Results 76 to 100 of 133
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06-27-2019, 11:44 AM #76
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06-27-2019, 12:46 PM #77
Yes, medical board made up of... yep you guessed it, other doctors.
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06-27-2019, 12:54 PM #78indentured servant
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- Dec 2005
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- 2,767
what's orange and looks good on hippies?
fire
rails are for trains
If I had a dollar for every time capitalism was blamed for problems caused by the government I'd be a rich fat film maker in a baseball hat.
www.theguideshut.ca
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06-27-2019, 01:17 PM #79
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06-27-2019, 01:25 PM #80Squaw Cares
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- Sep 2008
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- NorCal
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- 530
let us know when you get their letter stating your coverage is dropped.
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06-27-2019, 01:54 PM #81
Which is always hysterical given that they refuse to tell you what anything may cost up front. What other industry gets to operate that way?!
I've told this story multiple times around here, but it annoyed me so bad when my wife and I went into Bozeman Deaconess for a standard ultrasound for her pregnancy. They asked us to sign the agreement saying we were responsible for payment no matter what, so I asked a fair enough question: "Could you please tell us what the cost of a routine ultrasound might be?" Girl said "No, we don't have that information. You'll find out when you get the bill." So, how does a hospital not know how much their own services cost?! It's beyond me.
Oh yeah, and the one and only radiology department INSIDE the damn hospital is somehow NOT affiliated with said hospital, and magically "out-of-network"? Please someone explain to me how this is legal for an industry to operate this way?
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06-27-2019, 02:19 PM #82
Commoditized farming and ranching kinda works that way. That's why farmers are so fucked.
Gee, hope the wheat price is high enough this year (this thing be changing my emojis. Wanted guy shrugging, turned it to girl shrugging and girl symbol. I think that's a different month.)
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06-27-2019, 02:42 PM #83
I’ll probably regret this.
The u has many doctors who work at IHC as well. At the U facility your copay is $5. If you go to an in network doc but not at a u facility it’s a $30 copay. Same doc out of network is a deductible then 65% of the allowable charge.
If you have written proof of in network and they directed you to the other facility you will not be held accountable but you will need to prove it and deal with the bullshit.
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06-27-2019, 02:45 PM #84
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06-27-2019, 04:33 PM #85
Again, another example of bullshit provider practices. You pay no matter what, even if you get bullshit information.
Always get a firm quote before you do anything. Being a health agent, providers staff hates me. I ask a million questions. And since I mostly pay out of pocket with my shitty Obamacare, I do the same with doctors. Last week this little ENT bitch was complaining that I was keeping him. No fuck you, I’m paying $250 on the way out to get my drivers license back, because your greedy staff thinks they can hold on to other peoples property.
At least I’m not black. Would probably want cash upfront.
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06-27-2019, 05:19 PM #86
The dinosaurs yes. In California young doctors are beating down the doors trying to get into Kaiser Permanente so they can work for a salary and not deal with the business end of things. I think our acceptance rate is something like 1 doc in 10.
I don't know about Utah but in CA the medical board has 6 docs out of 12
The reason the receptionist can't tell you what it will cost you is because everyone is paying something different--the negotiated rate is different, the copay is different, they don't know if you've reached your deductible, and they don't know how the visit will be coded. If you go into the hospital for an operation--inpatient or outpatient, they usually send you to the business office ahead of time to figure out the cost, but that takes a fair amount of figuring.
They will usually have to check with your insurance company, and even then you will only get a base figure for an uncomplicated procedure. If you have to stay extra, if there are complications, it's more. Generally speaking, only Medicare pays a fixed rate for a hospitalization--based on the diagnosis and other patient factors.
As far as non-network providers in a network hospital--in California the insurance company pays them the same rate as they pay network providers and the patient can only be billed the copay for a network provider. That should be the law everywhere. Congress has been looking at this at the federal level for a while--nothing signed yet. I don't think there's a final bill passed by both houses. I don't know the details.
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06-27-2019, 05:29 PM #87
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06-27-2019, 06:40 PM #88
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06-28-2019, 12:02 PM #89
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06-28-2019, 12:13 PM #90
The cost of processing bills is huge--at both ends: the provider and the insurer. There is enormous cost savings if everyone is on a prepaid plan like Kaiser with no fee for service. Any copays are collected upfront. Deductibles are still a problem with some individual plans--Kaiser didn't used to have these, and they require Kaiser to generate a bill. I don't have a problem with visit copays, but deductibles, besides increasing administrative costs discourage people from seeking care which defeats the purpose of a prepaid plan which incentivizes people to get preventative care and stay healthy.
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06-28-2019, 01:14 PM #91
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06-28-2019, 01:55 PM #92
Our hospital uses epic. Most hospital docs use daily visit note templates which are autopopulated all the previous diagnoses, problems, and imaging. These notes have huge amounts of data which repeats every day and due to their length are very difficult for the responsible doc to review. Admitting diagnoses which are subsequently ruled out continue to be propagated in the daily notes and often in the discharge summary and diagnoses--because no one bothered to delete them. Easy for a biller to base a code on such inaccurate information. (Another thing that happens is that the note is autopopulated with the daily labs but the doc who "wrote" the note doesn't look at it and fails to notice a dangerous lab value--I saw this happen with a potentially lethal potassium value. Docs are trained to complete the EMR but not to use it effectively as a clinical and communication tool. It's been coopted by the business office and lawyers for their purposes.)
As far as entering false data--a doc can obviously do this deliberately and with the intent to defraud or they have a template for a normal history and physical which includes negative findings for all 12 organ systems. They use their template, change the findings for the musculoskeletal system to describe the sprained ankle, but don't bother to delete all the negative findings from systems they didn't examine.
I used to get calls from coders asking me if I could add such and such to my discharge summary so they could charge a higher diagnosis. Sometimes the request was appropriate, sometimes not. Of course these folks have no medical training and they're under a lot of pressure not to miss an opportunity to upcode.
I appreciate your faith in the integrity of the docs you worked with and it may very well be deserved but I have encountered enough shady practice to view the integrity of fee-for-service docs with a degree of skepticism.
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06-28-2019, 02:02 PM #93
Dude, get Gephardt, seriously!
https://kutv.com/news/get-gephardt/n...ll-or-email-us
I work at the U and it’s said a lot that they have a very low threshold for settling things out of court. Hope you fuck them good.There's nothing better than sliding down snow, and flying through the air
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06-28-2019, 02:52 PM #94Registered User
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- Aug 2007
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- United States of Aburdistan
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I got a concussion and memory loss on top of Guardsman pass once, and the ambulance was going to a non-network hospital. I said it's out of network, medic said no, it's in your network, don't worry. I fuzzily said OK. Bu it was out of network and the ride to the non-network hospital in Murray was very long and very expensive because of how long it was. I called up the manager of the ambulance service and complained, he was nice and gave me a 'poor man's discount' but said technically they have to go to the closest hospital, not the in-network one the patient prefers. Fuuuuck, really?
Hope this story helps someone else in the same situation...
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09-11-2019, 10:00 AM #95
Update:
So after all that... months of people in offices somehwere checking different boxes, and making some adjustment for something or who the fuck knows what.... after being told that the facility was out of network at the facility, turns out that they decided everything is in network. How is anybody supposed to make a qualified decision about what to do? Nobody knows. Just got off the phone with the billing people, and they said in the future to avoid confusion, make sure with the insurance company that the facility where the visit will take place is in network. They couldn't tell me what facility I needed to go to for the appointment until the day of. Impossible. Our system is so broken it's not even funny.sigless.
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09-11-2019, 10:05 AM #96
yes it is broken
i'm off to a new hospital in arkansas monday for twelve days! whoppee!
somebody go out for a beer with me in bentonville or fayetteville?
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09-11-2019, 10:09 AM #97
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09-11-2019, 10:18 AM #98Banned
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- May 2007
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- Sandy, Utah
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yep totally broken. And I believe the ins co's live off the fact that tons of people will just "pay it" so the company wins.
Ive had multiple instances of stuff not being covered when it should clearly be, all instances were billing errors on the part of the Dr in most cases. Simply refiling the claim with the right "code" gets the bill paid.
Wonder how much they make off "mistake" payments.
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09-11-2019, 10:45 AM #99
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09-11-2019, 10:50 AM #100Registered User
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- Dec 2009
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