MONDAY'S RANT

[selmaS]

"Rainy days and Mondays always get me down".....so lets rant all day Monday- each Monday a different topic-we will poll for next weeks.....so this week lets do a favorite of mine.....doctors!!


post ur rant and get it out of ur system and enjoy the rest of the week!!

[selmaS]

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[selmaS]

well I guess we don't need to scold u.....if ur paying ur learned the lesson...do not over do!!

[Shane99]

Yeah, I had an overall good holiday weekend.

The shoulder thing is my own fault. We started putting our Christmas decorations out, so I decided I could move a chair - been paying for it ever since. :)

[selmaS]

sorry to hear that...is that y u've been AWOL.....haven't seen u here much...thought it was just the Holiday.

I hope u were able to enjoy ur Turkey day.

[Shane99]

Okay, my rant is - a new symptom. Well, actually just a drastic increase in pain level of an old symptom.

Across my right shoulder blade going to my upper arm, I'm having severe shots of pain and my arm hurst so bad I can barely use it today. It's been hurting this ay for 3 days now.

Stoopid arm and shoulder pains :'(

[selmaS]

well I am confused by my PC again...he ordered an Xray to look for a syrinx???I see him 2morrow....but I know this can not show that, Y doesn't he??

come on...who else needs to rant today???

[selmaS]

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[selmaS]

I am glad u were able to get it out and I am sure it can help me than just me!!

I am looking up my info now.I am happy yo know where to direct these kinds of questions!!....

[Stargazey]

If you have a procedure in the hospital while admitted it is considered inpt. If you go to the hospital and have it done in Outpatient services it is outpt. The best thing to do is to go to a facility that does the US or xray, or MRI that is not affiliated with the hospital. So then you are not taking up hosp. services or time.  You make an appt with outside facility like a Drs. office. usually it is less.  But you need to talk to your insurance company to make sure you are still in network if you go to outside facility.  I had my MRI and xrays at a facility called SMIL (Scottsdale Medical Imaging Lab) They do all kinds of imaging, us, mammos, xrays, ct. . I know how it works in the west, not sure how you have to do it on the east coast.  Medical communities can really be different because of locals.  There are alot of stand alone facilities here so you can have procedures done w/o going to hospital.   The NS have priviledges at several hospital here, so they can reach a larger demographic and because there are so many different insurance companies they belong to.  Some insurance companies say you can only go to  their contracted facilities. So for the Doc to make money he tries to get contracted with all insurance companies and the hospitals that are contracted with.  That's why we need to change our health care system, because it is the insurance company that decides your point of care not necessarily the physician.  There are people (usually nurses) who review charts to make sure Docs aren't over utilizing hospital or tests.  If they do, they are dropped. and the alternative the patients have to find another physician. because they have been dropped from your plan.  Oops, here I go again. I could write a book about the downfall of the health insurance system and how they control the health of patients. Even if a Dr. wanted to order a certain test for someone, they have to get approval, even if it is warranted. It is just all too much. I guess that's why I am a little crazy, cause I know how things work and then to have a diagnosis like Chiari, it is just too  much!!!! Talk about throwing kerosene on a fire that is already burning.  Sorry, I went off again.....Sometimes it comes into my mind I just have to get it out.  Used to be a very intelligent gal.... but then along came Chiari....and the memory went. I guess it's still in here somewhere !?  Hugs, Star

[selmaS]

don't be sorry ...u gave some good advice.....I wasn't aware it could be a wrong code...thought it was a trend  in NS with links to Hospitals......

I also had a scheduled US that was billed the same as outpatient and it cost me more money because ins said it was outpatient.....yeah I am not in the hosp so how else do u get the test done with out the added cost?

[Stargazey]

Hi, girl.  You are going with one today!!! Well, here's what you do. 1) Contact insurance comp. that Dr. is charging out pt visit. It is really office visit usually the codes are 90's - or 99's unless they  have changed. Tell them time and place of visit. Talk to Dr.and tell him that he coded charges wrong. 2) Call the Insurance Corp. investigation dept in your state. And if it is Medicare they are in Big trouble. Medicare will hang them up by the you-know-what! A dr. office cannot double dip as it were. you can check about coding by calling your individ. insurance co. and asking about office codes vs. hosp code (inPt vs Out Pt.) I had a ER doc. try to bill me for an chest xray, that he did not do.  I told the billing office, they did nothing except accept the money paid by the ins. co and bill me. So I called the insurance comp. and the called the hospital billing office and told them who and when I spoke to ins. comp. they were really backing up to see how fast they could refund the ins. company. Always document every thing.And remember, the staff at the Doctors offices are barely high school grads. who have gone to a Bryman School for maybe a year to becomed Med. assistants.  And some barely understand ICD-9 and CPT codes. and just plop any old code in the system. Also watch your face to face time with Dr. that't what he is suppose to bill for. An extended visit charge is usually for 45 mins of face to face.  So keep an eye on your watch. and take your own chart notes. regarding your care. The docs bill on 15 min. increments.But it is supposed to be face to face time. Not waiting in exam room almost naked!   I guess I went a little long :) Sorry,
But I get going, and ur well......Sorry.   Remember I have experience with this type of business. But can honestly say. We were different than alot of others. It's hard to find PCP who is really into the patients and not how many they can cram in a hour. There is just no way, anyone can understand what's going on with you in 3-5 mins.But the patients are the only ones who can change this. We can't let insurances tell the Dr. how many pt. they have to see and how to treat them. I'm done. Sorry, again.......

[selmaS]

I expected to go home afterward and so did they....I just don't get it..I think it's a loophole we have to fill in.

[tink71083]

As far as I am concerned I agree with you. If you see them in an office.. you are IN the office but they consider it outpatient because you go home after. It is silly and just costs us more money :(

[selmaS]

Hi tink....but if u see them in an office, y is it outpatient services....I did not go to the emrg room??

[tink71083]

Yes!!! I don't understand it at all. But I guess they figure since we are not admitted to a hospital it is considered outpatient. Can't they just cut us some slack? I mean they already make $100 to stick a popsickle stick down your throat and say you're fine.

[selmaS]

I started a new thread for this Monday's Rant......

this weeks rant is insurance companies.....and drs that schedule appoint and report it to the ins as outpatient services.....what? I was in an office...so now the ins doesn't cover as much...and I owe how much???.....ne one else notice this trend...drs billing as outpatient services????