Health Insurance

6/9/2016 2:15pm
kkawboy14 wrote:
Has Obamacare helped or hurt you? I provide group for my company and it keeps going thru the roof but it is easier to get good...
Has Obamacare helped or hurt you?

I provide group for my company and it keeps going thru the roof but it is easier to get good coverage
Simple: Inner city: BAD. Only people that fill them out are the ones that want to bitch. Rural area: relatively good because not many people fill...
Simple:

Inner city: BAD. Only people that fill them out are the ones that want to bitch.

Rural area: relatively good because not many people fill them out because they don't need to bitcg. They're generally happy with their care.
Yeah, it's just funny to hear management people going crazy over patient satisfaction numbers when every hospital within the same county probably has the exact same numbers. It would be interesting to gather those statistics and compare them to demographics, voting trends, socioeconomic status, and all those other things that could be affecting our reimbursement
6/9/2016 3:53pm Edited Date/Time 6/9/2016 3:56pm
Won't study that because it's either 5 get paid. 4 doesn't.

If they figure out people give 1s because they were in the ED waiting for 6 hours you can't win. Won't get reimbursed as much. No reason to waste resources (p value studies.
6/9/2016 3:57pm
Bah. For whatever reason I posted two paragraphs after p studies. Too angry to re post.

6/9/2016 4:00pm Edited Date/Time 6/9/2016 4:02pm
Anyway. CMS won't reimburse unless people are happy and if they're not happy off the get go because of the 8 hour wait time in the ER....what do the Hospitals do ? Start posting tHese signs places. its not primary care. This just justifies using an ER as a doctor visit. Which makes people angry five years down the road when everyone and their sister pop in to the ER for that scratchy throat.




Signs should say: if you're not dieing cal your doctor. If you're not able to be seen there go to a minute clinic or urgent care. Unless of course you are dieing. Or can't breathe. Or are stuporous.

The Shop

ToolMaker
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6/9/2016 4:33pm
kzizok wrote:
Toolmaker, Our stories have been about the large number of patients who abuse the system so much that it interferes with the care of legitimate patients...
Toolmaker,

Our stories have been about the large number of patients who abuse the system so much that it interferes with the care of legitimate patients, like yourself. If the non legitimate patients were not a factor, ER's would run like they are designed to. So next time you have long waits, etc. Dont blame the ER, blame the huge number of people who abuse the system. The point about the wi-fi scenario isn't about giving people something to pass the time. Its just an example to show you that with true emergencies, peoples' first priority is their health issue.
I totally did not intend to imply that the problem is with the ER itself. I can see all the little snot nosed munchkins waiting to be seen because their parents did not take them to the appropriate place. But I also see the folks in the ER that are pretty worn out over having to look at the people that just don't belong there and sometimes their enthusiasm towards some of the people that are as you say "legitimate" is less than visible. I can see where it really wears one out to slave over 5, 10, 25 people that could have gone to a GPs office, and then have minimal time for true emergencies.
TM
6/9/2016 6:06pm Edited Date/Time 6/9/2016 6:07pm
Hey sometimes what looks docile at the surface might be really bad. They still get a solid assessment, but if it the feathers and quacks don't add up to a duck, then, well---it probably isn't a duck. But that's what makes healthcare even harder because a a clinician you still have to be vigilant in your assessments. It can become taxing when you have 50 sheep herders who cry wolf, and then you get that one who has the potential to get super sick--of course at the end of a long grueling day. Makes it easy to miss stuff. But you gotta stay focused and help your coworkers maintain focus too. I think he mental part of the job is the hardest. Some days I go home and just sit in a dark room of silence. It's calming. The job itself is taxing on the mind, then the govt taxes the other parts.....makes it even more difficult.
Beast666
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Englewood, CO, USA
6/10/2016 4:51pm
I have several gripes about the entire healthcare system.

1. single billing. I am sick and tired of getting all different bills from the hospital, doctor, x-ray, Etc. If a doctor or x-ray tech works inside of an ER the billing should be out of the ER and only the ER. I get it that the doctor or x-ray tech may be working on there own but they are using the same facilities.
Think of it this way a motorcycle tech working in a dealership technically is an independent contractor working out of that shops building. no different than a doctor working out of an ER. How would you feel if you took your bike into the shop only to get a bill from the shop, the tech that worked on the bike, the lot tech that washed your bike, and the parts person that pulled parts for the repair.

2. Nationwide services. The US is 1 country why cant the insurance companies allow full coverage while you are in the country. I had to go into an ER in CO yet my insurance will only pay part of the bill since I was outside of UT. Now I am getting buried by bills of stuff that the insurance will not pay. Also they refuse to pay for follow up care unless I go back to UT, Yet I am not mobile enough to make the 600 mile trip.

3. Get your story straight. When I went to the ER I was diagnosed with a fractured pelvis, and fractured L5. After going through the headache of switching insurance from UT to CO, I proceeded to try and set up appointments with an orthopedist and neurosurgeon. I was told that i did not need a referral to see a specialist. I call up ortho and after being on hold for a hour I am told that I need to see neuro and need to go to an urgent care clinic to get the referral since I did not have a PCP in CO yet. At the UC the ortho tells me that the pelvis fracture was several years old and fully healed up and sets up the neuro referral. When I call up Neuro they say that I need to go to a PCP as neuro cannot do anything for me. Go see a PCP I get told that my L5 is fine and I have a fractured Sacrum and offers me more pain pills and to check back in 2 weeks with no suggestions for rehabbing so I can get back to my new job that I had only been at for 3 weeks prior to the injury. Yet I am in daily pain walking, sitting with my right calf cramping up on a regular basis, this has been going on for 3 weeks and I have no clue when I will be able to go to work much less be able to walk 100 yards pain free.
ToolMaker
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6/11/2016 6:29am
Beast666 wrote:
I have several gripes about the entire healthcare system. 1. single billing. I am sick and tired of getting all different bills from the hospital, doctor...
I have several gripes about the entire healthcare system.

1. single billing. I am sick and tired of getting all different bills from the hospital, doctor, x-ray, Etc. If a doctor or x-ray tech works inside of an ER the billing should be out of the ER and only the ER. I get it that the doctor or x-ray tech may be working on there own but they are using the same facilities.
Think of it this way a motorcycle tech working in a dealership technically is an independent contractor working out of that shops building. no different than a doctor working out of an ER. How would you feel if you took your bike into the shop only to get a bill from the shop, the tech that worked on the bike, the lot tech that washed your bike, and the parts person that pulled parts for the repair.

2. Nationwide services. The US is 1 country why cant the insurance companies allow full coverage while you are in the country. I had to go into an ER in CO yet my insurance will only pay part of the bill since I was outside of UT. Now I am getting buried by bills of stuff that the insurance will not pay. Also they refuse to pay for follow up care unless I go back to UT, Yet I am not mobile enough to make the 600 mile trip.

3. Get your story straight. When I went to the ER I was diagnosed with a fractured pelvis, and fractured L5. After going through the headache of switching insurance from UT to CO, I proceeded to try and set up appointments with an orthopedist and neurosurgeon. I was told that i did not need a referral to see a specialist. I call up ortho and after being on hold for a hour I am told that I need to see neuro and need to go to an urgent care clinic to get the referral since I did not have a PCP in CO yet. At the UC the ortho tells me that the pelvis fracture was several years old and fully healed up and sets up the neuro referral. When I call up Neuro they say that I need to go to a PCP as neuro cannot do anything for me. Go see a PCP I get told that my L5 is fine and I have a fractured Sacrum and offers me more pain pills and to check back in 2 weeks with no suggestions for rehabbing so I can get back to my new job that I had only been at for 3 weeks prior to the injury. Yet I am in daily pain walking, sitting with my right calf cramping up on a regular basis, this has been going on for 3 weeks and I have no clue when I will be able to go to work much less be able to walk 100 yards pain free.
I think part of it is that fact that they can "spread the pain" when they sued. but the flip side is that there are so many insurance policies that it's very difficult for them to know the ins and outs of all of them. but yes I think there's something fishy about 15 different bills for the same visit. Maybe the problem is that if they get partial payment or none at all, which doctor or nurse or tech would get paid and which gets nothing? So they say to the docs, go after it on your own.
On a side note I use this product all the time and it's great, 2-3 tablets, let them melt under the tongue and very quick relief from the cramps.
http://www.hylands.com/products/hylands-leg-cramps
you're welcome, Wink
6/11/2016 7:22am
It's so right it's inefficient and not sustainable.
jasonward73
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6/11/2016 9:43am
IWreckALot wrote:
So, putting your bias aside, do you think the AHA is a fair deal for all insurees? The best I can tell, it shifted the shit...
So, putting your bias aside, do you think the AHA is a fair deal for all insurees? The best I can tell, it shifted the shit end of the deal from one subsection of the population to another subsection. I'm alright with the new pre-existing condition rules to a degree. But more looking for a comment on if the new plan is actually better, or if it's just a different version of shitty.
IMO, a different version of shitty. But what you describe is the core of all insurance. They are betting that a greater percentage of people will NOT use them then do use them. It's their business model.

The system is totally fucked from every single aspect.

Healthcare should never have a profit margin.
kzizok
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6/11/2016 10:40am
IWreckALot wrote:
So, putting your bias aside, do you think the AHA is a fair deal for all insurees? The best I can tell, it shifted the shit...
So, putting your bias aside, do you think the AHA is a fair deal for all insurees? The best I can tell, it shifted the shit end of the deal from one subsection of the population to another subsection. I'm alright with the new pre-existing condition rules to a degree. But more looking for a comment on if the new plan is actually better, or if it's just a different version of shitty.
IMO, a different version of shitty. But what you describe is the core of all insurance. They are betting that a greater percentage of people will...
IMO, a different version of shitty. But what you describe is the core of all insurance. They are betting that a greater percentage of people will NOT use them then do use them. It's their business model.

The system is totally fucked from every single aspect.

Healthcare should never have a profit margin.
Two spot on comments, in all facets.

BTW, just to shed a little light on the multiple bills issue. A lot of ER's dont employ the providers (Dr's, NP', PA's etc). They use them as contractors, often times with a company that the providers work for (or own). That is one of the reasons you see some seperate bills. However, that adds another layer of entities that want their cut of profits. Heathcare in the US is so top and middle managment heavy that costs are out if control and will only get worse.

I agree the AHA, is just a different version of shitty. What really makes it worse though is our government telling us if we dont do it their way then you will be penalized. Of course, in some fashion, some of the monetary penalties paid go towards costs from people who make no contributiion to society. In other words, it would sound something like this, "I see that you are working but cant afford insurance, AHA or private, so since you didn't have money for that, we are going to fine you even though we already established your inability to pay. Once you do scrape the penalty together, we will use that to subsidize the bills of those that don't bother to work. Have a nice day, Uncle Sam!
motogrady
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6/11/2016 1:07pm

So, I've been at this job for maybe 3 years.
Not believing in the younger generation giving a fuck about my welfare, kinda even thinking they will eventually
want what I've got and then off me, I've been setting up a company of my own.
Just a small contracting business.
I'm ahead enough with what I've been doing on the side to make the jump, enough to live on for maybe a year plus
finance a few smaller jobs.
The licenses are in place, the van is in the driveway, it's paid for, I have a deal going with a customer for a
shop I can work out of, for free, the bank account is open, the iPad and phone are activated and paid for.

But, the cheapest obmacare I can find, if I say I'm shooting for 50 k a year, is 680.00 for a bronze plan.
That's 170.00 a week. 34.00 a day for every 5 days a week.
Before I make anything.
Before I pay any of the other taxes and overhead a small business requires.

And they wonder why some want the whole effin thing to just implode. And start all over.
6/11/2016 7:06pm
motogrady wrote:
So, I've been at this job for maybe 3 years. Not believing in the younger generation giving a fuck about my welfare, kinda even thinking they...

So, I've been at this job for maybe 3 years.
Not believing in the younger generation giving a fuck about my welfare, kinda even thinking they will eventually
want what I've got and then off me, I've been setting up a company of my own.
Just a small contracting business.
I'm ahead enough with what I've been doing on the side to make the jump, enough to live on for maybe a year plus
finance a few smaller jobs.
The licenses are in place, the van is in the driveway, it's paid for, I have a deal going with a customer for a
shop I can work out of, for free, the bank account is open, the iPad and phone are activated and paid for.

But, the cheapest obmacare I can find, if I say I'm shooting for 50 k a year, is 680.00 for a bronze plan.
That's 170.00 a week. 34.00 a day for every 5 days a week.
Before I make anything.
Before I pay any of the other taxes and overhead a small business requires.

And they wonder why some want the whole effin thing to just implode. And start all over.
Sickening ain't it ?
ToolMaker
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6/12/2016 6:44am
Is that something new? I don't recall any friends getting denied for
broken leg injury from skiing or injuries from motorcycle riding?
TM
6/12/2016 8:00am
Depends on your insurance policy. Read the packet of small print. Speed contest is bound to be in there somewhere.
kzizok
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6/12/2016 8:09am Edited Date/Time 6/12/2016 8:10am
ToolMaker wrote:
Is that something new? I don't recall any friends getting denied for
broken leg injury from skiing or injuries from motorcycle riding?
TM
No, its not new. I have been fortunate that when I or my son got injured I was able to be seen in an ER where I worked. You can probably read between the lines on that.

Similar issues with insuring vehicles, trailers and even your MX bike.

Competition=denial of claim(s).

Then it becomes your burden of proof otherwise. Exactly what insur. co. wants to draw the process out. That increases their chance of not paying or reducing the dollar amount of the claim.

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