Venting: Timely filling manual claims with Premera

TLDR Warning; Make sure you understand your Insurance providers rules for Timely Filling or else you may lose your ability to leverage the benefits you pay for.

I just… needed to vent to a community that i feel would care about this issue and understand why this situation feels so toxic.

So, I recently did another audit of my year worth of claims because I’m paranoid, my therapist is out of network and thus I must submit claims manually. The dangerous thing about this with Premera is that they don’t display any Submitted but Unprocessed claims, that are out of network on their tracker. Which is odd given they have a robust tool for manual submission.

Well, this time I decided after year 2020 I’m going to double check 2019 in case, which i was also a Premera client. Turns out, I missed 5 months’ worth of claims, spread out throughout 2019. This is where i learned that they won’t allow me to submit / realize the value of claims after 365 days….

I… am struggling with the stress this creates. Not only does the health insurance company fail to provide tracking of manually submitted claims through their system or inbox, but they can benefit from you missing a claim? With the absurd cost of health insurance and little opportunity to pick your own Health Insurance provider this feels like my health is something they profit and prey on…

I’m trying to appeal to them, i expect to be let down and incredibly overwhelmed as a result… but I just… please don’t make my mistake. Over submit if you have to, I’m considering sending the last 3 months every week to ensure my claims can’t be denied due to ‘timely filing”…

submitted by /u/Sinvoid_1211
[link] [comments]
TLDR Warning; Make sure you understand your Insurance providers rules for Timely Filling or else you may lose your ability to leverage the benefits you pay for. I just… needed to vent to a community that i feel would care about this issue and understand why this situation feels so toxic. So, I recently did another audit of my year worth of claims because I’m paranoid, my therapist is out of network and thus I must submit claims manually. The dangerous thing about this with Premera is that they don’t display any Submitted but Unprocessed claims, that are out of network on their tracker. Which is odd given they have a robust tool for manual submission. Well, this time I decided after year 2020 I’m going to double check 2019 in case, which i was also a Premera client. Turns out, I missed 5 months’ worth of claims, spread out throughout 2019. This is where i learned that they won’t allow me to submit / realize the value of claims after 365 days…. I… am struggling with the stress this creates. Not only does the health insurance company fail to provide tracking of manually submitted claims through their system or inbox, but they can benefit from you missing a claim? With the absurd cost of health insurance and little opportunity to pick your own Health Insurance provider this feels like my health is something they profit and prey on… I’m trying to appeal to them, i expect to be let down and incredibly overwhelmed as a result… but I just… please don’t make my mistake. Over submit if you have to, I’m considering sending the last 3 months every week to ensure my claims can’t be denied due to ‘timely filing”…
submitted by /u/Sinvoid_1211 [link] [comments]Read Morer/HealthInsurance

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