Random Thoughts the 13th: Jason Takes RTT

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ImJustKCClone

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Faceless "experts" at insurance companies know more than doctors. :rolleyes:

Got a call a a few weeks back from insurance company asking if I'd like to talk to one of their on staff pharmacists. Was suspecting because my drugs are so expensive (to say nothing of my killer co-pay for these) but thought "What the hell, never know, maybe they have advice or maybe might pick up on some possible bad drug interaction etc". Pharmacist calls and I can't believe it is an actual licensed pharmacist. JFC, I knew more about the drugs I was taking than she did. It was shocking. It was like talking to a pharmacist in some comedy where the pharmacist is a valley girl. :eek:
I'm still arguing with ours over a medication I was prescribed while on our cruise. First time in about 25 years I've had to file a claim (they've been filed directly by my pharmacy or the medical provider since the 90s). I very clearly stated on the claim form that this was on a cruise ship (multiple times, in fact), that I had provided them with copies of every piece of documentation that I was given, and that pharmaceutical options were limited because hello - cruise ship???

They paid 50% (instead of reimbursing up to my copay of $5-$15) because the medicine prescribed was not "the preferred medication" (ie, generic). Again - hello, cruise ship, limited options????? They also want me to include a signed form from the doctor with my appeal. Well, iirc, he was headed home to Spain after we docked. So yeah, I'll just pop on over there, find him, and get him to sign an excuse slip for me. :rolleyes:

Granted, it's not THAT much money compared to some drugs (8 pills at $12 per pill). It's the principal of the thing. I filled out everything they wanted, gave detail, and I don't think they saw anything but the drug name, and it was a NOPE, despite mitigating circumstances. :mad:
 

CycloneErik

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I'm still arguing with ours over a medication I was prescribed while on our cruise. First time in about 25 years I've had to file a claim (they've been filed directly by my pharmacy or the medical provider since the 90s). I very clearly stated on the claim form that this was on a cruise ship (multiple times, in fact), that I had provided them with copies of every piece of documentation that I was given, and that pharmaceutical options were limited because hello - cruise ship???

They paid 50% (instead of reimbursing up to my copay of $5-$15) because the medicine prescribed was not "the preferred medication" (ie, generic). Again - hello, cruise ship, limited options????? They also want me to include a signed form from the doctor with my appeal. Well, iirc, he was headed home to Spain after we docked. So yeah, I'll just pop on over there, find him, and get him to sign an excuse slip for me. :rolleyes:

Granted, it's not THAT much money compared to some drugs (8 pills at $12 per pill). It's the principal of the thing. I filled out everything they wanted, gave detail, and I don't think they saw anything but the drug name, and it was a NOPE, despite mitigating circumstances. :mad:

On the other hand, you have health insurance. I work two jobs for the privilege of having no health insurance and making less than I did as a TA (by thousands).
 

VeloClone

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I don't pay any medical bills until I get an Explanation of Benefits (EOB) from my insurance company so I can match up what the provider is charging and what the insurance company covered. Sometimes the provider squawks because they don't get the "payment due upon receipt", but I have never had good luck getting anything back without a long dragged out fight if overpaid.

There is one hospital in Des Moines that I am pretty sure I will die in an ambulance before I willingly go to because I made the mistake of giving them money on the way out the door one time even though we had insurance. We gave far less than what we would owe but they just applied it to one of the many bills and the bill was less than the total amount we paid that day. I kept asking them what happened to the other $200 and they claimed to be working on it as they sent us to collections.

#Mercyisthedevil
 

CycloneErik

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I realize that. We pay a pretty hefty premium for it as we're not yet Medicare eligible. I'm sorry if I offended.

You didn't. I just hate the insurance impossibilities.
Worked myself through a major health crisis this semester based off of accumulated knowledge and research skills, but there were medicines which could have helped make it much less severe.

It also made me realize yet again that some people don't have even those advantages, so they just end up dead for no reason.
 

ImJustKCClone

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You didn't. I just hate the insurance impossibilities.
Worked myself through a major health crisis this semester based off of accumulated knowledge and research skills, but there were medicines which could have helped make it much less severe.

It also made me realize yet again that some people don't have even those advantages, so they just end up dead for no reason.
I'm sorry you're dealing with that. I hope things improve for you in the future.
 
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JMA1125

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Googling shoulder impingement. :oops: Well, actually already knew a little because my Yankees Dellin Betances is on injury list with this.

Got a referral to see an orthopedic following exam by GP doctor today.

Also was dark out by 4:15 so, Miller Time (actually Dos Equis).
I had a shoulder impingement. It caused pain all down my arm and I originally thought it was an elbow issue until an ortho visit proved otherwise. Cortisone shots and PT didn’t help. What helped was chiropractic, but it took six months. I’m not a fan of chiropractors but I will say that my shoulder is finally better.
 
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CloneLawman

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Wherever I go, there I am.
I'm not an IRS guy. I work for the legal system and can get him disbarred, probably.

That being said, it's worth it. @CloneLawman - Do you prefer Venmo or Zelle? Maybe Bitcoin, like that time I paid you to hire me those mercenaries.
Venmo most definitely is my preference, but however you'd like to roll is fine with me. How did those mercs turn out for you?
 
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jcyclonee

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I do have this buddy, Croaker, who captains a group known as the Black Company. If you hire them, though, there may not be any Australia left.
I don't care. Get him on the line. If there's no Australia I still have my civil servant job and maybe the Kiwi king will abdicate without a fight.






Wait, do they have beaches with hot surfers in New Zealand?
 

CloneLawman

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And why would you? Do they even have enough staff left to respond to inquiries?
They have computers to kick out all sorts of spurious notices. I run into a lot of people who never question those notices and pay the amount shown. The notices are often wrong (in the Government's favor of course) so they dont concern themselves about being correct.
 
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VeloClone

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And why would you? Do they even have enough staff left to respond to inquiries?
Yeah, that is the math that always has me scratching my head. When it is something like for every $1 you spend on tax enforcement you get back some ridiculous amount like $10 of recovered revenue why would you ever decrease the budget?* Having adequate staffing would allow them to review some of those spurious notices that Lawman is talking about decreasing they bad pub.

*I know the answer why, but that is a political discussion for the cave...

I don't like paying for seed corn so I am going to only plant half as much seed in my fields this year.
 
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