Search found 902 matches

by toofache32
Thu Aug 17, 2017 5:17 pm
Forum: Personal Finance (Not Investing)
Topic: Billing 99212 for rx refill?
Replies: 38
Views: 2688

Re: Billing 99212 for rx refill?

I just looked it up and Medicare pays $25 for this in a facility (facility fee is separate) and $44 in a non-facility office.
by toofache32
Wed Aug 16, 2017 1:14 pm
Forum: Personal Finance (Not Investing)
Topic: Billing 99212 for rx refill?
Replies: 38
Views: 2688

Re: Billing 99212 for rx refill?

I agree much of the info here applies to in-network care which is not relevant to the original question. For OON, it's completely between the provider and the patient. My insurance covers some out of network stuff. How should I handle this? Would it be fraudulent for me to submit the receipt for re...
by toofache32
Wed Aug 16, 2017 1:03 pm
Forum: Personal Finance (Not Investing)
Topic: Billing 99212 for rx refill?
Replies: 38
Views: 2688

Re: Billing 99212 for rx refill?

I agree much of the info here applies to in-network care which is not relevant to the original question. For OON, it's completely between the provider and the patient.
by toofache32
Tue Aug 15, 2017 11:01 pm
Forum: Personal Finance (Not Investing)
Topic: Billing 99212 for rx refill?
Replies: 38
Views: 2688

Re: Billing 99212 for rx refill?

I thought the code was 99441 but I could be wrong since I don't bill for refills. It takes time to refill a Rx. Pull the chart, review the chart, authorizing the refill, calling or faxing the pharmacy (sometimes multiple times to push it through). A billable patient visit could be performed in this...
by toofache32
Mon Aug 14, 2017 11:48 pm
Forum: Personal Finance (Not Investing)
Topic: Billing 99212 for rx refill?
Replies: 38
Views: 2688

Re: Billing 99212 for rx refill?

I thought the code was 99441 but I could be wrong since I don't bill for refills. It takes time to refill a Rx. Pull the chart, review the chart, authorizing the refill, calling or faxing the pharmacy (sometimes multiple times to push it through). A billable patient visit could be performed in this ...
by toofache32
Tue Aug 01, 2017 11:05 pm
Forum: Personal Consumer Issues
Topic: prescriptions drugs and claw backs
Replies: 20
Views: 1452

Re: prescriptions drugs and claw backs

In health care, including medicine, it is all about leverage. The more leverage you have, the more ability you have to control costs and make money. But then layers are added like the addition of pharmacy benefit managers that actually add costs to the system. Health care economics is pretty comple...
by toofache32
Tue Aug 01, 2017 10:43 pm
Forum: Personal Consumer Issues
Topic: prescriptions drugs and claw backs
Replies: 20
Views: 1452

Re: prescriptions drugs and claw backs

Wait a minute! The insurance company is on your side! They have your best interests at heart!
Insurance companies are a bloated middle man that only serves themselves and makes healthcare more expensive by removing market forces. I have been saying this for years here.
by toofache32
Sun Jul 30, 2017 8:22 pm
Forum: Personal Consumer Issues
Topic: TSA Pre-check for free
Replies: 75
Views: 5540

Re: TSA Pre-check for free

Interesting. I had dinner this week with a good buddy who is a "government employee." Piss him off and your name will show up on the no-fly list.
by toofache32
Sun Jul 30, 2017 6:17 pm
Forum: Personal Consumer Issues
Topic: Your "at peace" moments.
Replies: 98
Views: 11099

Re: Your "at peace" moments.

Sorry duplicate post.
by toofache32
Sun Jul 30, 2017 6:14 pm
Forum: Personal Consumer Issues
Topic: Your "at peace" moments.
Replies: 98
Views: 11099

Re: Your "at peace" moments.

I can think of two.... Looking into the eyepieces straight in front of me while my hands are working down lower. The 9-0 Nylon is smaller than a human hair but magnified through the scope. Tie the knots and release the clamps. Red life flows. I leave while the Fellow closes the case. The other start...
by toofache32
Sun Jul 30, 2017 5:08 pm
Forum: Personal Consumer Issues
Topic: TSA Pre-check for free
Replies: 75
Views: 5540

Re: TSA Pre-check for free

Is your friend over 65? They do sometimes give low-risk folks (typically elderly or teens) TSA-Pre for the day - but it certainly isn't guaranteed - you will never know until you check in. (Even with having paid - they will occasionally bump you for a random full check). They might even have some p...
by toofache32
Sat Jul 22, 2017 10:45 pm
Forum: Personal Finance (Not Investing)
Topic: Medical malpractice attorney - how to find?
Replies: 29
Views: 2123

Re: Medical malpractice attorney - how to find?

I never thought of suing the first cardiologist. I think he did his best, but he made a mistake. No one is perfect. It's hard to accept that when the stakes are so high, but even the best physicians will make errors, just like Ruth or Buffett. This is one of the main reasons I am no longer in-netwo...
by toofache32
Sun Jul 16, 2017 10:20 pm
Forum: Personal Finance (Not Investing)
Topic: Dental Insurance Coverage
Replies: 3
Views: 929

Re: Dental Insurance Coverage

I am that oral surgeon who does multiple biopsies each week. This has nothing to do with dental insurance although there are dental CDT codes for an oral biopsy. I have never ever seen dental insurance cover this. Lots of misinformation in Mouses post. There is no wizardry in getting Medicare to pay...
by toofache32
Sun Jul 16, 2017 10:03 am
Forum: Personal Consumer Issues
Topic: Please explain how Medicare Billing works?
Replies: 90
Views: 6518

Re: Please explain how Medicare Billing works?

It sounds like the Welcome to Medicare visit wasn't indicated.
by toofache32
Sat Jul 15, 2017 8:52 pm
Forum: Personal Consumer Issues
Topic: Please explain how Medicare Billing works?
Replies: 90
Views: 6518

Re: Please explain how Medicare Billing works?

You get what they pay for. This is Medicare after all.
by toofache32
Sat Jul 15, 2017 8:31 pm
Forum: Personal Consumer Issues
Topic: Please explain how Medicare Billing works?
Replies: 90
Views: 6518

Re: Please explain how Medicare Billing works?

toofache32 wrote:I hope for your sake this is not that UHC AARP "Secure Horizons" plan. Denial is the name of the game.


Is this the Secure Horizons plan?
by toofache32
Mon Jul 10, 2017 10:16 pm
Forum: Personal Consumer Issues
Topic: Need to get dental implant done..
Replies: 23
Views: 1625

Re: Need to get dental implant done..

I would suspect that if an implant "failed" there may be something about replacing it that makes it more complex then an initial implant. If that's the case it may be harder to shop remotely for an overseas dentist unless you have friends/relatives in that area that are familiar with loca...
by toofache32
Mon Jul 10, 2017 9:35 pm
Forum: Personal Consumer Issues
Topic: instant pot [Pressure cooker]
Replies: 34
Views: 2953

Re: instant pot

This thread is completely different from what I expected with the title. Must be a Colorado thing.

EDIT: now I see "pressure cooker" has been added so now it makes sense.
by toofache32
Tue Jul 04, 2017 10:12 pm
Forum: Personal Finance (Not Investing)
Topic: Medical Insurance Cover a Fractured Zygoma?
Replies: 15
Views: 2029

Re: Medical Insurance Cover a Fractured Zygoma?

I fix zygomas routinely and I have never seen insurance deny this, at least not that anyone told me.
by toofache32
Tue Jul 04, 2017 7:37 pm
Forum: Personal Consumer Issues
Topic: Please explain how Medicare Billing works?
Replies: 90
Views: 6518

Re: Please explain how Medicare Billing works?

Are there some primary care Physicians who, legitimately, are able to have profitable Medicare practices? I notice that, in this area, the Medicare Advantage and Medicare Cost providers do a lot of promotion and advertising - so they must have a positive financial bottom line. dri Are they private ...
by toofache32
Tue Jul 04, 2017 5:27 pm
Forum: Personal Consumer Issues
Topic: Please explain how Medicare Billing works?
Replies: 90
Views: 6518

Re: Please explain how Medicare Billing works?

The sad part is that when Medicare and insurance companies make getting paid so burdensome, frustrating, and expensive....many private docs just drop the plan. That's what I did in my office. Are there some primary care Physicians who, legitimately, are able to have profitable Medicare practices? I...
by toofache32
Tue Jul 04, 2017 3:43 pm
Forum: Personal Consumer Issues
Topic: Please explain how Medicare Billing works?
Replies: 90
Views: 6518

Re: Please explain how Medicare Billing works?

The sad part is that when Medicare and insurance companies make getting paid so burdensome, frustrating, and expensive....many private docs just drop the plan. That's what I did in my office. Are there some primary care Physicians who, legitimately, are able to have profitable Medicare practices? I...
by toofache32
Mon Jul 03, 2017 7:42 pm
Forum: Personal Consumer Issues
Topic: Please explain how Medicare Billing works?
Replies: 90
Views: 6518

Re: Please explain how Medicare Billing works?

The sad part is that when Medicare and insurance companies make getting paid so burdensome, frustrating, and expensive....many private docs just drop the plan. That's what I did in my office.
by toofache32
Wed Jun 28, 2017 8:53 am
Forum: Personal Finance (Not Investing)
Topic: Financing Engagement Ring/ Credit Score Potential Consequences
Replies: 39
Views: 2120

Re: Financing Engagement Ring/ Credit Score Potential Consequences

My point was that when upgrading an engagement ring, it's no longer an engagement ring. I obviously hit a nerve with the upgraders here. Nothing wrong with purchasing nice things. My comments were regarding those who like to replace engagement rings, not purchasing new jewelry, cars, etc. Sure it's...
by toofache32
Wed Jun 28, 2017 7:47 am
Forum: Personal Finance (Not Investing)
Topic: Financing Engagement Ring/ Credit Score Potential Consequences
Replies: 39
Views: 2120

Re: Financing Engagement Ring/ Credit Score Potential Consequences

My point was that when upgrading an engagement ring, it's no longer an engagement ring. I obviously hit a nerve with the upgraders here. Nothing wrong with purchasing nice things. My comments were regarding those who like to replace engagement rings, not purchasing new jewelry, cars, etc.
by toofache32
Tue Jun 27, 2017 10:50 pm
Forum: Personal Finance (Not Investing)
Topic: Financing Engagement Ring/ Credit Score Potential Consequences
Replies: 39
Views: 2120

Re: Financing Engagement Ring/ Credit Score Potential Consequences

What are the chances you've got one of those women who will want to "upgrade" the ring in a few years? This would play into my willingness to splurge at the beginning. My wife has gold-digging friends who "upgraded" their rings later when the husband's income increased. My wife s...
by toofache32
Tue Jun 27, 2017 10:43 pm
Forum: Personal Finance (Not Investing)
Topic: Payment to Dr's office
Replies: 11
Views: 1107

Re: Payment to Dr's office

Just stay in touch. If you call them once a month or so and ask about it they're not going to send you to collections. The process is way slower than any of us would like. I occasionally get a foreigner who wants to pay their ED bill in full at the time of service (like 3 am.) It's basically imposs...
by toofache32
Fri Jun 23, 2017 9:45 pm
Forum: Personal Finance (Not Investing)
Topic: Personal training and massage expenses
Replies: 14
Views: 1306

Re: Personal training and massage expenses

Toilet paper keeps me healthy. I should get my S Corp to pay for it.
by toofache32
Thu Jun 22, 2017 9:19 pm
Forum: Personal Consumer Issues
Topic: Please explain how Medicare Billing works?
Replies: 90
Views: 6518

Re: Please explain how Medicare Billing works?

7. I haven't been for a bone density test for a while so the doctor referred me. The results showed my bones aren't so strong so I was sent to the hospital for an bi-annual injection. I was asked by the nurse practitioner if I was on a walker. I laughed and told her that I hauled 40 bags of soil a ...
by toofache32
Thu Jun 22, 2017 2:40 pm
Forum: Personal Consumer Issues
Topic: Please explain how Medicare Billing works?
Replies: 90
Views: 6518

Re: Please explain how Medicare Billing works?

7. I haven't been for a bone density test for a while so the doctor referred me. The results showed my bones aren't so strong so I was sent to the hospital for an bi-annual injection. I was asked by the nurse practitioner if I was on a walker. I laughed and told her that I hauled 40 bags of soil a ...
by toofache32
Thu Jun 22, 2017 2:05 pm
Forum: Personal Consumer Issues
Topic: Please explain how Medicare Billing works?
Replies: 90
Views: 6518

Re: Please explain how Medicare Billing works?

Lynette wrote:
nisiprius wrote:Pssst. By the way. Apple, penny, table. Also, DEFPOTEC.



????


I'm just as confused.
by toofache32
Thu Jun 08, 2017 11:46 pm
Forum: Personal Consumer Issues
Topic: My Wife is having our 5th child. What is an appropriately extravagant push gift?
Replies: 90
Views: 7429

Re: My Wife is having our 5th child. What is an appropriately extravagant push gift?

What is a "push gift"? I have never heard that term. An expectation of a material gift when the real gift is that which you delivered. I have never heard of this and don't know how this idea came into existence. From the description of a "push gift" where it sounds like she is a...
by toofache32
Thu Jun 08, 2017 11:05 pm
Forum: Personal Consumer Issues
Topic: Please explain how Medicare Billing works?
Replies: 90
Views: 6518

Re: Please explain how Medicare Billing works?

Amount Provider Charged: $300 Medicare-Approved Amount: $100 Amount Medicare Paid: $80 MAXIMUM YOU MAY BE BILLED: $20. But I do not get billed. Medicare bills my Medigap insurance company the $20 automatically. They pay. In due course I get another notice from my Medigap insurance company saying so...
by toofache32
Tue Jun 06, 2017 12:52 am
Forum: Personal Consumer Issues
Topic: Source for Finding and Understanding Medical Billing Codes
Replies: 8
Views: 653

Re: Source for Finding and Understanding Medical Billing Codes

To toofache32: Over and above pre-authorization, is there anything I (or my surgeon) can do to increase the likelihood of payment? The thought of bearing the full cost of the surgery is VERY intimidating. When insurance is involved, there are never guarantees unfortunately. The insurance company al...
by toofache32
Tue Jun 06, 2017 12:25 am
Forum: Personal Finance (Not Investing)
Topic: How does a mere mortal navigate healthcare/insurance issues
Replies: 50
Views: 4905

Re: How does a mere mortal navigate healthcare/insurance issues

This issue of being directly billed for non network providers (that you had no choice in selecting) in an in network facility is a problem that needs to be addressed. This practice is unfair to consumers. This thread deals with anesthesiologists but also routinely occurs with er physicians and thos...
by toofache32
Tue Jun 06, 2017 12:16 am
Forum: Personal Finance (Not Investing)
Topic: How does a mere mortal navigate healthcare/insurance issues
Replies: 50
Views: 4905

Re: How does a mere mortal navigate healthcare/insurance issues

When I went in for my age-50 screening colonoscopy a couple of years ago, the check-in person got to the end of check in and then unexpected asked me to write a pre-procedure check (a couple of thousand $, if I recall). I got very confused and stuttered out "but a screening colonoscopy is cove...
by toofache32
Tue Jun 06, 2017 12:04 am
Forum: Personal Finance (Not Investing)
Topic: How does a mere mortal navigate healthcare/insurance issues
Replies: 50
Views: 4905

Re: How does a mere mortal navigate healthcare/insurance issues

I had the exact same thing happen to me during a colonoscopy, pre-ACA not that I think that matters. I didn't read the entire thread but I don't the it matters if the provider was an MD or a nurse or the guy who cleans the toilets in the office (I'm expecting to see a billing code for that any day ...
by toofache32
Mon Jun 05, 2017 11:59 pm
Forum: Personal Consumer Issues
Topic: Source for Finding and Understanding Medical Billing Codes
Replies: 8
Views: 653

Re: Source for Finding and Understanding Medical Billing Codes

As usual, the government resource is unhelpful and burdensome. I use www.codingtoday.com for coding. As usual, this efficient and simple resource costs money, as it should. If your surgeon is in-network and expects to be paid by insurance, the surgeon will (should) pre-authorize your surgery with yo...
by toofache32
Mon Jun 05, 2017 10:42 pm
Forum: Personal Finance (Not Investing)
Topic: How does a mere mortal navigate healthcare/insurance issues
Replies: 50
Views: 4905

Re: How does a mere mortal navigate healthcare/insurance issues

It's hopeless. Things I've run into: Doctor is not in network and has been trying to join in network for 3 years. Network tells me that they have enough of that specialty so are not accepting new doctors. We go to network list and in calling around find several interesting things. Doctors who are r...
by toofache32
Sun Jun 04, 2017 5:31 pm
Forum: Personal Consumer Issues
Topic: Please explain how Medicare Billing works?
Replies: 90
Views: 6518

Re: Please explain how Medicare Billing works?

What CPT code was billed on your EOB?
And did your visit address any existing health conditions?
by toofache32
Sun Jun 04, 2017 4:41 pm
Forum: Personal Consumer Issues
Topic: Please explain how Medicare Billing works?
Replies: 90
Views: 6518

Re: Please explain how Medicare Billing works?

What CPT code was billed on your EOB?
And did your visit address any existing health conditions?
by toofache32
Sun Jun 04, 2017 2:36 pm
Forum: Personal Consumer Issues
Topic: Please explain how Medicare Billing works?
Replies: 90
Views: 6518

Re: Please explain how Medicare Billing works?

I hope for your sake this is not that UHC AARP "Secure Horizons" plan. Denial is the name of the game.
by toofache32
Sat Jun 03, 2017 1:14 am
Forum: Personal Consumer Issues
Topic: Medi-Cal (for CA) equivalent in Texas
Replies: 5
Views: 675

Re: Medi-Cal (for CA) equivalent in Texas

FB01 wrote:Hi,

California has Medi-Cal which provides free Medical to Senior Citizens with GC and low income. Does Texas has similar thing?

-FB


What's GC?
by toofache32
Fri May 26, 2017 7:05 pm
Forum: Personal Consumer Issues
Topic: Should I drink or sell my Pappy 12 year?
Replies: 65
Views: 7520

Re: Should I drink or sell my Pappy 12 year?

CheapFool wrote:Entered a lottery with ABC fine wine and spirits and won the option of buying 1 bottle of Pappy Van Winkle 12 year. I haven't drank much bourbon. I'm a Scotch fan (Lagavulin, Laphroaig, Highland Park).


What do you mix with the Laphroaig to hide the turpentine taste?
by toofache32
Wed May 24, 2017 9:29 am
Forum: Personal Consumer Issues
Topic: Lawyers charging for asking about fees
Replies: 62
Views: 8128

Re: Lawyers charging for asking about fees

Just some follow up. Turns out the item was not a charge for asking about the lawyer's bill after all, but a completely legit charge relating to something else. Thank you for following up. Would you consider editing your original post, to add a note saying that? Many people may not read to the end ...
by toofache32
Sat May 20, 2017 8:09 pm
Forum: Personal Consumer Issues
Topic: Lawyers charging for asking about fees
Replies: 62
Views: 8128

Re: Lawyers charging for asking about fees

No sense in arguing. One strategy: "Of course, I'm happy to pay your bill, in full and on time. As soon as I receive it, I'll leave a review for you online." So you're recommending extortion? Are reviews that are left on Amazon website considered extortions? It's not the review. It's thre...
by toofache32
Sat May 20, 2017 7:30 pm
Forum: Personal Consumer Issues
Topic: Lawyers charging for asking about fees
Replies: 62
Views: 8128

Re: Lawyers charging for asking about fees

Jonathan wrote:No sense in arguing. One strategy: "Of course, I'm happy to pay your bill, in full and on time. As soon as I receive it, I'll leave a review for you online." 8-)


So you're recommending extortion?
by toofache32
Wed May 17, 2017 8:25 pm
Forum: Personal Finance (Not Investing)
Topic: Challenging a Late Medical Bill
Replies: 22
Views: 1740

Re: Challenging a Late Medical Bill

[...]When I was an in-network doctor with insurance plans, my record was 18 months to get a claim adjudicated. Only after they finalized the claim was I able to know how much to bill the patient for their part. This was for a 10 hour surgery.[...] PS: I am really curious - with a name like toofache...
by toofache32
Wed May 17, 2017 7:51 pm
Forum: Personal Finance (Not Investing)
Topic: Challenging a Late Medical Bill
Replies: 22
Views: 1740

Re: Challenging a Late Medical Bill

The bill noted, "Call this number if you have any questions" so I called it. Someone picks up and states, "Hi, are you paying a bill today?" "No, I had a question about the bill." "OK, looks like your bill is due next week for services rendered last year related t...
by toofache32
Tue May 16, 2017 10:17 pm
Forum: Personal Finance (Not Investing)
Topic: Challenging a Late Medical Bill
Replies: 22
Views: 1740

Re: Challenging a Late Medical Bill

Glad to hear the baby is doing well. The real question is when was the claim adjudicated (finally approved, denied, etc). It could be that the provider has been trying to get payment from the insurance company this entire time. When I was an in-network doctor with insurance plans, my record was 18 m...