a result, I have approximately a 70% loss in the left ear, mostly in the higher registers, which makes many women's and children's voices hard for me to hear. I also depend a lot on lip reading. I do not feel that someone could look at my post and that by unjustic and say that his was probably caused by being hard of hearing, while mine seemed normal, I say to you, bullcrap! His post is almost impossible to understand, but I did pick up that he felt he was arrested wrongly for domestic violence. I am not sure how the laws run in Georgia, but in Arizona, and most states I have heard of, if there is even the slightest evidence of violence, (bruising, scratches, cuts, etc.) then someone is going to jail, and the police officers have no discretion.
I was a deputy sheriff, and one night I was sent on a possible domstic dispute. The wife had some bruises, which looked fairly old, due to the colors. As I had no choice, I cuffed and stuffed the husband. the wife got real brave then, and ended up screaming at him in my patrol car. then she committed the unforgiveable sin. She kicked my car door, right on the star. I called for another unit to transport her, so they both went to jail. Him for Assault under the Domestic Violence Act, and her for Damaging County Property.
Nujustic, quit your belly achin' about being arrested and put your energy into a little education so people won't think you are an ignorant hillbilly, and you will have more opportunities than to lay around drunk, beating up your wife.
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