Archive | March, 2014

Darrell Issa and Chris Christie

17 Mar

All in all it was a pretty exciting couple weeks for the GOP, especially with the Russian Menace looming, invading, and being all decisive, giving every Republican a valid reason to mention Reagan. It’s natural Republican Viagra!

 

Darrell Issa, the richest occasionally working man in Congress, abruptly concluded a hearing this week with Lois Lerner dissatisfied with her audacity to not self-incriminate and make “IRS” the new “Benghazi” after “Fast and Furious”, it was discovered, only reminds conservatives that Paul Walker is dead. May he rest.

After less than 20 minutes, Issa adjourned to get on with the rest of his day demanding the truth and hair coloring products. What happened next made many wonder if Chairman Issa was in desperate need of a nap and juicebox when he not only refused to allow any Democrats to ask questions but then cut off ranking member, Congressman Elijah Cummings’ microphone. As we all know, cutting the mike of an outspoken Civil Rights proponent completely disarms them. To his chagrin and numerous MSNBC footage reels, Rep Elijah Cummings wanted to ask a question in the way most middle managers give a performance evaluations–with all of the criticism getting around to one point justifying a generous 5 cents per hour raise. However, press mikes continued to record the entire exchange as Cummings lectured Republicans like it was Shakespeare in the House.

By the end of the exchange the future talking point that Lerner wouldn’t answer questions she hadn’t planned to answer to begin with was lost and we all learned a valuable lesson: gaveling just makes some people feel powerful. Also, the “cut the mike” gesture will now be referred to as the Issa instead of the O’Reilly.

 

CPAC was also this week showing us Mitch McConnell carrying a shotgun, because things in the Senate have gotten that bad. Bobby Jindal compared Obama to Jimmy Carter in material he’ll soon be turning into his own sitcom called “Tired False Premise”. Look for it this Fall on NBC. This was far better than Donald Trump who’s losing more of his toupe every time he appears in public, who thought Carter was already dead. He’s not certain as he has not seen the long form death certificate.

Chris Christie enthusiastically spoke and sounded very hungry….for the GOP to win in 2014. He was finally invited back to CPAC after upsetting conservatives in past years by working with President Obama to acquire Hurricane Sandy relief and expanding Medicaid in New Jersey. He remarked that the GOP cannot govern if they don’t win, but should have reminded everyone that constituents can’t vote if they aren’t alive. He also said that the GOP ideas were better than those of the Democrats. This coming from the guy whose playbook allegedly includes shutting down the busiest bridge in the world as political payback and withholding hurricane relief funds to the mayor of Hoboken. If his ideas get any newer he’s going to start taking the cannoli BY THE TRUCK.

Aside 16 Mar

Friday, March 14, 2014, was my last day in healthcare as a biller. Seven years in reimbursement. It’s been an interesting, frustrating experience at times. I’m not sad to be moving on, but the things I’ve learned really have opened my eyes to how flawed the American system really is when it comes to providing consistently affordable maintenance healthcare. 
So I thought I would write down a quick list of the things I’ve learned in hopes it may help you. Or the healing process (ha!). Really, I’m tired of working Medicare audits this week.
1. Insurance companies are assholes. They only care about their shareholders interests or the law. If they can prove any reason not to pay something they will. Every time.
2. If anyone says, “You’re insurance will cover it” punch them in the gut and give them my Twitter handle. Your insurance will accept the charges but everything is still subject to coinsurance, copays, and the DEDUCTIBLE. You should be hearing hushing, ominous music in your head. Learn what those are for your policy. Be discerning when suggested treatment and equipment. Discuss with everyone.
3. Most all equipment “rents” for several months THEN it “converts to a purchase”. Most of the stuff I dealt with was for aged and elderly: Hospital beds, nebulizers, wheelchairs, etc. Oxygen rents but never converts. Hey, there are no absolutes. Insurance and government payers do this to reduce costs. They have no way of knowing just exactly how long you will use whatever and they’re not medical equipment Santa.
4. This entire field and business is over-complicated, messy, and automated. Claims are flying out the door all the time, payments are coming in, errors errywhere. Ask someone how the billing works before you troll them how it’s supposed to work.
5. Due to the penalties, jail time, and sheer amount of work it would take (laziness wins) there are very few companies that are willfully billing fraudulently. It’s almost impossible to overbill a medical payer because of how claims are adjudicated and the established rate. I could bill Medicare all day $300 for a box of bandages. They’re only going to pay $2.10. Things are billed with codes, codes match dollar amounts and limits for time frames (only 500 bandages a month!), and if everything lines up there’s some payment. Medical billing is unlike any other billing. 

There’s plenty more, but really that’s the short of it. If you understand that much it’s not so scary, at least based anecdotally on the hundreds of phone calls I’ve taken.