Insurance denied revision

[Gt1956]

Perhaps my theory is faulty. By I still maintain that hospitals play the books. They might even have rules that are different for their industry. Powerful lobby group.
I do know this for fact. My daughter suffered from depression & alcohol addiction. Finally died due to an aneurysm. She had several interactions with our local hospital. The billing department has a group that sorts the claims. They have a very short window of days to accomplish this. Being unemployed, they would first try to get her on Medicaid. Funny part, it was for only their bill. If that failed, they would shift her over to their "charity" column. This was told to me in person by an employee of the hospital. Ok, so I guess that charity isn't truly a "loss". But I'm sure that the charity $$ gets to their tax return somehow. So would they deduct the charity amount? Wouldn't that mean that they didn't pay taxes on the total "list" price of the charity amount? In my mind this all fits into the "business secret" part of the actual price that insurance companies negotiate.
As for the recapture of deducted depreciation of a rental home. Mull this over for a minute. If you always buy nicer upscale homes that you are willing to live in for 3 years. There is a well established method to NOT pay on any gain. Think 3 out of the last 5 phrase. It is being done more than you think.
Another method is to only sell your rental if you are to carry the contract. This allows you to get better than most bank rates of return & you can spread your recapture out over a long enough time to avoid getting pushed into a higher bracket than if you didn't carry the note.
It is almost like Congressmen own rental property.

[Lost Sheep]

Yep, the entire medical fee structure (and the world's most powerful labor union, the A.M.A) keep pricing and discounting secret, and the billing system is so obscure that anyone sick enough to need medical care is doubly handicapped at understanding it. Confusing bills piled on top of a mind distracted by illness/injury.

If you always buy nicer upscale homes that you are willing to live in for 3 years. There is a well established method to NOT pay on any gain. Think 3 out of the last 5 phrase. It is being done more than you think.

Once per lifetime and capped at (I think) $250,000 of gain.

But I'm sure that the charity $$ gets to their tax return somehow. So would they deduct the charity amount?

Yes, but only the amount they actually spent (cost of bandages, medications etc and depreciation amortization and salaries) allocated to the charity column. The amount on the bill is not significant, only the hospital's cost of the care.

Perhaps my theory is faulty. By I still maintain that hospitals play the books. They might even have rules that are different for their industry. Powerful lobby group.

Yes, they "play" the books and also normally play by the books. As President Trump said during the 2016 campaign, he takes advantage of the tax laws as they are written (and made no apology for that) whether (this is my add-on) they are fair and equitable or not. He promised to fix the unfairness/inequality when he became President but stated it would have been stupid not to take the law as written. The intent of the Congress not being his problem.

Another method is to only sell your rental if you are to carry the contract. This allows you to get better than most bank rates of return & you can spread your recapture out over a long enough time to avoid getting pushed into a higher bracket than if you didn't carry the note.
It is almost like Congressmen own rental property.

Yes, installment sales are a powerful tool to shift a tax burden into future years. There is also the old trick (and I don't know if it still works) to sell an asset for U.S. currency in silver or gold coin. ($100,000 in coin being worth $500,000 -to pull an example out of thin air). You only recognize gain on the face value of the gain. The problem is that when you convert the coinage into present-day currency you are obliged to declare the uptick as income.

[Gt1956]

The once in a lifetime has been changed. It only has to be your primary residence for 3 of the last 5 years. Several money shows on the radio have confirmed it. Yes, there is a cap. But whatever it is. If you can avoid federal tax on it every 3 years you're going to be doing good.

[Gt1956]

Just double checked. I have missed one slight complication.
Check the IRS topic #701. Basic rules are $250k exclusion for single filers. $500k for joint filers. Must own & use as primary home for 2 of the last 5 years. The catch that I missed is that you can't claim the exclusion if you have used the exclusion on a prior home during the 2 years prior to the sale of the current home. No mention of your basis in the home, only your gain. Don't forget that you can't depreciate dirt so you can be selling a single family home for more than the exclusion limits.
How would you like $250,00 tax free.
I understand your point on the not being declared as income problem that you have pointed out. My family had to deal with that concerning a failed Savings Institution that was operating under a state banking license rather than a federal license. My reply is that we don't know the tax laws that hospitals operate under.
Based upon my discussion with our local hospital over my daughter. I can only conclude that they are spending employee's time for a good reason. She definitely explained it as I have described. She did use the charity word plain & clearly.

[MK1965]

I see my post turned to tax evasion discussion.
MK

[Lost Sheep]

I see my post turned to tax evasion discussion.
MK

Evasion is different in a very important factor from avoidance. One will send you to jail. The other could let you into the White House.

I felt a bit embarrassed about side-tracking the thread, but got caught up in the issues. A bit of lack of self-control. Kind of like getting the the edge of orgasm or eating Lay's Potato Chips. Couldn't stop.

I will try to quit touching it.

[Gt1956]

Sorry MK. Kind of drifted because of my feelings about how some segments of the medical industry makes money.
Back to you. I know that I have posted this story before but in case it was in a thread that you didn't follow.
My wife needed a procedure that for some reason our health insurance just wouldn't cover. Never actually gave a reason for the denial. After batting the issue around for a couple of weeks. I forget how it was brought up but they offered to cover it at a higher co-pay. While not happy about it. We accepted the offer.
I guess the take away on this is to keep your ears open for even a hint of a similar offer. As it first came up, they weren't real open how they worded it. After a few calls back & forth the offer was described better.
Maybe you could even bring a compromise up on your own? Good luck.

[SW0110]

Any word on the revision approval. Worst months of my life, well not really, but stressful anyway from the day I knew my titan did not work anymore till my ams was put in. 2.5 long months.

Very stressful. I think it is a doctor office issue not providing the company with the right information. Hopefully they have someone in their office who specializes in working with insurance.

They have to code removal of implant and install of implant. 2 separate codes. The first says something like removal of implant due to nonfunctionabilty.

[Ronn1708]

Has your status changed? Did you finally get approved?

[MK1965]

As of now, it is still STATUS QUO.
I am re-scheduled for revision on 9.9.
When I call Aetna, I don get much info from them.
Still waiting for decision.
MK