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EDIT: This is a fully clothed post.
A little dark comic levity for this morning (the only kind I know how to do) on how Eve came to be Eve:
While Eve was still a professional model/actress, she kept her hair platinum blonde, shoulder-length, and wavy. One of her big roles was in a stage production of "All About Eve".
Then, fourteen years ago, she abruptly changed her hair back to its normal light brown and straightened it, which made it look longer.
Around this time, there was a big family funeral. In the memory slideshow during the service, all the pictures with her in them were of her as a blonde. One of WW's grad school friends, Sandra the Cow (who has to make everything about herself), came up to us at the reception asking us who our third sister was and why she was unable to be there. Completely straight-faced, my sister said, "Eve? Eve couldn't make it. She's out of town." So Sandra the Cow writes a long post on their alumni group message board dishing about Eve as if she were actually close to our family and knew anything about us.
I called Eve to tell her about it so we could have someone to laugh about to make ourselves feel better.
Thereafter, Eve has been our secret code word for "I think this person is an ignorant a*****e."
And now we lost Finn.
No rats left :(
I am so sorry...thats a loss.
And now we lost Finn.
No rats left :(
Oh, no. I'm so sorry, Woran.
And now we lost Finn.
No rats left :(
Sorry to hear that Woran. It always sucks.
And now we lost Finn.
No rats left :(
Wow. Too fast.
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I love Palladium's honesty when explaining their experience point system where they basically say "we know our combat system is a hot mess so that's why you get more experience with skill checks and roleplaying then from combat"....
Holy s!#*.Seriously?
From The Experience Level System in the Rifts Ultimate Edition.
"You will also notice that the characters get the most experience from using their heads and roleplaying interaction rather than killing things. Killing monsters is a good thing and fun to play, but ultimately it breaks down to little more than target practice , not growth as a human being or a deep character . Consequently, experience is gained from using the right skill at a critical moment or using skill knowledge to win or survive a situation, or taking an action that rescues others."
And now we lost Finn.
No rats left :(
I'm sorry, that's terrible!
I continue to be impressed by Anthem Blue Cross in California.
In July, GothBard checked their website and confirmed that our new doctor was in-network.
In August, they denied our claim, stating that the doctor had been out-of-network when GothBard had gone. I filed an appeal, which involved maybe half an hour on the phone and a couple of letters. All the preliminary stuff before getting out the "big guns" (such as the downloaded timestamped PDF showing the doctor as in-network as of the date of service).
And we waited, and waited, and waited...
...and yesterday got the letter, "Your grievance has been approved. We will cover this visit in full."
Yeah, it took 3 months, but that's pretty much standard for any bureaucracy. The fact that we didn't have to do any of the legwork or burden of proof, and they just looked it up, figured it out, and approved the grievance impresses me.
It's nothing like United Health Care, where every grievance (and there were many) took hours to do due diligence and prove coverage.
So, a bright spot on this sunny, damp morning.
And now we lost Finn.
No rats left :(
Ach - sorry to hear that, Woran.
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It's nothing like United Health Care, where every grievance (and there were many) took hours to do due diligence and prove coverage.
I worked briefly for health insurance. The switching of hats between calls was the best part.
"Hello! Thank you for calling UHC/Blue Cross/Your state of "X" plan/"Your "X company" plan/Medicare/Medicaid/etc"
Typically when I saw claims get denied it was either because the Doctor didnt show their work or explain the medical necessity(Even if it should be obvious) or because whoever filed the claim didn't put the operation under the right code. Like if they pulled a tooth but mislabeled it as the next tooth over that wasn't pulled. Then the claim needs to be submitted all over again.
But then there's really dumb **** too like bridges being covered but not the prep work immediately preceding it. Let's just say after that job I read my benefits packages like a hawk.
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It's nothing like United Health Care, where every grievance (and there were many) took hours to do due diligence and prove coverage.
I worked briefly for health insurance. The switching of hats between calls was the best part.
"Hello! Thank you for calling UHC/Blue Cross/Your state of "X" plan/"Your "X company" plan/Medicare/Medicaid/etc"
Typically when I saw claims get denied it was either because the Doctor didnt show their work or explain the medical necessity(Even if it should be obvious) or because whoever filed the claim didn't put the operation under the right code. Like if they pulled a tooth but mislabeled it as the next tooth over that wasn't pulled. Then the claim needs to be submitted all over again.
But then there's really dumb **** too like bridges being covered but not the prep work immediately preceding it. Let's just say after that job I read my benefits packages like a hawk.
Well, this was seriously,
UHC: Your provider is not recognized in our network. Please provide their license number, the diagnostic code, etc., etc.Us: OK. Here you go!
UHC: Thank you. Your provider has been confirmed.
UHC: Your provider is not recognized in our network...
Us: But we just showed you that information LAST month!
UHC: Oh, you're right, our bad.
And over and over again, month after month, year after year. Every single out-of-network claim we ever filed was denied, even though we were in a high-end PPO. And every time we called, the helpful call center person would say, "Yep, I have no idea why they denied it. Let me just resubmit."
And every resubmittal worked.
So either the call center person had a "magic button", or UHC just denied all out-of-network claims on principle, in the hopes that we'd forget to appeal one.
After working with UHC for years, I strongly suspect it was the latter.
Ah, the problems with knowing what you know!
The pilot on the heater in the studio kept going out. I did all the usual fixed: Vacuum out the heater, blow out the pilot with compressed air, etc., all to no avail.
So either the pilot itself or the thermocouple (mysteriously called the "electrode" in the parts list) is bad. I have no qualms about wiring, so I went ahead and ordered a new thermocouple and just put it in. It's working fine, but if it doesn't work the problem is in the pilot, which means gas work.
And I know what I don't know, and I don't know gas, so that's calling in a pro. Bleah.
And now we lost Finn.
No rats left :(
Sorry, Woran. Big hugs.
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It's nothing like United Health Care, where every grievance (and there were many) took hours to do due diligence and prove coverage.
I worked briefly for health insurance. The switching of hats between calls was the best part.
"Hello! Thank you for calling UHC/Blue Cross/Your state of "X" plan/"Your "X company" plan/Medicare/Medicaid/etc"
Typically when I saw claims get denied it was either because the Doctor didnt show their work or explain the medical necessity(Even if it should be obvious) or because whoever filed the claim didn't put the operation under the right code. Like if they pulled a tooth but mislabeled it as the next tooth over that wasn't pulled. Then the claim needs to be submitted all over again.
But then there's really dumb **** too like bridges being covered but not the prep work immediately preceding it. Let's just say after that job I read my benefits packages like a hawk.
Well, this was seriously,
UHC: Your provider is not recognized in our network. Please provide their license number, the diagnostic code, etc., etc.
Us: OK. Here you go!
UHC: Thank you. Your provider has been confirmed.
UHC: Your provider is not recognized in our network...
Us: But we just showed you that information LAST month!
UHC: Oh, you're right, our bad.And over and over again, month after month, year after year. Every single out-of-network claim we ever filed was denied, even though we were in a high-end PPO. And every time we called, the helpful call center person would say, "Yep, I have no idea why they denied it. Let me just resubmit."
And every resubmittal worked.
So either the call center person had a "magic button", or UHC just denied all out-of-network claims on principle, in the hopes that we'd forget to appeal one.
After working with UHC for years, I...
I have the *exact* same insurance as you. When Aiymi went into the hospital two years ago, her visits from the hospitalist were denied. They said that the hospital was in-network, but the hospitalist, well, that guy was certainly out-of-network.
Now just how in the F*!# is that possible? A hospitalist is, by definition, a doctor that is employed by the hospital. If the hospital is in the network, then the hospitalist has to be in network. "Not according to our records."
Took us 8 months to get them to change their minds.
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The college friend who lost his wife last year? I just watched the live-stream of their eldest daughter's wedding. In the same university chapel, and officiated by the same monk, as at her parents' wedding in 1996.
Damn dust in my eye.
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Had a job interview the other day. They asked me to "describe yourself, within a nutshell". I said "It's dark and really cramped in here. There's no air. I can't breathe! Please, does anyone have a nutcracker? Let me out!!"
- laughter - My brother is looking for a job. I will have to tell him this one.
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Now just how in the F*!# is that possible? A hospitalist is, by definition, a doctor that is employed by the hospital. If the hospital is in the network, then the hospitalist has to be in network. "Not according to our records."
Hospitals don't apply for In-Network status. Individual doctors do. Most people/receptionist/insurance customer service people will say their whole hospital is in-network if most of them are*, but if a doctor needs to renew their status or is new, they may not be. Hospitals will handle most of the paperwork prep for them but the doctors themselves have to sign off and submit it.
Typically doctors who don't run their own practice(or even if they do) work at multiple hospitals. Especially if they're a specialist or don't have enough patients at a particular location.
*If you call and check with a live person, chances are when pulling up the hospital you are asking for, will just look at the first few names listed for the hospital and assume everyone at the hospital is in-network without scrolling down. Always ask for people by their exact name.
Now back to Assassin's Creed Valhalla
I'm having the big sad today.
You have every right to mourn. We are here for you.
So sorry, Woran.
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Now just how in the F*!# is that possible? A hospitalist is, by definition, a doctor that is employed by the hospital. If the hospital is in the network, then the hospitalist has to be in network. "Not according to our records."Hospitals don't apply for In-Network status. Individual doctors do. Most people/receptionist/insurance customer service people will say their whole hospital is in-network if most of them are*, but if a doctor needs to renew their status or is new, they may not be. Hospitals will handle most of the paperwork prep for them but the doctors themselves have to sign off and submit it.
Typically doctors who don't run their own practice(or even if they do) work at multiple hospitals. Especially if they're a specialist or don't have enough patients at a particular location.
*If you call and check with a live person, chances are when pulling up the hospital you are asking for, will just look at the first few names listed for the hospital and assume everyone at the hospital is in-network without scrolling down. Always ask for people by their exact name.
Now back to Assassin's Creed Valhalla
Scavion, this is not aimed personally at you - I know you're speaking from your professional experience and trying to explain how the system works. I appreciate that. I don't appreciate how the insurance companies have completely perverted how the US health system works.
Hospitalists, among other duties, typically perform the rounds that most doctors no longer do themselves. There was a time when a doctor physically checked in on all of their patients that were in the hospital. That's no longer the case and *most* have abdicated that responsibility to the hospitalists. No patient lying in a hospital bed should ever have to say "Whoa, hold on, Doc. Before you look in on me, are you in my insurance network?"
In Aiymi's case, our doctor worked at an outpatient clinic ran by the same outfit as the hospital itself. Everything in-network, except, apparently, this hospitalist?
Ridiculous.
(There were other problems too, but that's a different rant.)
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In Aiymi's case, our doctor worked at an outpatient clinic ran by the same outfit as the hospital itself. Everything in-network, except, apparently, this hospitalist?
On the Aetna insurance website, on the page Tips To Avoid Surprise Medical Bills, the introduction to the page is this anecdote:
When Catherine Conelly needed surgery to repair a hernia in 2015, she took steps to avoid any financial surprises. She confirmed that the surgeon was in-network and looked up the procedure on her insurance company’s website to see what percentage was covered by her plan. “On the day of the operation, I felt a little anxious about the procedure — that’s where my head was at. I was no longer thinking about the logistics,” says Catherine, 29, who lives in San Luis Obispo, California.
The surgery went smoothly, but a month later she received an unexpected bill for $1,200. The anesthesiologist assigned to her surgery had been out-of-network, and the hospital charged Catherine for the amount not covered by insurance. “I was never given an option to choose which anesthesiologist I wanted. I thought it was all in-network,” she says.
More than a third of Americans say they’ve received a surprise medical bill, according to a 2015 Consumer Reports survey. To head off unexpected charges, experts advise asking questions up front and doing some research before any health care visit or treatment.
[snip: 6 Tips For Avoiding The Most Common Healthcare Costs]Catherine spent months writing letters to the hospital and appealing her case, and eventually the charges were removed. Today, she shares her story with family and friends to remind them to be diligent before going in for medical procedures. “I tell them to ask their doctor ahead of time, ‘Who is going to be in the room and are they in-network?’ Find that information out as soon as possible,” she says.
Notably, none of the "Six Tips" tells you how to avoid having an out-of-network anesthesiologist during your surgery.
The other notorious 'out of network' hotspot is the Emergency Room at most hospitals. Almost every doctor there is a contract physician hired by companies that provide emergency specialists.
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It turns out reading people talk about insurance is actually just as bad as having to deal with insurance.
Let me know when you're done.
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It turns out reading people talk about insurance is actually just as bad as having to deal with insurance.
Let me know when you're done.
Same.
I'm using the "when I give blood with the Red Cross, they can use it and nothing flags as abnormal" as a measure of relative health, because I can't afford insurance.
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Note: I do pay out-of-pocket for the kids' annual checkups and all of our flu shots. I'm not completely irresponsible. The coverage is just too expensive.
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We have insurance, I just don't like to talk about it.
I assume that's what all the hospitals are about.
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I don't appreciate how the insurance companies have completely perverted how the US health system works.
I completely 10 zillion percent agree. I'm just shouting into the ether hoping it helps someone someday.
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Raven's Head is awesome. One shotted the Vampire Ex-Paladin and Blood Knight.
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Fantasy Monster: Dragon-Bear. A bear that hunts dragons.
Fantasy Monster: Dragon-Bear. A bear that hunts dragons.
I like it. A lot.
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I am pretty sure the talks about American health insurance are taking us dangerously close into politicis kill-zone.
Though I am not sure if mocking American health-care system counts as politicis or is merely unelegant as kicking someone who is down.
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Ow! Ow! Ow! Hurt us some more!!!
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I feel asleep twice on today's session.
We also had two characters—including Gorbacz—reach dying state. Gorbacz seems to be making a tradition of getting to 0 hit points on each session... Ok, two sessions is not far enough to call that tradition, but the trend is starting well.
I like Gorbacz.
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I wonder what kajehase is up to.
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I am pretty sure the talks about American health insurance are taking us dangerously close into politicis kill-zone.
Though I am not sure if mocking American health-care system counts as politicis or is merely unelegant as kicking someone who is down.
The fact that healthcare reform is controversial is much like the fact that punching nazis has become controversial: It's a horribly grim commentary in and of itself on U.S. politics, and that's all I'll say.
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Yesterday Mrs Sunrise and I introduced Homunculus #1 to Kill Bill, and he loved it. As do I, it has two of my favorite villain monologues of all time:
The biggest R I feel is regret
Oh, and the theme track by Chingon is a total earworm that's still stuck in my head.
I wonder what kajehase is up to.
I was wondering that too. There does seem to have been a bit of a Scandinavian exodus from the forums (Kajehase, Sissyl, Kjeldorn, etc.)