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A+ and deductibles

Discussion in 'Insurance Issues' started by BrendaK, Feb 13, 2009.

  1. BrendaK

    BrendaK Neonatal Diabetes Registry

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    We've used A+ for quite some time. I know that it takes them forever to bill the insurance company. However, they say that the claim is always processed by the date the supplies were shipped out. So my question is about deductibles. Here's the scenerio: A+ has shipped our January shipment. When they bill the insurance the first $400 will be written off by A+ because that is the yearly deductible. After they bill for January our insurance will show we have met the deductible. However, they have not billed the insurance company yet.

    Carson got a new pump last week. Since A+ has not billed for anything yet, it shows we owe the yearly $400 deductible. Fine -- we will pay that.

    But what happens when A+ goes back and bills for January -- the claim will be dated in January. By then we will have paid for a deductible in Febuary.

    Anyone following me here? What happens with the insurance billing? Lots of people have said that A+ delays their billing because they are hoping people will meet the deductible in the meantime. But I don't see how that can be right since they date the claim the date the shipment was sent.

    I'm not necessarily trying to get out of paying a deductible, I'm just trying to figure out what will happen in this insurance scenerio -- and not having to pay a deductible would sure be nice :)
     
  2. zell828

    zell828 Approved members

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    We use A+ too. I have a similar question. We ordered sensors through MM since A+ no longer carries them. We should have met our deductible but we got a $900 bill for the sensors last week. So obviously A+ hasn't billed the insurance yet for this year. What do you do with something like that?
     
  3. BrendaK

    BrendaK Neonatal Diabetes Registry

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    It's been awhile since I posted this question and have since found out the answer. The insurance company bases the deductible on the date they receive the claim, not the date of service. So if they get a claim for a dr's visit on 6/1/09 but then A+ bills on 6/15/09 for supplies you got back in January, the deductible will go first towards the dr's visit, because they got the claim first.

    Does that make sense? That's why A+ does not bill for a LONG time, they are hoping that you meet your deductible on your own first, so they will receive more in payments.
     
  4. WestinsMom

    WestinsMom Approved members

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    Interesting! I have never used A+ and don't have a deductible but am always interested in how they do it.
     
  5. Jacob'sDad

    Jacob'sDad Approved members

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    Good timing for this topic to resurface. Aplus has now met Jacob's yearly deductible. BUT we are now switching to my wife's insurance which is with the same company but has a much lower deductible. I'm sure Aplus will be very happy about that NEXT YEAR. But what about this year? That new deductible has to be met. Will they balk? Will they boot us? When should I call them? Insurance changes July 1st.
     
  6. zell828

    zell828 Approved members

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    So basically if we need to order anything (like sensor) we should wait and do it towards the end of the year so A+ files their claims first and we meet our deductible then, I take it.
     
  7. BrendaK

    BrendaK Neonatal Diabetes Registry

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    You got it! Unfortuantely BCBS is now out of network for A+, so it doesn't really matter for us because all of the A+ supplies goes towards our seperate out of network deductible. I'm thankful we can still use them, though!

    A+ just started billing BCBS in June for supplies that were sent in January. I think they run 6-9 months behind for billing.
     

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