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health insurance question
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sal79
LIF Adult
Member since 8/06 1464 total posts
Name:
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health insurance question
i jsut got the claim from our last well child check up with db. it says claim denied, due to the fact htat we met our covered services for well baby care for the year. Our oed does check ups every month for the first year, so this may be true. but, my question is - is a year a calendar year - or a year of insurance. for example, are we now finished until dec 08, or is the year up in auguat 08, since db was born august 07? i hope this makes sense.
also, i am not going to worry about it till ped sends a bill, btu do you think they will resubmit claim under a different code?
editing to add - since augusy, I had 7 covered well child visits. since january, I had 3 covered ones. I;m going to assume a year is from when we added her to the plan, since it doesnt make sense that I only get 3 visits a year. I have empire BCBS PPO, btw.
Message edited 5/4/2008 8:01:39 PM.
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Posted 5/4/08 7:54 PM  |
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hbugal
Lesigh
Member since 2/07 15928 total posts
Name:
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Re: health insurance question
Honestly it really depends upon your insurance company. I would call and find out exactly...
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| Posted 5/4/08 7:56 PM |
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dm24angel
Happiness
Member since 5/05 34581 total posts
Name:
Donna
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Re: health insurance question
Posted by hbugal
Honestly it really depends upon your insurance company. I would call and find out exactly...
it actually doesnt.
Well child care is a New York State Mandate.
I cannot remember exactly but I believe it is 7 visits and one in hospital visit. ( thats first yr)
Once your over that, if you live in NY insurance wont pay.
It starts day of birth.
Your next set of well child visits will start as of 1st birthday.
Ask your insurance for the mandate so you know how many visits you get.
Again, I havent been to work in a bit, but I think for ages 1-5 ( first b-day on) its 5 visits?
Message edited 5/4/2008 8:02:34 PM.
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| Posted 5/4/08 8:01 PM |
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sal79
LIF Adult
Member since 8/06 1464 total posts
Name:
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Re: health insurance question
Posted by dm24angel
Posted by hbugal
Honestly it really depends upon your insurance company. I would call and find out exactly...
it actually doesnt.
Well child care is a New York State Mandate.
I cannot remember exactly but I believe it is 7 visits and one in hospital visit. ( thats first yr)
Once your over that, if you live in NY insurance wont pay.
It starts day of birth.
Your next set of well child visits will start as of 1st birthday.
Ask your insurance for the mandate so you know how many visits you get.
Again, I havent been to work in a bit, but I think for ages 1-5 ( first b-day on) its 5 visits?
ok, this makes sense, since we had 7 visits. I have another question - we're switching health insurance next month, dh is changing jobs, so the count starts again, right? a;sp. dp any companies give mroe than 7 the first year?
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| Posted 5/4/08 8:10 PM |
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dm24angel
Happiness
Member since 5/05 34581 total posts
Name:
Donna
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Re: health insurance question
Posted by sal79
Posted by dm24angel
Posted by hbugal
Honestly it really depends upon your insurance company. I would call and find out exactly...
it actually doesnt.
Well child care is a New York State Mandate.
I cannot remember exactly but I believe it is 7 visits and one in hospital visit. ( thats first yr)
Once your over that, if you live in NY insurance wont pay.
It starts day of birth.
Your next set of well child visits will start as of 1st birthday.
Ask your insurance for the mandate so you know how many visits you get.
Again, I havent been to work in a bit, but I think for ages 1-5 ( first b-day on) its 5 visits?
ok, this makes sense, since we had 7 visits. I have another question - we're switching health insurance next month, dh is changing jobs, so the count starts again, right? a;sp. dp any companies give mroe than 7 the first year?
no companies give more then 7 since its a mandate...a lot like a "law" , but yes the count would start over, the info is not "sent" to the new insurance.
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| Posted 5/4/08 8:18 PM |
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