# In this country the question to ask your doctor when having a heart attack is not can you help me... **URL:** \ **Category:** The BBQ Pit\ **Created:** [November 28, 2017, 9:32pm UTC](https://boards.straightdope.com/t/in-this-country-the-question-to-ask-your-doctor-when-having-a-heart-attack-is-not-can-you-help-me/802984 "2017-11-28T21:32:38Z")\ **Posts on this page:** 13\ **Page:** 3
**Author:** ![Icarus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/icarus/32/72_2.png) [@Icarus](https://boards.straightdope.com/u/Icarus)\ **Post date:** [November 29, 2017, 2:45pm UTC](https://boards.straightdope.com/t/in-this-country-the-question-to-ask-your-doctor-when-having-a-heart-attack-is-not-can-you-help-me/802984/41 "2017-11-29T14:45:33Z")
It is my desire that everyone in this thread who is a US citizen, and finds our system to be chaotic and lacking keeps this in mind the next time they vote. All politics is local and personal. ---
**Author:** ![kaylasdad99](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kaylasdad99/32/3398_2.png) [@kaylasdad99](https://boards.straightdope.com/u/kaylasdad99)\ **Post date:** [November 29, 2017, 3:00pm UTC](https://boards.straightdope.com/t/in-this-country-the-question-to-ask-your-doctor-when-having-a-heart-attack-is-not-can-you-help-me/802984/42 "2017-11-29T15:00:05Z")
> [@elbows](#): > > Not that I know shit about the American system, beyond it being shit, of course, but I did read a very interesting medical hack that y’all might enjoy hearing. I cannot attest to it’s effectiveness, clearly. > > It goes like this: > > Whenever you’re refused coverage for something call insurance company to speak with the HIPAA compliance officer (by federal law, they MUST have one!) One wonders if the that law also requires that this officer be easily reachable by phone. The workaround sounds pretty sweet. That said, I suspect that high levels of patience, persistence, and willingness to play phone tag for several days will need to come into play. ---
**Author:** ![asahi](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/asahi/32/8693_2.png) [@asahi](https://boards.straightdope.com/u/asahi)\ **Post date:** [November 29, 2017, 3:44pm UTC](https://boards.straightdope.com/t/in-this-country-the-question-to-ask-your-doctor-when-having-a-heart-attack-is-not-can-you-help-me/802984/43 "2017-11-29T15:44:40Z")
I’ve known people who have just paid hospitals piecemeal. I would think that it’s bad press for a hospital to take someone to court over a medical bill and it’s bad press for insurance companies to deny claims. ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [November 29, 2017, 4:01pm UTC](https://boards.straightdope.com/t/in-this-country-the-question-to-ask-your-doctor-when-having-a-heart-attack-is-not-can-you-help-me/802984/44 "2017-11-29T16:01:31Z")
> [@asahi](#): > > … and it’s bad press for insurance companies to deny claims. I got the impression that ship has sailed for the insurance companies. ---
**Author:** ![Icarus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/icarus/32/72_2.png) [@Icarus](https://boards.straightdope.com/u/Icarus)\ **Post date:** [November 29, 2017, 4:05pm UTC](https://boards.straightdope.com/t/in-this-country-the-question-to-ask-your-doctor-when-having-a-heart-attack-is-not-can-you-help-me/802984/45 "2017-11-29T16:05:47Z")
> [@asahi](#): > > …it’s bad press for insurance companies to deny claims. Um, seriously, that is their primary business model. It’s a feature, not a bug. ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [December 1, 2017, 5:13pm UTC](https://boards.straightdope.com/t/in-this-country-the-question-to-ask-your-doctor-when-having-a-heart-attack-is-not-can-you-help-me/802984/46 "2017-12-01T17:13:09Z")
> [@Icarus](#): > > It is my desire that everyone in this thread who is a US citizen, and finds our system to be chaotic and lacking keeps this in mind the next time they vote. 😕 Patriotic conservatives are happy to risk bankruptcy if it means that Allah-lovers and lazy blacks don’t get their diseases and injuries treated. ---
**Author:** ![TAmnesia](https://avatars.discourse-cdn.com/v4/letter/t/51bf81/32.png) [@TAmnesia](https://boards.straightdope.com/u/TAmnesia)\ **Post date:** [December 3, 2017, 4:52pm UTC](https://boards.straightdope.com/t/in-this-country-the-question-to-ask-your-doctor-when-having-a-heart-attack-is-not-can-you-help-me/802984/47 "2017-12-03T16:52:57Z")
Kinthalis, the Appeals Department letter did not simply state, “Nope, we’re not paying.” By law they have to give you a specific reason that falls into one of several categories. Can you share what that reason was? Secondly, there are three levels of Appeals and you need to exhaust. The first is a clerical review of the coverage protocols, the second is reviewed by a medical professional, and the third by a Board of Trustees or an executive committee of the insurance company, with the advice of a medical professional unrelated to the other professional. It isn’t until the third Appeal that your entire situation is considered. It’s very important that you follow through to the end - unless of course, you agree with the specific reason they give for denying your claim. So, while you may have been denied because you visited an out-of-network hospital emergency department for the treatment of a non-emergent condition, it gives you the opportunity to further explain your individual circumstances. Then, if you owe them payment after all, call them and tell them you will be making monthly payments of $ \_\_\_ . They don’t want to ruin your life and have no interest in giving a collection agency half of what they collect. But they need to hear from you. Finally, visit your doctor and take your medication religiously so you can be there for your family, watch your son grow up, and tell him how much you love him. ---
**Author:** ![BigAppleBucky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bigapplebucky/32/178_2.png) [@BigAppleBucky](https://boards.straightdope.com/u/BigAppleBucky)\ **Post date:** [December 3, 2017, 10:46pm UTC](https://boards.straightdope.com/t/in-this-country-the-question-to-ask-your-doctor-when-having-a-heart-attack-is-not-can-you-help-me/802984/48 "2017-12-03T22:46:39Z")
> [@Kinthalis](#): > > Yep I just a got a letter from their appeals department who say they have reviewed my appeal and have decided, nope, we’re not paying. In your situation I would bring my plight to my state insurance commissioner. (You might start at your board of health.) My wife did this because our insurance company at the time determined that a series of rabies shots was “optional”. Considering that maybe one person in a million survives an active case of rabies, their stance seemed patently ridiculous to us. And, in fact it was. The insurance company president eventually called my wife an appologized for the “misunderstanding” after getting his ears blistered by someone from the NY commissioner of insurance office. ---
**Author:** ![John\_Bredin](https://avatars.discourse-cdn.com/v4/letter/j/96bed5/32.png) [@John\_Bredin](https://boards.straightdope.com/u/John_Bredin)\ **Post date:** [December 4, 2017, 10:07pm UTC](https://boards.straightdope.com/t/in-this-country-the-question-to-ask-your-doctor-when-having-a-heart-attack-is-not-can-you-help-me/802984/49 "2017-12-04T22:07:00Z")
> [@BigAppleBucky](#): > > The insurance company president eventually called my wife an appologized for the “misunderstanding” after getting his ears blistered by someone from the **NY** commissioner of insurance office. (Emphasis added.) Would the insurance commissioner of an [del]anti-regulation[/del] pro-business state be as diligent, though? :dubious: ---
**Author:** ![Doctor\_Jackson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/doctor_jackson/32/32_2.png) [@Doctor\_Jackson](https://boards.straightdope.com/u/Doctor_Jackson)\ **Post date:** [December 5, 2017, 2:29pm UTC](https://boards.straightdope.com/t/in-this-country-the-question-to-ask-your-doctor-when-having-a-heart-attack-is-not-can-you-help-me/802984/50 "2017-12-05T14:29:51Z")
> [@John\_Bredin](#): > > (Emphasis added.) Would the insurance commissioner of an [del]anti-regulation[/del] pro-business state be as diligent, though? :dubious: Care to list those states you question? I’m in Georgia and my Insurance Commissioner’s office was a huge help. ---
**Author:** ![John\_Bredin](https://avatars.discourse-cdn.com/v4/letter/j/96bed5/32.png) [@John\_Bredin](https://boards.straightdope.com/u/John_Bredin)\ **Post date:** [December 5, 2017, 3:15pm UTC](https://boards.straightdope.com/t/in-this-country-the-question-to-ask-your-doctor-when-having-a-heart-attack-is-not-can-you-help-me/802984/51 "2017-12-05T15:15:42Z")
> [@Doctor\_Jackson](#): > > Care to list those states you question? I’m in Georgia and my Insurance Commissioner’s office was a huge help. I don’t know. I wasn’t asking rhetorcially but in earnest, albeit with some skepticism. Some states have elected governments that believe being pro-business means removing as many regulations as politically feasible, and promote themselves as low-regulation states to potential new or relocating businesses. I honestly don’t know if that extends to insurance, but it’s not preposterous to suspect so. I’m pleasantly surprised to learn it isn’t so in at least one such state. ---
**Author:** ![kaylasdad99](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kaylasdad99/32/3398_2.png) [@kaylasdad99](https://boards.straightdope.com/u/kaylasdad99)\ **Post date:** [December 5, 2017, 3:56pm UTC](https://boards.straightdope.com/t/in-this-country-the-question-to-ask-your-doctor-when-having-a-heart-attack-is-not-can-you-help-me/802984/52 "2017-12-05T15:56:41Z")
> [@asahi](#): > > …and it’s bad press for insurance companies to deny claims. > [@Grim\_Render](#): > > I got the impression that ship has sailed for the insurance companies. Sailed, capsized, gone over a waterfall and cracked open on the rocks. And then the rocks got cancer. ---
**Author:** ![edwards\_beard](https://avatars.discourse-cdn.com/v4/letter/e/7bcc69/32.png) [@edwards\_beard](https://boards.straightdope.com/u/edwards_beard)\ **Post date:** [December 6, 2017, 6:57pm UTC](https://boards.straightdope.com/t/in-this-country-the-question-to-ask-your-doctor-when-having-a-heart-attack-is-not-can-you-help-me/802984/53 "2017-12-06T18:57:06Z")
> [@elbows](#): > > Not that I know shit about the American system, beyond it being shit, of course, but I did read a very interesting medical hack that y’all might enjoy hearing. I cannot attest to it’s effectiveness, clearly. > > It goes like this: > > Whenever you’re refused coverage for something call insurance company to speak with the HIPAA compliance officer (by federal law, they MUST have one!) Ask for the names and credentials of everyone accessing your info, involved in that decision. (Again by law you’re entitled to know!) > > They will likely reverse their decision immediately rather than admit it’s most always low paid high school grads, (even if it’s medical personnel it won’t be a board certified Dr from the applicable specialty!) They so, SO desperately don’t want you to know this or to have to reveal it. > > Any refusal, to provide what you’ve asked, should be reported to US Office of Civil Rights as an actionable HIPAA violation. > > (Before you rag at me, I’m a Canadian, but when I read about it I thought it was pretty slick and wondered how many Americans knew this.) Either way, it’s a great story, right? [And story](https://www.truthorfiction.com/hippa-medical-hack-for-denied-insurance-claims/) [is all](https://www.snopes.com/hipaa-medical-hack-insurance-claim-denials/) [this is.](https://hipaahealthlaw.foxrothschild.com/2015/12/articles/articles/debunking-a-viral-medical-hack-meme/) [Previous page](https://boards.straightdope.com/t/in-this-country-the-question-to-ask-your-doctor-when-having-a-heart-attack-is-not-can-you-help-me/802984.md?page=2)