Search found 1338 matches

by toofache32
Wed Nov 14, 2018 10:30 pm
Forum: Personal Consumer Issues
Topic: Direct Primary Care-Anyone use it?
Replies: 40
Views: 3008

Re: Direct Primary Care-Anyone use it?

Not ideal, I agree. But if patients are fed up with their HMO and want to see me, I am happy to work with them as long as they realize it may be clunky. As for the HMO docs, they get paid the same whether the patient comes to see them or not , and they are already overwhelmed with their own workloa...
by toofache32
Sat Nov 10, 2018 2:20 pm
Forum: Personal Consumer Issues
Topic: HIPAA Information available to out of town ER or not?
Replies: 19
Views: 869

Re: HIPAA Information available to out of town ER or not?

What most healthcare professionals believe about HIPAA is that they cannot release ANYTHING without the patient's permission. In fact, if the information to be released is specifically to be helpful to taking care of that same patient's medical problem, then it is perfectly OK for other hospitals o...
by toofache32
Sat Nov 10, 2018 1:23 pm
Forum: Personal Consumer Issues
Topic: HIPAA Information available to out of town ER or not?
Replies: 19
Views: 869

Re: HIPAA Information available to out of town ER or not?

I get calls ALL THE TIME from ERs who don't have a pediatric neurologist, including ERs who don't have anyone in their system. There is a severe shortage of peds neurology in most parts of the country, and I frequently find myself on the receiving end of un-paid consultations. "Hey Dr. Neurosphere,...
by toofache32
Sat Nov 10, 2018 11:35 am
Forum: Personal Consumer Issues
Topic: HIPAA Information available to out of town ER or not?
Replies: 19
Views: 869

Re: HIPPA Information available to out of town ER or not?

Edit: my uninformed opinion is indeed uninformed. Should've stopped after writing the disclaimer. Disclaimer: I am not a medical professional. My understanding of HIPAA leads me to think this is a CYA thing. I'd be interested in hearing from the myriad medical professionals here though. https://www...
by toofache32
Sat Nov 10, 2018 11:09 am
Forum: Personal Consumer Issues
Topic: Federal Employees Dental and Vision Insurance Program (FEDVIP) dental coverage
Replies: 14
Views: 1286

Re: Federal Employees Dental and Vision Insurance Program (FEDVIP) dental coverage

The federal plans are among the lowest paying plans out there. Be careful. Care to elaborate? When a payor reimburses at rates lower than the cost to provide the services, providers have to be “creative” to make a profit. Think Medicaid. I’m always fascinated how these discussions focus on price, b...
by toofache32
Fri Nov 09, 2018 10:07 pm
Forum: Personal Consumer Issues
Topic: Federal Employees Dental and Vision Insurance Program (FEDVIP) dental coverage
Replies: 14
Views: 1286

Re: Federal Employees Dental and Vision Insurance Program (FEDVIP) dental coverage

The federal plans are among the lowest paying plans out there. Be careful.
by toofache32
Fri Nov 09, 2018 10:04 pm
Forum: Personal Consumer Issues
Topic: Appealing Insurance Dental Claim Decision
Replies: 10
Views: 829

Re: Appealing Insurance Dental Claim Decision

Her benefits packet at her new employer stated that out of network preventative was covered at 100%. Her insurance company when questioned on the phone said they pay 100% based on their fee schedule, not what's billed. When logging in to their website their is a small note to that statement in a di...
by toofache32
Fri Nov 09, 2018 9:58 pm
Forum: Personal Consumer Issues
Topic: HIPAA Information available to out of town ER or not?
Replies: 19
Views: 869

Re: HIPAA Information available to out of town ER or not?

You guys have no idea how many pissed off wives I have dealt with when I call their husband to review biopsy results, and the wife answers the phone and wants to know the results. But he did not list her on the HIPAA form. Sorry ma'am, for $50,000 a pop, you can take it up with your husband. Oh, and...
by toofache32
Fri Nov 09, 2018 9:55 pm
Forum: Personal Consumer Issues
Topic: HIPAA Information available to out of town ER or not?
Replies: 19
Views: 869

Re: HIPPA Information available to out of town ER or not?

Edit: my uninformed opinion is indeed uninformed. Should've stopped after writing the disclaimer. Disclaimer: I am not a medical professional. My understanding of HIPAA leads me to think this is a CYA thing. I'd be interested in hearing from the myriad medical professionals here though. https://www...
by toofache32
Mon Nov 05, 2018 12:46 pm
Forum: Personal Consumer Issues
Topic: Dentist replaced crown a few months back and now I'm told the tooth needs to be pulled!
Replies: 49
Views: 3431

Re: Dentist replaced crown a few months back and now I'm told the tooth needs to be pulled!

... It would not surprise me if this new dentist tries to sell me an implant. Perhaps this is why he is recommending that the tooth be pulled. Do you want a bridge instead? A partial denture? Or do you want the best option? I’m sure he’ll give you whatever is feasible. No to the bridge and denture....
by toofache32
Mon Nov 05, 2018 8:45 am
Forum: Personal Consumer Issues
Topic: Dentist replaced crown a few months back and now I'm told the tooth needs to be pulled!
Replies: 49
Views: 3431

Re: Dentist replaced crown a few months back and now I'm told the tooth needs to be pulled!

... It would not surprise me if this new dentist tries to sell me an implant. Perhaps this is why he is recommending that the tooth be pulled. I had an implant about a year ago and have been very satisfied with the result. Far better than the stopgap measures they tried for years to save a flawed t...
by toofache32
Mon Nov 05, 2018 8:41 am
Forum: Personal Consumer Issues
Topic: Dentist replaced crown a few months back and now I'm told the tooth needs to be pulled!
Replies: 49
Views: 3431

Re: Dentist replaced crown a few months back and now I'm told the tooth needs to be pulled!

This is not a perfect science. There was too much damage but there is no way to know for sure in advance, and he tried to save your tooth. This is generally the correct choice when it's uncertain. Would you have preferred he pulled it at the beginning, looked at it in his hands and said "oh it wasn...
by toofache32
Mon Nov 05, 2018 8:31 am
Forum: Personal Consumer Issues
Topic: Dentist replaced crown a few months back and now I'm told the tooth needs to be pulled!
Replies: 49
Views: 3431

Re: Dentist replaced crown a few months back and now I'm told the tooth needs to be pulled!

CurlyDave wrote:
Mon Nov 05, 2018 12:02 am
CobraKai wrote:
Sun Nov 04, 2018 1:10 pm

... It would not surprise me if this new dentist tries to sell me an implant. Perhaps this is why he is recommending that the tooth be pulled.

Do you want a bridge instead? A partial denture? Or do you want the best option? I’m sure he’ll give you whatever is feasible.
by toofache32
Sun Nov 04, 2018 10:11 pm
Forum: Personal Consumer Issues
Topic: Multiple newspaper and magazine subscriptions - how much do you pay to stay informed?
Replies: 51
Views: 2360

Re: Multiple newspaper and magazine subscriptions - how much do you pay to stay informed?

I have not read through all of this. But if you have Bogleheads, then you have Google. Why would anyone ever pay for news and information in the first place when you have google and all of the internet?? What were you paying for that you could not get for free??
by toofache32
Sun Nov 04, 2018 10:03 pm
Forum: Personal Consumer Issues
Topic: Dentist replaced crown a few months back and now I'm told the tooth needs to be pulled!
Replies: 49
Views: 3431

Re: Dentist replaced crown a few months back and now I'm told the tooth needs to be pulled!

RudyS wrote:
Sun Nov 04, 2018 9:53 pm
Several have mentioned that it takes time to get used to a crown. I've got 3, DW has 2, and all of them were comfortable from day 1. Maybe one needed to be filed down a bit more, but that was that. Wondering what there is going on that would require getting used to.
Occlusion.
by toofache32
Sun Nov 04, 2018 1:50 pm
Forum: Personal Consumer Issues
Topic: Dentist replaced crown a few months back and now I'm told the tooth needs to be pulled!
Replies: 49
Views: 3431

Re: Dentist replaced crown a few months back and now I'm told the tooth needs to be pulled!

This is not a perfect science. There was too much damage but there is no way to know for sure in advance, and he tried to save your tooth. This is generally the correct choice when it's uncertain. Would you have preferred he pulled it at the beginning, looked at it in his hands and said "oh it wasn'...
by toofache32
Sat Nov 03, 2018 10:27 pm
Forum: Personal Consumer Issues
Topic: Post FiRE job...teaching??
Replies: 33
Views: 3909

Re: Post FiRE job...teaching??

So confused.
If you're financially independent then why would you want a job?? If you NEED the job then you're not financially independent.
I can think of a hundred hobbies and past times I would rather do.
by toofache32
Mon Oct 29, 2018 11:28 pm
Forum: Personal Consumer Issues
Topic: Dental Mishap
Replies: 46
Views: 4814

Re: Dental Mishap

Well luckily I have very exceptional straight teeth that never needed braces, and have never needed any pulled beyond the 4 wisdom teeth that were removed when I was still in HS. I'd really hate to go to my next dental cleaning/roentgen appt and leave with dentures. You won't. Dentures take at leas...
by toofache32
Mon Oct 29, 2018 10:42 pm
Forum: Personal Consumer Issues
Topic: Dental Mishap
Replies: 46
Views: 4814

Re: Dental Mishap

By the way, case law has shown the value of a single adult tooth to be worth about $15,000 in a state I previously lived in where one of my mentors was an expert witness in these exact types of cases. If someone thinks it's $100,000 for a single tooth, they must have had lots of gold in that tooth. ...
by toofache32
Mon Oct 29, 2018 10:40 pm
Forum: Personal Consumer Issues
Topic: Dental Mishap
Replies: 46
Views: 4814

Re: Dental Mishap

Mingus, calm down. This is a horrible scenario and I'm so sorry this happened to the OP's family. I have seen it happen several times with colleagues and myself. It's never as clear cut as one would expect. Root cause analyses show multiple sources of error. The most common is clerical/communication...
by toofache32
Mon Oct 29, 2018 10:20 pm
Forum: Personal Consumer Issues
Topic: Dental Mishap
Replies: 46
Views: 4814

Re: Dental Mishap

GET A LAWYER I would value any of my healthy, un-filled teeth at around $100K. Do the math. Everyone is looking for a lottery ticket....and at the same time people on this forum complain about healthcare costs. Oh, the irony... And sometimes people are rightfully pissed about incompetent medical pr...
by toofache32
Mon Oct 29, 2018 9:30 pm
Forum: Personal Consumer Issues
Topic: Dental Mishap
Replies: 46
Views: 4814

Re: Dental Mishap

AlphaLess wrote:
Wed Oct 24, 2018 8:16 pm
GET
A
LAWYER

I would value any of my healthy, un-filled teeth at around $100K.
Do the math.
Everyone is looking for a lottery ticket....and at the same time people on this forum complain about healthcare costs. Oh, the irony...
by toofache32
Sat Oct 27, 2018 10:08 pm
Forum: Personal Consumer Issues
Topic: "consultation fee": standard for preventative colonoscopy?
Replies: 61
Views: 3409

Re: "consultation fee": standard for preventative colonoscopy?

I am a surgeon and I do not do consults. I just walk in to the OR after the patient I have never met is asleep and do my stuff. :oops:
by toofache32
Mon Oct 22, 2018 9:38 pm
Forum: Personal Consumer Issues
Topic: Car Dealer told us car was Certified, but it isnt
Replies: 80
Views: 5371

Re: Car Dealer told us car was Certified, but it isnt

What year is the vehicle? What was the problem with it? it is a 2013, we bought it 4 months ago and it had a squeeling noise in front of car. Wife is 5 1/2 months pregnant so we didn't want to take it to the dealer we bought it from an hour and a half away one way, so I called and even talked to th...
by toofache32
Mon Oct 22, 2018 9:08 pm
Forum: Personal Consumer Issues
Topic: Dentist "Service Fee" for Filing Insurance Claim?
Replies: 33
Views: 3233

Re: Dentist "Service Fee" for Filing Insurance Claim?

A service fee seems reasonable. There is paperwork and other trouble involved. $150 for a service fee, however, I would fight as outrageous. JT Never heard of it. Part of doing business. The Dental fees are very high already. It's good to have an opinion. No matter the cost, many people will think ...
by toofache32
Mon Oct 22, 2018 8:55 pm
Forum: Personal Consumer Issues
Topic: Dentist "Service Fee" for Filing Insurance Claim?
Replies: 33
Views: 3233

Re: Dentist "Service Fee" for Filing Insurance Claim?

My dentist gives a 5% discount for payment by cash or check at time of service. The foregone 5% could be seen as a service fee for filing insurance. Ralph My office looked into the legalities of this for an in-network provider and we never could get a definitive answer. The insurance companies requ...
by toofache32
Mon Oct 22, 2018 10:52 am
Forum: Personal Consumer Issues
Topic: Dentist "Service Fee" for Filing Insurance Claim?
Replies: 33
Views: 3233

Re: Dentist "Service Fee" for Filing Insurance Claim?

I was asked to pay a small fee in cash to fill out forms and I was annoyed, but complied. I think it's a start of a bad trend like the nuisance small copays that now account for a large portion of the business and generating office visits seems to be the way to collect more copays. It's like the lu...
by toofache32
Mon Oct 22, 2018 7:36 am
Forum: Personal Consumer Issues
Topic: Dentist "Service Fee" for Filing Insurance Claim?
Replies: 33
Views: 3233

Re: Dentist "Service Fee" for Filing Insurance Claim?

I was asked to pay a small fee in cash to fill out forms and I was annoyed, but complied. I think it's a start of a bad trend like the nuisance small copays that now account for a large portion of the business and generating office visits seems to be the way to collect more copays. It's like the lu...
by toofache32
Sun Oct 21, 2018 10:50 pm
Forum: Personal Consumer Issues
Topic: Dentist "Service Fee" for Filing Insurance Claim?
Replies: 33
Views: 3233

Re: Dentist "Service Fee" for Filing Insurance Claim?

You forgot to include the most important information....is this dentist in-network with your dental insurance? If not, then the dentist is doing a service for you that you could do yourself. Also, the comparisons to medical insurance are irrelevant because dental and medical insurance are completely...
by toofache32
Sun Oct 21, 2018 1:56 am
Forum: Personal Finance (Not Investing)
Topic: Health care prices in Wisconsin
Replies: 4
Views: 838

Re: Health care prices in Wisconsin

These are DRG codes which means these are hospital facility fees, not physician charges. However, the ratio comparison of private insurance to Medicare is probably accurate. This list says Medicare pays $12,000 for a knee replacement. The physicians payment by Medicare for knee replacement (CPT 2744...
by toofache32
Sun Oct 14, 2018 1:24 pm
Forum: Personal Consumer Issues
Topic: No bill to me - but found strange things on my health plan records
Replies: 32
Views: 2834

Re: No bill to me - but found strange things on my health plan records

I had the second half of the shingles vaccination at an appointment at the end of August. My insurance was charged $30.05 for "Immunization" and $200 for "Preventive Med". These were reduced to $19.97 and $168 by insurance plan agreements. My cost was $0. These charges were the exact same 4 months ...
by toofache32
Sat Oct 13, 2018 11:31 pm
Forum: Personal Consumer Issues
Topic: Reducing overall medical costs. Do we do anything?
Replies: 67
Views: 3207

Re: Reducing overall medical costs. Do we do anything?

Use your PCP as a first step instead of immediately jumping to a specialist. I know two young people on Medicaid. They are both in their 20s. Both told me how they had just made appointments with various specialists. Girl number one told me she was going to see a podiatrist (along with two other sp...
by toofache32
Sat Oct 13, 2018 11:29 pm
Forum: Personal Consumer Issues
Topic: Reducing overall medical costs. Do we do anything?
Replies: 67
Views: 3207

Re: Reducing overall medical costs. Do we do anything?

Eat well and don't drive fast. Always wipe, stay off the pipe.
by toofache32
Sat Oct 13, 2018 11:23 pm
Forum: Personal Finance (Not Investing)
Topic: Medical Balance Billed Illegally?
Replies: 14
Views: 1052

Re: Medical Balance Billed Illegally?

You need to find out from the doctor if they were in-network at the time of services. Not from the insurance. I have been through this with multiple insurance companies as a doctor. I submit my letter to the insurance company that I am will no longer be in-network with their insurance. My longest re...
by toofache32
Fri Oct 12, 2018 11:55 pm
Forum: Personal Consumer Issues
Topic: No bill to me - but found strange things on my health plan records
Replies: 32
Views: 2834

Re: No bill to me - but found strange things on my health plan records

...No financial concerns for me - but makes me wonder what else "strange" might be in my medical records that I have not seen. :confused ... I thought Kaiser had EMR. My former physician had them for many years and I always had online access. Now PCP (starting soon) I'm not so sure, but I'm not rea...
by toofache32
Fri Oct 12, 2018 3:29 pm
Forum: Personal Finance (Not Investing)
Topic: Website article on lawsuits over hospital balance / surprise billing
Replies: 56
Views: 2423

Re: Website article on lawsuits over hospital balance / surprise billing

The incident I had was when I went in for a fairly simple procedure (ESI) which I could plan and negotiate ahead of time. I had in-network neurologists and neurosurgeon and had it done at an in-network hospital. I made it clear to everyone involved that I did not consent to care from anyone out of ...
by toofache32
Fri Oct 12, 2018 3:23 pm
Forum: Personal Finance (Not Investing)
Topic: Website article on lawsuits over hospital balance / surprise billing
Replies: 56
Views: 2423

Re: Website article on lawsuits over hospital balance / surprise billing

PS: Insurance should have to pay the charges for out of network if they haven't secured a!l the services their policyholders need. Instead, they leave customers uncovered. THIS! If the insurance refuses to negotiate acceptable fees then they shouldn't get to just walk away from it. As it stands now...
by toofache32
Fri Oct 12, 2018 3:16 pm
Forum: Personal Finance (Not Investing)
Topic: Website article on lawsuits over hospital balance / surprise billing
Replies: 56
Views: 2423

Re: Website article on lawsuits over hospital balance / surprise billing

I purchased health care this week in an urgent situation. The practice does not accept any insurance. I was seen and taken care of. They told me it cost $532. I gave them my credit card and paid the bill and thanked the doctor for seeing me. How easy was it to get the price ahead of time? Was it a ...
by toofache32
Fri Oct 12, 2018 2:29 pm
Forum: Personal Finance (Not Investing)
Topic: Website article on lawsuits over hospital balance / surprise billing
Replies: 56
Views: 2423

Re: Website article on lawsuits over hospital balance / surprise billing

If a hospital is OON and they should just accept whatever insurance feels like they are worth, how does the hospital know if that payment is in line with what that insurance pays other hospitals? If the payments were not high enough to be acceptable during negotiations, why should the hospital be f...
by toofache32
Fri Oct 12, 2018 2:24 pm
Forum: Personal Finance (Not Investing)
Topic: Website article on lawsuits over hospital balance / surprise billing
Replies: 56
Views: 2423

Re: Website article on lawsuits over hospital balance / surprise billing

The beauty of OON is that it does not involve insurance and has nothing to do with insurance. I provide a cost which the patient pays. Very simple. You were saying the patient could not SEE an OON doctor without OON benefits. I am saying that patients are not limited by their insurance and can pay ...
by toofache32
Fri Oct 12, 2018 2:19 pm
Forum: Personal Finance (Not Investing)
Topic: Website article on lawsuits over hospital balance / surprise billing
Replies: 56
Views: 2423

Re: Website article on lawsuits over hospital balance / surprise billing

If a hospital is OON and they should just accept whatever insurance feels like they are worth, how does the hospital know if that payment is in line with what that insurance pays other hospitals? If the payments were not high enough to be acceptable during negotiations, why should the hospital be fo...
by toofache32
Fri Oct 12, 2018 2:15 pm
Forum: Personal Finance (Not Investing)
Topic: Website article on lawsuits over hospital balance / surprise billing
Replies: 56
Views: 2423

Re: Website article on lawsuits over hospital balance / surprise billing

If you have no out of network benefits you can't even see them if you wanted. Huh? Anyone can see any doctor they want. My practice is completely out of network with all medical insurance and I am busy. I think you need to re-think this completely incorrect statement. Man you don't know how insuran...
by toofache32
Fri Oct 12, 2018 2:11 pm
Forum: Personal Finance (Not Investing)
Topic: Website article on lawsuits over hospital balance / surprise billing
Replies: 56
Views: 2423

Re: Website article on lawsuits over hospital balance / surprise billing

Pretty shady and the reason is illegal for medicare patients and illegal in majority of states for commercial insurance. Best for all to check with their state laws concerning balanced billing. If there is an issue in your state simply get all your care at a major health system or university settin...
by toofache32
Fri Oct 12, 2018 2:05 pm
Forum: Personal Finance (Not Investing)
Topic: Website article on lawsuits over hospital balance / surprise billing
Replies: 56
Views: 2423

Re: Website article on lawsuits over hospital balance / surprise billing

If you have no out of network benefits you can't even see them if you wanted. Huh? Anyone can see any doctor they want. My practice is completely out of network with all medical insurance and I am busy. I think you need to re-think this completely incorrect statement. Man you don't know how insuran...
by toofache32
Fri Oct 12, 2018 2:00 pm
Forum: Personal Finance (Not Investing)
Topic: Website article on lawsuits over hospital balance / surprise billing
Replies: 56
Views: 2423

Re: Website article on lawsuits over hospital balance / surprise billing

For me, a real puzzle: On the one hand, the US (compared to other countries) has a very large total medical care expenses per person, while on the other hand a great many providers claim health insurance, medicare, medicaid, etc. pay so little - that it is, allegedly, actually below their costs of ...
by toofache32
Fri Oct 12, 2018 1:13 pm
Forum: Personal Finance (Not Investing)
Topic: Website article on lawsuits over hospital balance / surprise billing
Replies: 56
Views: 2423

Re: Website article on lawsuits over hospital balance / surprise billing

...Hospitals agree to accept the lowest amounts from Medicare and Medicaid... Seems like I've seen that repeatedly. A few HMOs seem to negotiate better prices as well. I've heard good things about Kaiser. There's a fundamental problem with medical services not really being a "market". A fair market...
by toofache32
Fri Oct 12, 2018 12:45 pm
Forum: Personal Finance (Not Investing)
Topic: Website article on lawsuits over hospital balance / surprise billing
Replies: 56
Views: 2423

Re: Website article on lawsuits over hospital balance / surprise billing

...Hospitals agree to accept the lowest amounts from Medicare and Medicaid... Seems like I've seen that repeatedly. A few HMOs seem to negotiate better prices as well. I've heard good things about Kaiser. There's a fundamental problem with medical services not really being a "market". A fair market...
by toofache32
Fri Oct 12, 2018 12:42 pm
Forum: Personal Finance (Not Investing)
Topic: Website article on lawsuits over hospital balance / surprise billing
Replies: 56
Views: 2423

Re: Website article on lawsuits over hospital balance / surprise billing

Pretty shady and the reason is illegal for medicare patients and illegal in majority of states for commercial insurance. Best for all to check with their state laws concerning balanced billing. If there is an issue in your state simply get all your care at a major health system or university settin...
by toofache32
Fri Oct 12, 2018 12:31 pm
Forum: Personal Finance (Not Investing)
Topic: Website article on lawsuits over hospital balance / surprise billing
Replies: 56
Views: 2423

Re: Website article on lawsuits over hospital balance / surprise billing

staythecourse wrote:
Fri Oct 12, 2018 9:23 am

If you have no out of network benefits you can't even see them if you wanted.
Huh? Anyone can see any doctor they want. My practice is completely out of network with all medical insurance and I am busy. I think you need to re-think this completely incorrect statement.