Risk Adjustment and Incentives for Upcoding in Medicare
To account for differences in disease burden across a Medicare Advantage (MA) plans patient population, uses risk adjustment based on...
health insurance
Aetna typed in wrong CPT Code — interposed two digits — was correct on provider’s bills
This is totally on them. Caused them to reimburse somewhat less than they should have (reimbursements go by check to...
Options for my mom to see a neurologist and get her medication
Hello, My mom is currently on medi-cal and we've been worried about her cognitive decline and history with seizures. So...
Why is it so difficult to find Dual-SNP plans in California?
I moved to California from VA (not my choice). I have Medicare and Medicaid (in CA it's called MediCal). In...
Insurance denying extra night stay at hospital following spine surgery
A week after spine surgery at an in-network hospital by an in-network surgeon, I received a letter from Anthem BCBS...
COBRA, my ex employers group plan changed, I was never notified and it’s been 5 months now, COBRA continued to draft my account for 3 before I found out because they stopped billing me.
So, my ex employer did not notify me that the group plan for health insurance changed. Despite that, the company...
How to get prescriptions without insurance?
Hello! I need help in deciding what to do with my case. I have maintenance medications for my asthma and...
Accidentally started a second medicaid application. Will this affect my original app that I submitted?
It’s been a while since I applied the first time and now both mine and my kid’s benefits have ended,...
Legally married before ceremony for health insurance gap, any pitfalls legally?
We're getting married in early August in California, USA My fiance is in a bind in terms of health insurance...
Question about Kansas Medicaid (KanCare)
I am so confused right now. I have been on KanCare Medicaid since having my 3rd child in 2022. I...
