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Politics : Sioux Nation
DJT 11.54+4.2%Nov 28 9:30 AM EST
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To: ThirdEye who wrote (48623)11/14/2005 12:31:18 AM
From: 10K a day  Read Replies (1) of 361303
 
OKAY.

1. a physical Therapist bills private insurance. One private insurance says they r not responsible for the claim and will not accept liability but states they are aware of another insurance that is responsible and must accept liability. Both insurance say they r not going to pay the claim but the patient has 2 insurances and both insurance confirm coverage but neither will accept liability saying it is the other carrier who must pay....BUT Neither carrier can even communicate with the other insurance because of HIPAA. And they refuse to communicate anything to the provider saying it is the other insurance liability. but both insurance state the provider can not bill the patient directly by law. RIDICULOUS.

2. ANOTHER CASE: A private insurance company pays the patient DIRECTLY for a claim that a physical therapist bills. They refuse to provide any information to the therapist who PERSONALLY BILLED the claim claiming hipaa privacy laws. Meanwhile the patient got paid a large sum of money and the therapist got nothing for providing the services. It's difficult to even pursue this in small claim because the therapist doesn't even know how much the patient was paid. RIDICULOUS.

Conclusion: Insurance companys use HIPAA and ERISA to game the system and avoid paying claims. As far as i'm concerned it's mis representation.

that's the best i can do.
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