Health Insurance Claim Denied? See What Insurers Said Behind the Scenes
This is some of the best hacking I&#x27;ve seen on Hacker News in a long time!<p>My son broke his arm skiing a few months ago and we went to the clinic that is at the ski resort.  They x-rayed him, set the bone a little (thankfully it didn&#x27;t need much), put on a splint, and put his arm in a sling.  Straightforward simple stuff.<p>The clinic is not on our insurance so we filed a claim with them after the fact ourselves using the detailed receipt the clinic provided.  It was out of network so they didn&#x27;t pay for most of it (for some reason they did pay the $12 or whatever for the sling), but they applied the cost to our out-of-network deductible.  Except not the cost the clinic charged, the cost they thought the clinic should have charged, which was of course about $150 less.  What??  I&#x27;d love more insight into how all that makes sense in someone&#x27;s mind.