this is ridiculus

[Jogeephus]

We all got another choice. Just lay down and die at home without the Doctors help.

This is my plan cause I don't want to lose everything I've worked for if I get really sick. I hope to be able to leave something to my children other than debt. I just hope my doctor will keep me with some good scripts if there is much pain involved.

So reform it without government taking control.

HOW?
Do we just ask them to please stop making so much profit

You shop around.

My friend's uncle got bit by a rattlesnake last summer. Don't think he had the time to shop around. His bill came to $80,000 and some change. This is double what a bite cost two years ago. But I guess the price of oil went up so its only reasonable.

 

[Lammie]

So reform it without government taking control.

That's going to be hard since Medicaid and Medicare are state and federally funded programs. The irony of this is that he has a Medicare part D presription plan and they don't seem to use it. It comes out of his social security check. He has to have it but he certainly isn't getting any benefit from it.

I'd like to see some sort of grass roots effort, but it is hard to fight city hall, so to speak. The drug companies and medical lobby have all the money in the world. I don't.

 

[Tod Dague]

In the end, I have to agree a person does need some sort of health insurance, got to have it, and dish out the dough, whether I want to or not.

GMN

You gotta have it or lose what you have. The whole system is broken. Too much greed. Ie, a fella had a skin tag on his neck. You know those little things about the size of a tick. He went to the doctor to have it removed. He spent more time in the waiting room than he did with the doctor. Doctor just numbed it and cut it off. No stitches neccessary. Bill for 5-10 minutes = $8000.

Another way they get you is coding. Each procedure has a code which is essentially a bunch of numbers that only a few know how to read. Unfortunately for one certain doctor, I know someone who knows how to read this stuff. Bill I received came to $4000 after insurance. Had the code explained to me and the code showed my sone was surgically operated on - which he was not. I pointed this out to the lady that does the billing and she deleted the whole bill and said I owed nothing. Said it was an honest mistake. Ok, fine. Then why did the same doctor do the same thing two years later with my other son? They deleted that bill too. But what about the insurance company? Do you think they made it right with them?

Watch the news in the near future cause there is going to be a lot of information on coding once the federal auditors hit the hospitals. Some heads should roll.

Its already has. They are the RAC (Recovery audit contractor) audits. They aren't just looking at coding but medical necessity as well. This is what closed down several hospitals in Florida. If the audit contractor deems a case was coded wrong or doesn't meet medical necessity the hospital has to give the payments back then they can appeal. The overturn rate was so high on the medical necessity side that they have put a hold on this part of the audit until it is corrected. What you see billed to medicare is not what they pay. We have several layers that a cases must go through be fore it is ever billed to insure that everything is correct be fore it is ever billed. Cases are looked at prior to admission from all points of admission (ED, transfers, clinics, surgical) , concurrently, and post discharge by two groups that are employed by the hospital and a third independent audit. We rather have it right on the front end than have the hospital suffer the wrath of medicare.

 

[Tod Dague]

My friend's uncle got bit by a rattlesnake last summer. Don't think he had the time to shop around. His bill came to $80,000 and some change. This is double what a bite cost two years ago. But I guess the price of oil went up so its only reasonable.

I'm sorry I was refering to insurance. It didn't even accure to me tha the hospitals were considered rich. I work for a non profit and the for profit hospitals in my area are going broke.

 

[GMN]

How can it cost $80,000 for a snake bite, antivenom, and on your way?

GMN

 

[Tod Dague]

How can it cost $80,000 for a snake bite, antivenom, and on your way?

GMN

Depends on the location, how long until treatment was started, how much venom was injected, and co-morbid conditions. I've seen some people stay in the ICU for an extensive time.

 

[alisonb]

If you can try and get hold of this DVD-written and directed by Micheal Moore- SICKO.Very thought provoking!!

 

[gimpyrancher]

Remember, all insurance companies get a discount on charges from the hospital. Uninsured individuals are charged up to double the rate of what insurance companies pay for the same procedures.

 

[Lammie]

I have caught several billing errors in the past. It isn't uncommon at all. If you think that regular insurance is bad, try Medicare. There's rampant fraud going on there. Part of my dad's "restorative therapy" is walking up and down the road each day. He does this by himself. Medicaid and Medicare are billed thousands a month for it. It blows me away. So if his insurance won't pay for it anymore, will he not be allowed to walk anymore??? Pediatrist charged 300.00 to trim his toenails. He isn't diabetic or anything. He77, I've been trimming them myself and there are still bills associated with this service. It's just stupid. His phamacy bill is thousands per month. He takes about seven different meds, including asperine. Nothing experimental, no drug trials. Stuff that he could get a Walmart for five bucks a month per script.

And the population is aging. We can't keep this up.

If he is just walking down the road why is he still involved with the restorative care? I don't understand, Is he still seeing the podiatrist? Why not just buy the the meds at wal-mart? He has every right to manage his care. Everybody does.

He had moderate Alzheimer's. He lives in a NH. The road is in front of the NH. So far he hasn't wandered off. He can't live alone because he's real good in the mornings but come evening he becomes delusional. When I say "by himself". I mean he normally walks with a couple other old guys with an aide watching. There is not a physical therapist there. It is billed as PT though.

 

[Tod Dague]

I have caught several billing errors in the past. It isn't uncommon at all. If you think that regular insurance is bad, try Medicare. There's rampant fraud going on there. Part of my dad's "restorative therapy" is walking up and down the road each day. He does this by himself. Medicaid and Medicare are billed thousands a month for it. It blows me away. So if his insurance won't pay for it anymore, will he not be allowed to walk anymore??? Pediatrist charged 300.00 to trim his toenails. He isn't diabetic or anything. He77, I've been trimming them myself and there are still bills associated with this service. It's just stupid. His phamacy bill is thousands per month. He takes about seven different meds, including asperine. Nothing experimental, no drug trials. Stuff that he could get a Walmart for five bucks a month per script.

And the population is aging. We can't keep this up.

If he is just walking down the road why is he still involved with the restorative care? I don't understand, Is he still seeing the podiatrist? Why not just buy the the meds at wal-mart? He has every right to manage his care. Everybody does.

He had moderate Alzheimer's. He lives in a NH. The road is in front of the NH. So far he hasn't wandered off. He can't live alone because he's real good in the mornings but come evening he becomes delusional. When I say "by himself". I mean he normally walks with a couple other old guys with an aide watching. There is not a physical therapist there. It is billed as PT though.

Restorative care doesn't require a physical therapist to be present. It has been a couple of years since I worked at a nursing home and then I didn't work on the billing or regulatory side of things, but I'm pretty sure that if they are billing for physical therapy then the physical therapist has to be providing the physical therapy. You can do a search for Medicare FI and your state to locate who is your fiscal intermediary to ask regulatory questions. I applaud you looking at the billing and asking questions. My recommendation to everyone is to manage their medical care as much as possible and be aware of what is being billed for and to do as much as you can for yourself. If you can buy the meds yourself cheaper than the institution then supply your own. If you have your own you have a right to use your own. If you go to the hospital it is a good idea to bring your meds from home (including any herbal meds and supplements) any ways if possible so the medical team has a full understanding as to exactly what you are taking.

You have the right to negotiate as to what you will pay for your care, there is no guarantee that you will save any money but it is worth the try. You won't have as much leverage as an insurance company because you don't have the mass that an insurance company does. If it truly an elective procedure you probably won't have any leverage. The place to go is the business office.

 

[Jogeephus]

How can it cost $80,000 for a snake bite, antivenom, and on your way?

GMN

What? Are you saying this person's life is not worth $80,000? (just kidding) Bet you never heard that before. It was a bad bite and it got in the vein. I will be able to give you another price for a snake bite shortly as my friend is in IC right now from a bite this weekend. This will be 2 bites in 3 years for this lucky soul.

Unfortunately, some kind soul didn't paint the snake blue for easy recognition. ;-) :lol2:

 

[Red Bull Breeder]

Hope for someones sake it wasn't a blue snake that bit him!! :lol:

 

[Alberta farmer]

My mother is in a nursing home. Not quite sure how it works but I think the bill is about $1200/month. Before that she lived in a "retirement home"...I think the bill was about $2400, but it was pretty upscale and had all kinds of extras. A person was required to be able to walk down to the dining room and basically take care of themselves. When she got so she couldn't walk and got pretty forgetful we had to move her to the nursing home.
The nursing home is on a college campus and they do a lot of training there for healthcare workers. She gets pretty good care and my sisters are in everyday to help take care of her and she seems to be fairly happy. It's not easy getting old.

 

[lakeportfarms]

How can it cost $80,000 for a snake bite, antivenom, and on your way?

GMN

What? Are you saying this person's life is not worth $80,000? (just kidding) Bet you never heard that before. It was a bad bite and it got in the vein. I will be able to give you another price for a snake bite shortly as my friend is in IC right now from a bite this weekend. This will be 2 bites in 3 years for this lucky soul.

Hey, I have a nice house in Michigan I'll sell to your friend...we don't have those biting snake thingys up here, would save a lot of money and time....of course there's the little problem of no jobs around here, except for shoveling snow.

 

[Jogeephus]

How can it cost $80,000 for a snake bite, antivenom, and on your way?

GMN

What? Are you saying this person's life is not worth $80,000? (just kidding) Bet you never heard that before. It was a bad bite and it got in the vein. I will be able to give you another price for a snake bite shortly as my friend is in IC right now from a bite this weekend. This will be 2 bites in 3 years for this lucky soul.

Hey, I have a nice house in Michigan I'll sell to your friend...we don't have those biting snake thingys up here, would save a lot of money and time....of course there's the little problem of no jobs around here, except for shoveling snow.

Haven't checked to see how she is doing yet but I'm thinking she might be interested. If not, I do think she will be interested in hiring out her yard work from this day on. Once I know she is OK, I'm surely going to give her husband some grief over this. Stuff like this will give me much fodder for fun.

 

[john250]

Haven't checked to see how she is doing yet but I'm thinking she might be interested.

If she's interested, there is another thread where she can buy a snowblower cheap. She has to go to TX to get it.