Insurance company has the power to deny ER visit payment to its insured
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splashmtn
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PostPosted: Mon Feb 12, 2018 12:21 pm    Post subject:

ExPatLkrFan wrote:
CandyCanes wrote:
ExPatLkrFan wrote:
ani007 wrote:
jodeke wrote:
I have Kaiser. If I call 911 and taken to the nearest urgent care facility the facility bills Kaiser and Kaiser pays the bill. I don't know how it works if I'm not in California.


i like Kaiser feel they got a handle on delivering healthcare iono mostly have had them


(bleep) Kaiser the horror stories are legion and that's just the one I knew from personal contact.


What horror stories?


How about my next door neighbor his brother went to Kaiser had to have a testicle removed . Yeah you got it they removed the wrong one.

I took my friend to Kaiser in Baldwin Park because he thought he was having a heart attack. He wa s under the care of a Kaiser cardiologist. Went with him to the ER and there was a line of about 200 people ahead of him with about 50 in line to get to the nurse for triage. I worked my way to the front of the line and explained the situation. After much demanding and angry word they took him in. After a few minutes he came out and they sent him to urgent care about 75 meters away. No wheel chair nothi g walk over buddy heart attack or what ever who cares. So we go over there same thing long ass line d a room full of people. After the same with me having to demand he be seen he was moved to the front of the line. And finally seen by a doctor who checked him out and told him you probably did have a heart attack. You can see your cardiologist probably in 2 or 3 weeks. No aspirin, no blood thinners nothing, oh and don't forget your co payment.

Well we walked out of that place I was fuming. By that time my friends wife was home and she took him to Queen of the Valley and sure enough he had a minor heart attack. They gave him some nitro and that cleared his pain. Admitted him and put him on blood thinners overnight. When it came time to pay Kaiser did not want to pay for the second opinion. Luckily for my friend his wife was an agent for the California Department of Justice specializing in medical fraud. She marched him down to the head administrator and demanded a meeting. When told he was busy she flashed her badge and wow he was available. Short story Kaiser paid the bill and he didn't pay his co pay. But everyone doesn't have a wife that works for the California Dept. of justice.

There's more but I'm tired of typing.


Here's a little secret for you anyone on this board. If you truly think you need assistance RIGHT NOW. not later, not you can wait in line. you or a loved one is experiencing pain in the chest or something like that. sure it MIGHT not by a heart attack. most times its not. most times its something else. but because it MIGHT be. you have to treat it as such until you're told its not by a professional.

What you do is call 911. DO NOT drive yourself, DO NOT have someone else drive you. CALL 911. The ambulance will take you in there. and you then become priority #1 over everyone in the room as walk ins. They figure if you got here you aint as bad off as you think you are Unless you are bleeding RIGHT THEN and there or you're passing out right then and there.

I was told this by THEM. most people are embarrassed to call for an ambulance. but if you need to be seen quickly. Call them.
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LakersRGolden
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PostPosted: Mon Feb 12, 2018 3:25 pm    Post subject:

splashmtn wrote:
ExPatLkrFan wrote:
CandyCanes wrote:
ExPatLkrFan wrote:
ani007 wrote:
jodeke wrote:
I have Kaiser. If I call 911 and taken to the nearest urgent care facility the facility bills Kaiser and Kaiser pays the bill. I don't know how it works if I'm not in California.


i like Kaiser feel they got a handle on delivering healthcare iono mostly have had them


(bleep) Kaiser the horror stories are legion and that's just the one I knew from personal contact.


What horror stories?


How about my next door neighbor his brother went to Kaiser had to have a testicle removed . Yeah you got it they removed the wrong one.

I took my friend to Kaiser in Baldwin Park because he thought he was having a heart attack. He wa s under the care of a Kaiser cardiologist. Went with him to the ER and there was a line of about 200 people ahead of him with about 50 in line to get to the nurse for triage. I worked my way to the front of the line and explained the situation. After much demanding and angry word they took him in. After a few minutes he came out and they sent him to urgent care about 75 meters away. No wheel chair nothi g walk over buddy heart attack or what ever who cares. So we go over there same thing long ass line d a room full of people. After the same with me having to demand he be seen he was moved to the front of the line. And finally seen by a doctor who checked him out and told him you probably did have a heart attack. You can see your cardiologist probably in 2 or 3 weeks. No aspirin, no blood thinners nothing, oh and don't forget your co payment.

Well we walked out of that place I was fuming. By that time my friends wife was home and she took him to Queen of the Valley and sure enough he had a minor heart attack. They gave him some nitro and that cleared his pain. Admitted him and put him on blood thinners overnight. When it came time to pay Kaiser did not want to pay for the second opinion. Luckily for my friend his wife was an agent for the California Department of Justice specializing in medical fraud. She marched him down to the head administrator and demanded a meeting. When told he was busy she flashed her badge and wow he was available. Short story Kaiser paid the bill and he didn't pay his co pay. But everyone doesn't have a wife that works for the California Dept. of justice.

There's more but I'm tired of typing.


Here's a little secret for you anyone on this board. If you truly think you need assistance RIGHT NOW. not later, not you can wait in line. you or a loved one is experiencing pain in the chest or something like that. sure it MIGHT not by a heart attack. most times its not. most times its something else. but because it MIGHT be. you have to treat it as such until you're told its not by a professional.

What you do is call 911. DO NOT drive yourself, DO NOT have someone else drive you. CALL 911. The ambulance will take you in there. and you then become priority #1 over everyone in the room as walk ins. They figure if you got here you aint as bad off as you think you are Unless you are bleeding RIGHT THEN and there or you're passing out right then and there.

I was told this by THEM. most people are embarrassed to call for an ambulance. but if you need to be seen quickly. Call them.


That's an expensive pass to the front of the line. The system is soo broken.
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governator
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PostPosted: Mon Feb 12, 2018 3:53 pm    Post subject:

LakersRGolden wrote:
splashmtn wrote:
ExPatLkrFan wrote:
CandyCanes wrote:
ExPatLkrFan wrote:
ani007 wrote:
jodeke wrote:
I have Kaiser. If I call 911 and taken to the nearest urgent care facility the facility bills Kaiser and Kaiser pays the bill. I don't know how it works if I'm not in California.


i like Kaiser feel they got a handle on delivering healthcare iono mostly have had them


(bleep) Kaiser the horror stories are legion and that's just the one I knew from personal contact.


What horror stories?


How about my next door neighbor his brother went to Kaiser had to have a testicle removed . Yeah you got it they removed the wrong one.

I took my friend to Kaiser in Baldwin Park because he thought he was having a heart attack. He wa s under the care of a Kaiser cardiologist. Went with him to the ER and there was a line of about 200 people ahead of him with about 50 in line to get to the nurse for triage. I worked my way to the front of the line and explained the situation. After much demanding and angry word they took him in. After a few minutes he came out and they sent him to urgent care about 75 meters away. No wheel chair nothi g walk over buddy heart attack or what ever who cares. So we go over there same thing long ass line d a room full of people. After the same with me having to demand he be seen he was moved to the front of the line. And finally seen by a doctor who checked him out and told him you probably did have a heart attack. You can see your cardiologist probably in 2 or 3 weeks. No aspirin, no blood thinners nothing, oh and don't forget your co payment.

Well we walked out of that place I was fuming. By that time my friends wife was home and she took him to Queen of the Valley and sure enough he had a minor heart attack. They gave him some nitro and that cleared his pain. Admitted him and put him on blood thinners overnight. When it came time to pay Kaiser did not want to pay for the second opinion. Luckily for my friend his wife was an agent for the California Department of Justice specializing in medical fraud. She marched him down to the head administrator and demanded a meeting. When told he was busy she flashed her badge and wow he was available. Short story Kaiser paid the bill and he didn't pay his co pay. But everyone doesn't have a wife that works for the California Dept. of justice.

There's more but I'm tired of typing.


Here's a little secret for you anyone on this board. If you truly think you need assistance RIGHT NOW. not later, not you can wait in line. you or a loved one is experiencing pain in the chest or something like that. sure it MIGHT not by a heart attack. most times its not. most times its something else. but because it MIGHT be. you have to treat it as such until you're told its not by a professional.

What you do is call 911. DO NOT drive yourself, DO NOT have someone else drive you. CALL 911. The ambulance will take you in there. and you then become priority #1 over everyone in the room as walk ins. They figure if you got here you aint as bad off as you think you are Unless you are bleeding RIGHT THEN and there or you're passing out right then and there.

I was told this by THEM. most people are embarrassed to call for an ambulance. but if you need to be seen quickly. Call them.


That's an expensive pass to the front of the line. The system is soo broken.

This is not true, arriving in an ambulance doesn’t get you to cut the line. Once triaged, if you’re not priority and there’s no bed available, you going out to the waiting area. Triage is exactly the same whether it’s by ambulance or walk in
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splashmtn
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PostPosted: Wed Feb 14, 2018 1:56 pm    Post subject:

governator wrote:
LakersRGolden wrote:
splashmtn wrote:
ExPatLkrFan wrote:
CandyCanes wrote:
ExPatLkrFan wrote:
ani007 wrote:
jodeke wrote:
I have Kaiser. If I call 911 and taken to the nearest urgent care facility the facility bills Kaiser and Kaiser pays the bill. I don't know how it works if I'm not in California.


i like Kaiser feel they got a handle on delivering healthcare iono mostly have had them


(bleep) Kaiser the horror stories are legion and that's just the one I knew from personal contact.


What horror stories?


How about my next door neighbor his brother went to Kaiser had to have a testicle removed . Yeah you got it they removed the wrong one.

I took my friend to Kaiser in Baldwin Park because he thought he was having a heart attack. He wa s under the care of a Kaiser cardiologist. Went with him to the ER and there was a line of about 200 people ahead of him with about 50 in line to get to the nurse for triage. I worked my way to the front of the line and explained the situation. After much demanding and angry word they took him in. After a few minutes he came out and they sent him to urgent care about 75 meters away. No wheel chair nothi g walk over buddy heart attack or what ever who cares. So we go over there same thing long ass line d a room full of people. After the same with me having to demand he be seen he was moved to the front of the line. And finally seen by a doctor who checked him out and told him you probably did have a heart attack. You can see your cardiologist probably in 2 or 3 weeks. No aspirin, no blood thinners nothing, oh and don't forget your co payment.

Well we walked out of that place I was fuming. By that time my friends wife was home and she took him to Queen of the Valley and sure enough he had a minor heart attack. They gave him some nitro and that cleared his pain. Admitted him and put him on blood thinners overnight. When it came time to pay Kaiser did not want to pay for the second opinion. Luckily for my friend his wife was an agent for the California Department of Justice specializing in medical fraud. She marched him down to the head administrator and demanded a meeting. When told he was busy she flashed her badge and wow he was available. Short story Kaiser paid the bill and he didn't pay his co pay. But everyone doesn't have a wife that works for the California Dept. of justice.

There's more but I'm tired of typing.


Here's a little secret for you anyone on this board. If you truly think you need assistance RIGHT NOW. not later, not you can wait in line. you or a loved one is experiencing pain in the chest or something like that. sure it MIGHT not by a heart attack. most times its not. most times its something else. but because it MIGHT be. you have to treat it as such until you're told its not by a professional.

What you do is call 911. DO NOT drive yourself, DO NOT have someone else drive you. CALL 911. The ambulance will take you in there. and you then become priority #1 over everyone in the room as walk ins. They figure if you got here you aint as bad off as you think you are Unless you are bleeding RIGHT THEN and there or you're passing out right then and there.

I was told this by THEM. most people are embarrassed to call for an ambulance. but if you need to be seen quickly. Call them.


That's an expensive pass to the front of the line. The system is soo broken.

This is not true, arriving in an ambulance doesn’t get you to cut the line. Once triaged, if you’re not priority and there’s no bed available, you going out to the waiting area. Triage is exactly the same whether it’s by ambulance or walk in
So you're saying they lied and it hasnt worked for my mother?

They told us this to our faces. I then instructed my mother to call them if she needed to instead of calling me to pick her up and take her and have us waiting forever in the waiting room. Sure enough, she called them, got on the red truck.whoooooo whooooooooo.. got to the ER thru the backdoor and was in front of the line. did not have to go to the waiting room at all. Every single time I or any of my other family members brought her in thru the front door ourselves. She was stuck waiting in line for HOURS. So it worked in that scenario. By the way the ambulance people have told others something similar. now maybe they are not supposed to do this but thats what happened and thats what they have said.
but like someone said now someone is going to have to pay the mileage.
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governator
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PostPosted: Wed Feb 14, 2018 3:01 pm    Post subject:

This is what I do by the way.
Not accusing anybody of lying, I don’t know your circumstances. I hope that if an ER doesn’t follow triage protocol that it’s isolated occurrences.
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splashmtn
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PostPosted: Thu Feb 15, 2018 3:49 pm    Post subject:

governator wrote:
This is what I do by the way.
Not accusing anybody of lying, I don’t know your circumstances. I hope that if an ER doesn’t follow triage protocol that it’s isolated occurrences.
I was just messing with you gov. But this is something that they told us. and it worked multiple times.

truth is it should be the case since if you're so bad off you need to call the red wagon. you need to be in the front anyway. if you come in on the wagon and we find out you have a stomach ache. by all means please head to the back of the line.
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governator
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PostPosted: Thu Feb 15, 2018 5:01 pm    Post subject:

splashmtn wrote:
governator wrote:
This is what I do by the way.
Not accusing anybody of lying, I don’t know your circumstances. I hope that if an ER doesn’t follow triage protocol that it’s isolated occurrences.
I was just messing with you gov. But this is something that they told us. and it worked multiple times.

truth is it should be the case since if you're so bad off you need to call the red wagon. you need to be in the front anyway. if you come in on the wagon and we find out you have a stomach ache. by all means please head to the back of the line.

All good!!! it's one of those things we ER people hold 'sacred', kinda. Triage and 'signing out' (leaving patients for the next person). But yeah, it still surprised me that the Aetna CEO admitted under oath about not reviewing patients' cases prior to denying coverage. Hope the justice system can put a regulation to prevent this
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