View Poll Results: Which state are you LEAST likely ever to visit or pass through (on the ground)?

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  • Arizona

    0 0%
  • California

    1 4.55%
  • Colorado

    0 0%
  • Connecticut

    2 9.09%
  • Florida

    1 4.55%
  • Georgia

    0 0%
  • Illinois

    0 0%
  • Indiana

    0 0%
  • Maryland

    2 9.09%
  • Massachusetts

    1 4.55%
  • Michigan

    0 0%
  • Minnesota

    0 0%
  • New York

    1 4.55%
  • North Carolina

    0 0%
  • Ohio

    0 0%
  • Oklahoma

    12 54.55%
  • Pennsylvania

    0 0%
  • Texas

    1 4.55%
  • Virginia

    0 0%
  • Washington

    1 4.55%
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Thread: Rep Retirement Lodge 201: A State You Don't Expect

  1. #781
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    Quote Originally Posted by leswp1 View Post
    This is true. I I think there is a difference between making informed choices for care and being able to shop for what you want like it is burger king. The patient should be an active participant and partner in making decisions but they aren't the managing partner. They don't have enough knowledge. We should not be a service industry where the client is always right and you have to make the client happy no matter what it takes. The insurance industry markets to the patient the nonsense about how they care and make sure the patient will get what they want and then they tell us we cannot consider what the patient really needs, only what the insurance company decrees is OK. The culture promotes the idea that this is an adversarial relationship that the medical person will be trying to screw the person out of what they are owed. They blame the Medical pro instead of the insurance that is actively working to provide as little care as possible to save $.

    The financial side is a fiasco all around. The ACA was supposed to change that. They gutted that part of the bill and what they didn't gut the current admin is not enforcing. The insurance co are having a party.

    You, as a pt, can't shop around for cost, find out what is covered, get a list of codes that will be covered by your plan. If you call to ask what the correct code is to get it reimbursed they refuse to give it to you because the Provider should know. (The provider can't find out the correct code when they call to ask either!) Some insurances arbitrarily decide that routine health maintenance tests/exams/procedures are not covered, even when they are standard of care. Or they only cover it at certain intervals that are not evidence based. They refuse to give a list or tell you they won't pay until after it is submitted. If you have ever had a diagnosis it cannot be on the slip or they can claim it is a diagnostic test and charge you. The minute a woman tells them she has a lump they charge her a diagnositic test and her 'free yrly mammo' is not covered. Most people don't know any of this. mr les just had a health maintenance procedure. It was billed by the Doc and the facility as Health Main. The anesthesia weasels billed him. I said this isn't right. He said it must be because of the deductible. I say no. He argues. I lose it and he calls to check. Sure enough it was not supposed to be billed to us. Don't you wonder how many of their patients are billed and pay blindly?

    We can't get a comprehensive list of codes or what is covered easily. They make a habit of changing codes, procedures for submitting billing and what is covered all the time. It is like a massive shell game. Example- Billing for something simple like a Physical is not simple. To get the most reimbursement you need to separately code for the physical, the breast, prostate, gyn exam, each lab you did, the fingerstick, the performance of the fingerstick, each immunization, for the administration of the immunization, additional administration of anything past one immunization, certain other screening tests, interpretation of certain tests. They don't tell you any of this. If your billing people aren't good or well hooked in you can miss a ton of reimbursement. Then they get you again because they keep back the withhold claiming you didn't do any of the 'measures' because they weren't billed. No matter that they are clearly documented as having been performed. If you didn't code it right it didn't happen.

    There are literally college programs with degrees for medical billing. Think about that.
    Not much to add to this other than "yup". I work on the clinical side of the outpatient world, so I get my tendrils into everything from booking to treating to billing (from an IT perspective, that is). One of my jobs is to update the diagnosis code lists every 6 months (they're available quarterly but f that). I'm working on the yearly regulatory update and it's a 6 week project all in itself. Isn't that insane? The diagnosis code list is so complicated and integrated into everything that it takes me weeks and weeks to process it.

    However, it does lead to some hilarious dx codes:

    • Sucked into jet engine [with further options for initial, sequala, etc.]
    • Excessive consumption of juice
    • Walking dead syndrome


    A human being was paid to add these to a potential diagnosis code list.
    I gotta little bit of smoke and a whole lotta wine...

  2. #782
    Veteran leswp1's Avatar
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    Quote Originally Posted by JF_Gophers View Post
    We are going at the beginning, so no track and field unfortunately. But the wife did pick Taekwondo, Tennis, and Beach Volleyball.

    Only other event i would have wanted is swimming.
    You get to go. That is cool!

    Quote Originally Posted by Swansong View Post
    Not much to add to this other than "yup". I work on the clinical side of the outpatient world, so I get my tendrils into everything from booking to treating to billing (from an IT perspective, that is). One of my jobs is to update the diagnosis code lists every 6 months (they're available quarterly but f that). I'm working on the yearly regulatory update and it's a 6 week project all in itself. Isn't that insane? The diagnosis code list is so complicated and integrated into everything that it takes me weeks and weeks to process it.

    However, it does lead to some hilarious dx codes:

    • Sucked into jet engine [with further options for initial, sequala, etc.]
    • Excessive consumption of juice
    • Walking dead syndrome


    A human being was paid to add these to a potential diagnosis code list.
    There are pages that people post codes. There are some truly hilarious ones that seem highly improbable. I haven't looked in awhile but they were a source of amusement. Finding the way they decided to word things is an art. My personal favorite involved trying to find something re the forearm. It was under pain in joint, forearm. Last I checked if you had a joint in your forearm you were in a world of pain. We used to put our heads together to try to find codes. Sort of like playing the 10,000 Pyramid. You can't use the actual word so what other words can you use? Below is a cut and paste with some deletes

    W55.21 Bitten by a cow (is there another code for being bitten by a bull?)
    W61.33 Pecked by a chicken
    Y92.253 Injured at the opera
    W56.22 Struck by an orca, initial encounter (The disturbing part of this is the "initial encounter", which implies that there will be a subsequent encounter (there actually is a code for that too). I guess the trainers at SeaWorld can rest assured that their injury will be billed extremely accurately.)
    V91.07 Burn due to water skis on fire
    V97.33XD Sucked into jet engine, subsequent encounter-When you get sucked into a jet engine and survive, only to get sucked into anotherjet engine, the universe is trying to tell you something significant.
    Y92.146 Swimming-pool of prison as the place of occurrence of the external cause
    W59.22XA Struck by turtle-Bit by a turtle, I would understand. Snapping turtles are dangerous! But I don't understand being struck by a turtle. If you are so slow that one of the slowest-moving animals can strike you, there are definitely other health concerns you should be worrying about.
    Y92.241 Hurt at the library
    There are so many things that could go wrong at the library. That many books undoubtedly causes an abundance of paper cuts, which could lead to infection. Or maybe an entire shelf of books fell on the patient! Or did the librarian fall off the bookshelf ladder? This code just isn't specific enough!

  3. #783
    Veteran leswp1's Avatar
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    V00.01XD: Pedestrian on foot injured in collision with roller-skater, subsequent encounter.
    Y93.D: Activities involved arts and handcrafts.
    W55.41XA: Bitten by pig, initial encounter​.
    W61.62XD: Struck by duck, subsequent encounter.
    W220.2XD Walked into lamppost, subsequent encounter.
    W22.02XD: V95.43XS: Spacecraft collision injuring occupant, sequela. *
    W61.12XA: Struck by macaw, initial encounter. ​

    * Has this even happened?

    Are these creative writing prompts?

    Good Morning Lodge!

  4. #784
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    Quote Originally Posted by leswp1 View Post
    V97.33XD Sucked into jet engine, subsequent encounter-When you get sucked into a jet engine and survive, only to get sucked into anotherjet engine, the universe is trying to tell you something significant.
    The universe is telling you something: you’re an idiot. As someone who works on an air ramp I can write off it happening once to bad luck maybe, if it happens twice you’re just dumb.

  5. #785
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    I think the concept of that is that you're seeing your doctor for a second visit after being sucked into the engine, but honestly who could know?

    Fortunately, there's an enormous industry of translating that gibberish into clinical speak so you don't need to scour some ridiculous database for exactly the right ICD 9 or 10 code - that comes with a rather substantial cost to the system. Because god forbid you attach the wrong one to a charge (or a .1 instead of a .11).

    Another reason that small, privately owned and independent practices are basically impossible to maintain. You need to be part of an IPA to have a prayer of survival.
    I gotta little bit of smoke and a whole lotta wine...

  6. #786
    Minding the gap MinnesotaNorthStar's Avatar
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    Quote Originally Posted by leswp1 View Post
    W59.22XA Struck by turtle-Bit by a turtle, I would understand. Snapping turtles are dangerous! But I don't understand being struck by a turtle. If you are so slow that one of the slowest-moving animals can strike you, there are definitely other health concerns you should be worrying about.
    Someone could always throw one at you. I would bet it has happened in Florida.

    Speaking of Florida, headed down to MIA for a day trip to do my Global Entry interview. There were no options close for 4-6 months and flights were wide open today.

  7. #787
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    Quote Originally Posted by Jimjamesak View Post
    The universe is telling you something: you’re an idiot. As someone who works on an air ramp I can write off it happening once to bad luck maybe, if it happens twice you’re just dumb.
    I thought you were past dumb and closer to dead.

    Quote Originally Posted by Swansong View Post
    I think the concept of that is that you're seeing your doctor for a second visit after being sucked into the engine, but honestly who could know?

    Fortunately, there's an enormous industry of translating that gibberish into clinical speak so you don't need to scour some ridiculous database for exactly the right ICD 9 or 10 code - that comes with a rather substantial cost to the system. Because god forbid you attach the wrong one to a charge (or a .1 instead of a .11).

    Another reason that small, privately owned and independent practices are basically impossible to maintain. You need to be part of an IPA to have a prayer of survival.
    That is why they have to hire billing companies. The bigger problem is the PHOs who bargain in a way to screw the small practices

  8. #788
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    Good morning to tLodge!
    Quinnipiac Bobcats
    2012-13, 2014-15, 2015-16, 2018-19 ECAC Regular Season Champions
    2013 East Regional Champions, Frozen Four
    2014 East Regional
    2015 West Regional
    2016 ECAC Tournament Champions, East Regional Champions, Frozen Four
    2019 Midwest Regional

  9. #789
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    Finally finished work this trip. Headed home for 12 hours, then coincidentally flying to Philly for a wedding this weekend. Who knows how long the trip will end up being, given Dorion is likely to have a say in my planned return flight on Monday. Packing for a week, hoping for less.

  10. #790
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    Or if you can get out!

    Good Morning Lodge!

    My friend's island was mostly spared. Thank God! Her father died this morning she is still trying to get home.

  11. #791
    We'll be back. Hammer's Avatar
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    Hello, 4 1/2 day weekend!
    FERRIS STATE UNIVERSITY: 2012 FROZEN FOUR


    God, that was fun...

  12. #792
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    Quote Originally Posted by Ralph Baer View Post
    I received $5.3M from Mr.Philip.Kabore. (He has to learn that we use spaces as separators, not periods. ) The total is now $636,917,305.46.
    I received $1.55M from Mr. Michael Richard Pompeo. The total is now $638,467,305.46.

    The total should be $641,317,326.06. I made an error on 7/22.
    Last edited by Ralph Baer; 08-30-2019 at 05:02 AM.

  13. #793
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    Evening, Lodge. Work bottomed out after 3pm today. NOTHING coming in. Tomorrow should be interesting.

    Hitting up the Fair Sat with the 'rents, Monday with a friend who's never been (that should be FUN! seriously).

    Perfect weather here, can't ask for much more.
    Never really developed a taste for tequila. Kind of hard to understand how you make a drink out of something that sharp, inhospitable. Now, bourbon is easy to understand.
    Tastes like a warm summer day. -Raylan Givens

  14. #794
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    Good morning to tLodge!
    Quinnipiac Bobcats
    2012-13, 2014-15, 2015-16, 2018-19 ECAC Regular Season Champions
    2013 East Regional Champions, Frozen Four
    2014 East Regional
    2015 West Regional
    2016 ECAC Tournament Champions, East Regional Champions, Frozen Four
    2019 Midwest Regional

  15. #795
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    S’upp y’all

  16. #796
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    Good Morning, y'all!

  17. #797
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    YESTERDAY:
    Vendor: Physical proof of notebook needs to be approved tomorrow. Are you working?
    Me: Yes, but not in the office. Let me check with designer from the agency, they should be the one to review/approve.

    Me: Hello agency - anyone working in office tomorrow so vendor can overnight proof for review/approval?
    Agency: Designer is in office and can approve! But she's leaving office at 3:00pm.

    Me: Here is name and address to deliver. Ship for morning delivery
    Vendor: Thanks! We will email you tracking when we have it.

    TODAY
    Me: Good morning vendor. Can you send me tracking I was supposed to get last night so I can share with agency/designer to be on lookout so they can provide the approval you need today?
    Vendor: Here you go! It was sent for afternoon delivery so by 3:00pm.
    Me: ::head desk:: I asked for morning delivery. Designer is leaving the office by 3:00pm. So, unless FedEx delivers before 3:00pm, you aren't getting your approval.

    Seriously, does no one read any more????

  18. #798
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    No, no they don't. This happens all the time.

    This is taken from another forum but this happens to me at least a couple times a month:

    PM - "are you free for a chat with the customer if we can arrange it this afternoon?"
    me - "sure, the only firm time commitment I have is at 4:15 for about 30 minutes."
    <PM email to customer> "hi customer, we are free at 4:15 for about 30 minutes if that works on your end."
    I gotta little bit of smoke and a whole lotta wine...

  19. #799
    Veteran leswp1's Avatar
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    Good Morning Lodge!

    HHH here. Tomatoes need the heat (trying to be positive)

  20. #800
    Defacing this tagline is a MAX foul Twitch Boy's Avatar
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    Re: Rep Retirement Lodge 201: A State You Don't Expect

    Quote Originally Posted by leswp1 View Post
    Good Morning Lodge!

    HHH here. Tomatoes need the heat (trying to be positive)
    Didn't know 9-time WWE champions were into gardening :P

    /fine, 14 if you count the WHC
    Michigan Tech Huskies Pep Band: There's No Use Trying To Talk. No Human Sound Can Stand Up To This. Loud Enough To Knock You Down.

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