this post was submitted on 28 Nov 2025
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[–] muusemuuse@sh.itjust.works 27 points 1 week ago* (last edited 1 week ago) (17 children)

So this sucks but you can avoid this with a simple trick. Call your insurance company first with the CPT codes for what you need done and where you plan to get it done. Your doctors office can give you the codes. They aren’t a trade secret or anything. Get diagnoses codes too if you can. Have the insurance company run the codes for you before you go. This does a couple things:

  1. You verify everyone involved is in network (be wary of anesthesiologists)
  2. You are getting a quote on a recorded line. The end price won’t be exact (especially is if the claim involves a hospital, fuck them, go to smaller providers whenever you can)
  3. if you get sticker shock anyway, you can call the insurance company back on that same recorded line and say the word “misquote”. This triggers an investigation that can strengthen your appeal.
  4. You now have evidence you can file internally with a quality of care/quality of service complaint if the provider did something shady with the billing, or with your state’s department of insurance if your insurance company is being bitchy.

Ideally, we would have single payer insurance, but we instead have a government that pays itself to make private enterprise do its job, then the shareholders in that private enterprise make sure nothing ever gets changed. -sigh-

In the mean time, if you really want to fuck them over, consider switching to health insurance company that does not have shareholders. In many states, they are legally mandated to refund any profit they make over a certain percentage at the end of the year and without shareholders, it’s harder to hide the money, which puts much more pressure on them to spend it on patient care.

United Health Care want you to believe their way is the only way to do this. They are wrong. A shareholder-free insurer still isn’t perfect but the pressures are different without the parasites.

[–] skeezix@lemmy.world 19 points 1 week ago (4 children)

is this seriously what you americans have to do?

[–] FatVegan@leminal.space 5 points 1 week ago

Freedom isn't free

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