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Old 11-29-2022, 09:32 AM
 
Location: NMB, SC
43,054 posts, read 18,216,027 times
Reputation: 34926

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Quote:
Originally Posted by moneill View Post
Back in 2001, made general check up appointments for my three kids. Dr.'s office calls me back, they aren't covered for well care visits. Phone insurance company. Yeah she has to put in as a 'physical'. Phone dcotor's office back...hey put it in as a physical. Dr.'s clerk says "oh yeah -- that happens all the time.............." Took everything I had to say -- then why didn't you try the second code before trying to charge me full price for a visit.

Sure more paperwork as more people on more insurance.

But this whole dance with insurance companies, and health care providers....Americans have been dealing with it for years.

I won't go into the fiasco that followed with required immunizaitons for the kids and wanting to charge me 75 dollars a pop until I told them I would go to county health office and pay 10 dolalrs and then the office found some forms I could sign to get the 10 dollar shot at THEIR office.

Health care in the USA is big business and you never know if you are getting something you need or just something that makes money for all involved.
'.
I got "sports physicals" for cash..cheaper and no need to go thru insurance.
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Old 11-29-2022, 09:41 AM
 
21,382 posts, read 7,934,145 times
Reputation: 18149
Quote:
Originally Posted by TMSRetired View Post
I got "sports physicals" for cash..cheaper and no need to go thru insurance.
Urgent cares always do them for about $20-$25 bucks at the start of the school year.

No insurance needed.

With insurance it's probably be $250.
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Old 11-29-2022, 09:41 AM
 
Location: Long Island
32,816 posts, read 19,469,405 times
Reputation: 9618
Quote:
Originally Posted by villageidiot1 View Post
If your wife worked in medical billing for two decades, she would know that ACA regulations made little difference in medical billing. It was no different before the ACA took effect.
but iit is all GOVERNMENT REQUIRED paperwork... the problem starts with the government..... Medicare for example has MORE paperwork than does private insurance...not much more, but still more
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Old 11-29-2022, 09:43 AM
 
Location: NMB, SC
43,054 posts, read 18,216,027 times
Reputation: 34926
Quote:
Originally Posted by villageidiot1 View Post
If your wife worked in medical billing for two decades, she would know that ACA regulations made little difference in medical billing. It was no different before the ACA took effect.
There is a difference. I had BCBS before ACA and BCBS under ACA...yes there was a difference.
And not only in paperwork but website pages as well.

ACA was not some invisible act that required no changes.
The IRS got involved early on because of tax provisions, requirements and restrictions.
1094-C, 1094-B, 1095-B.......
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Old 11-29-2022, 11:09 AM
 
Location: Jacksonville, FL
11,143 posts, read 10,703,406 times
Reputation: 9799
Quote:
Originally Posted by villageidiot1 View Post
If your wife worked in medical billing for two decades, she would know that ACA regulations made little difference in medical billing. It was no different before the ACA took effect.
It was hugely different before ACA took effect, actually. But go ahead, try to tell us otherwise.
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Old 11-29-2022, 11:10 AM
 
Location: Long Island
32,816 posts, read 19,469,405 times
Reputation: 9618
Quote:
Originally Posted by villageidiot1 View Post
If your wife worked in medical billing for two decades, she would know that ACA regulations made little difference in medical billing. It was no different before the ACA took effect.
the ACA made a big difference, as costs changed, coverage changed, etc

for most of us, the cost went up, and the coverage went down

the ACA was/is a pisspoor 3000 page law
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Old 11-29-2022, 11:14 AM
 
Location: NMB, SC
43,054 posts, read 18,216,027 times
Reputation: 34926
Quote:
Originally Posted by workingclasshero View Post
the ACA made a big difference, as costs changed, coverage changed, etc

for most of us, the cost went up, and the coverage went down

the ACA was/is a pisspoor 3000 page law
ACA pretty much put everyone on a high deductible HMO
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Old 11-29-2022, 12:22 PM
 
Location: A coal patch in Pennsyltucky
10,385 posts, read 10,647,904 times
Reputation: 12699
Quote:
Originally Posted by TMSRetired View Post
Denials and approvals are not new.
But the amount of paperwork involved now.....
Add to that EHR's that must be maintained
Paperwork for who? Electronic health records (EHR) should theoretically improve and streamline care. My wife is a CRNP and reviews faxed paper charts (from other hospitals) every night for the patients she will be seeing the next day.

Quote:
Originally Posted by moneill View Post
Back in 2001, made general check up appointments for my three kids. Dr.'s office calls me back, they aren't covered for well care visits. Phone insurance company. Yeah she has to put in as a 'physical'. Phone dcotor's office back...hey put it in as a physical. Dr.'s clerk says "oh yeah -- that happens all the time.............." Took everything I had to say -- then why didn't you try the second code before trying to charge me full price for a visit.

Sure more paperwork as more people on more insurance.

But this whole dance with insurance companies, and health care providers....Americans have been dealing with it for years.

I won't go into the fiasco that followed with required immunizaitons for the kids and wanting to charge me 75 dollars a pop until I told them I would go to county health office and pay 10 dolalrs and then the office found some forms I could sign to get the 10 dollar shot at THEIR office.

Health care in the USA is big business and you never know if you are getting something you need or just something that makes money for all involved.
'.
I'm running into something similar with my eye doctor. I had a checkup and the doctor said my vision had actually improved. I get a bill for a couple hundred bucks. The doctor's office said I hadn't met my personal deductible. The insurance says a checkup should be covered under insurance. Seems they ran some test that are not included under the annual wellness visit.

Quote:
Originally Posted by workingclasshero View Post
but iit is all GOVERNMENT REQUIRED paperwork... the problem starts with the government..... Medicare for example has MORE paperwork than does private insurance...not much more, but still more
Again, paperwork for who. I have Medicare and private insurance. I don't have any paperwork. The problem I have is figuring what I actually owe and what my costs will be.

Quote:
Originally Posted by TMSRetired View Post
There is a difference. I had BCBS before ACA and BCBS under ACA...yes there was a difference.
And not only in paperwork but website pages as well.

ACA was not some invisible act that required no changes.
The IRS got involved early on because of tax provisions, requirements and restrictions.
1094-C, 1094-B, 1095-B.......
Nothing has changed for me. I don't understand all these paperwork comments.

Quote:
Originally Posted by workingclasshero View Post
the ACA made a big difference, as costs changed, coverage changed, etc

for most of us, the cost went up, and the coverage went down

the ACA was/is a pisspoor 3000 page law
How do you know the ACA had anything to do with any of these issues?

I have lots of issues with healthcare. I was supposed to have a procedure done. I was waiting in the exam room when the doctor walked in and said they couldn't do the procedure because I was on Eliquis. All my doctors, hospitals, and pharmacy are all part of the same system and the Eliquis is clearly on the online medical record.

With this same doctor, they did a urinalysis during my first visit. I got a bill from Quest for the test. I would've been covered if they had used the health system's own lab.

Scheduling visits is also an issue. I can't call this office directly. I have had to call their central scheduling number to reschedule this procedure, except they can't schedule that procedure. Therefore, someone has to call me back.
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Old 11-29-2022, 12:24 PM
 
257 posts, read 165,521 times
Reputation: 335
All I have to do is get a costume like this so if I ever have to goto the hospital again the nurses with sit with ME all day!








Once I noticed in any health care setting staff is 90% with the computers and 10% with actual people it was impossible to un-notice it.




What exactly are they doing, dozens and dozens of people, 3 shifts, 1000s of hours a week inputting or doing WHAT ?
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Old 11-29-2022, 12:29 PM
 
Location: Long Island
32,816 posts, read 19,469,405 times
Reputation: 9618
Quote:
Originally Posted by villageidiot1 View Post
Paperwork for who? Electronic health records (EHR) should theoretically improve and streamline care. My wife is a CRNP and reviews faxed paper charts (from other hospitals) every night for the patients she will be seeing the next day.
paperwork/computer/fax work, the point is there are MORE processes now than ever before.... and 99.99% are due to government regulations



Quote:
Again, paperwork for who. I have Medicare and private insurance. I don't have any paperwork. The problem I have is figuring what I actually owe and what my costs will be.
paperwork for the provider....


Quote:
How do you know the ACA had anything to do with any of these issues?

I have lots of issues with healthcare. I was supposed to have a procedure done. I was waiting in the exam room when the doctor walked in and said they couldn't do the procedure because I was on Eliquis. All my doctors, hospitals, and pharmacy are all part of the same system and the Eliquis is clearly on the online medical record.

With this same doctor, they did a urinalysis during my first visit. I got a bill from Quest for the test. I would've been covered if they had used the health system's own lab.

Scheduling visits is also an issue. I can't call this office directly. I have had to call their central scheduling number to reschedule this procedure, except they can't schedule that procedure. Therefore, someone has to call me back.
electronic records are SUPPOSED TO help...but as you just showed, they dont...not all systems talk with each other

the ACA was supposed to fix some of these issues...but the ACA failed, and actually made things worse
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