Government run health care

[Edwina's Secretary]

Please explain that sentence.

I am sitting here, stunned.

And give me an example-I'm stripping my brain thinking about this.

With all those years in healthcare? How can you not understand...

Doctors over prescribe things like antibiotics...creating superbugs.

Unstunned now?

And why can't you just ask her what she means? Why do you have to be so snarky? And people say I'm nasty...geez...

[Grace]

If you have the time, check out how doctors bill the gov't. and how long they wait to get paid for YOUR visit.
YOU get immediate satisfaction for your treatment and the poor MD has to wait for money from BO and his ilk.

I get these statements from Medicare - they pay first. Then I get statements from my secondary insurance. I really can't believe the amount of time that passes between visit and final payment. No wonder some doctors get fed up and don't want to deal with Medicare.

I also see what Medicare will pay for diabetic supplies. Not near enough to reimburse my supplier.

HOWEVER, Richard, the money does not come from the President, be it Obama, Bush, Clinton. All this was in place long before any of them even thought of becoming president. Remember, LBJ - back in 1965. Why I bet you were just a young whipper-snapper back then?

[RICHARD]

I get these statements from Medicare - they pay first. Then I get statements from my secondary insurance. I really can't believe the amount of time that passes between visit and final payment. No wonder some doctors get fed up and don't want to deal with Medicare.

I also see what Medicare will pay for diabetic supplies. Not near enough to reimburse my supplier.

HOWEVER, Richard, the money does not come from the President, be it Obama, Bush, Clinton. All this was in place long before any of them even thought of becoming president. Remember, LBJ - back in 1965. Why I bet you were just a young whipper-snapper back then?

Don't you comment about my whipper snapper! LOLOLOL,
I know the money doesn't come from the Presidents.

I was making that statement as a slam about how slow the gov't. moves when it comes to billing. You know by now I am a little confused about how things work.

[Grace]

Don't you comment about my whipper snapper! LOLOLOL,

I'll do my best to avoid that subject from now on

[Edwina's Secretary]

I recently had a phone call from a medical facility - NOT the government - a provider. Wanted to know what they should do with an overpayment my husband made....

over 12 months ago.

You should also check out how long doctors wait for payment from private insurance companies.

Had a letter recently from a provider...my insurer was taking so long to pay they wanted me to ante up. Very threatening.

Private insurers are slow pay as well.

[Marigold2]

I have a moment so yes I will try and answer your question as best as I can.
What I meant by mental or physical is that if a person has a mental issue such as depression which can come about through a physical condition or a tramatic incident I don't feel it is a proper time to have a child until one is healed. If one is bi-polar and this disease is not stabilized on medicine it is not fair in my opinion to bring a child into this world when one is mentally stressed and having problems. The same can be said in my opinion for schizophrenia if the condition is to the point that you cannot function and take care of yourself then no I don't believe you should have a child until you are able to take care of yourself.
Also if you have a physical condition that keeps you from taking care of yourself such as cancer, heart disease or a thousand others I don't think it is fair to bring a child into this world if you probably won't be around to raise said child or be healthy enough to spend time with them.
It is not up to the grandparents to raise the child, they did their job and they are getting older and will have health issues. It is not fair for grandma who is 68 to have to raise a 14 year old with welfare money and social security.
Yes people lose their jobs, people get cancer, have car accidents, fall of the roof, lose an arm or a leg to accidents. I am not talking about those things. I am talking about people who decide to have a child when they are unable to take care of themselves and know that the chance of ever being able to take care of themselves is slim. I am talking about people who are on welfare for gererations. Welfare was designed for short term care to help people get training and get back on their feet. It should be there to help and there are many who deserve it and also deserve more money then what the government gives them so they can live a decent life and not feel deprived because they fought for our country and lost their eyesight or a limb.
And there are those that decide to have another child so they can stay on welfare longer and food stamps.
Again if one is on welfare or medicaid I think you have to look deep inside and ask yourself if having a child is the right thing to do today, tomorrrow and years from now. If the need to be with a child is so great perhaps being a foster mom or a big brother or a favorite aunt or uncle, working in a day care or reading to sick children in a hospital can be just as for forfilling in the long run.
So I hope that answers your question and if not well it's how I feel and that is that.

In post 14 I asked for an answer/explanation to/of this statement, and I'm still waiting. You dropped out of sight in your own thread and left it for others to give it a new life and direction.
Out of sight - out of mind????? I'm not that easily distracted.

[Marigold2]

It can take over a year for private insurance companies to pay and in some cases two years. I fight with them all the time, it's part of my job. Often it is a mistake on the patients part, they didn't have the right insurance card, or the receptionist or billers fault as they didn't enter the data correct or submit correct or it could be the processing company, the electronic biller or just the insurance company having some fun with you. I send patients bills that are two years old because that is how long it took for us to get the claim paid after fighing to get the correct insurance card from said patient, submitting it once, then again and again and doing an appeal. Such fun, can't even tell you. Finally after 19 months they pay $6.53, the rest went toward your deductable and now I am sending you a bill for $235.78. If you have a question please feel free to call your insurance company, what you mean you haven't done that yet? Well...................................

I recently had a phone call from a medical facility - NOT the government - a provider. Wanted to know what they should do with an overpayment my husband made....

over 12 months ago.

You should also check out how long doctors wait for payment from private insurance companies.

Had a letter recently from a provider...my insurer was taking so long to pay they wanted me to ante up. Very threatening.

Private insurers are slow pay as well.

[Edwina's Secretary]

I was talking with a neighbor. She worked at United for over 30 years. She did all different jobs. She was a flight attendant, worked the ticket counter - even did lost luggage.

She could tell all sorts of stories about working at United.

She didn't know so much about other airlines.

However, I would not consider her an authority on how to fix a jet engine. Or fly a plane. Or run an airlines.

Just because someone worked in or for an industry does not make them an expert on or about that industry!

Opps! Forgot the required snarky remark..."I have to laugh here!"

[Marigold2]

You are correct, Medicare does pay fast and they pay well. Better then most insurances. That is why Dr's love it. Also on Medicare you have one year to file a claim with Anthem or Blue Cross you have 6 months, with United Health Care I believe it's 90 days.
As for those dreaded secondary insurances, someone has to send the Explaninton of Benefits from the primary usually Medicare to them on paper, sometimes if we are busy 5 or 6 months can go by before we get to some. It is not the insurance company that holds it up it is the Dr's office. The secondary sometimes only pay $5.00 or $6.00 so it isn't on the top of our list to do. We are trying to get the surgery claims out first that is where the big bucks are.
Dr's are not so fond of Medicaid or Wellcare or Caresource as they are very hard to collect form and they pay very little.
Where Medicare might pay $100.00 for an office visit, Caresource will only pay $20.00 for same visit. A Dr cannot run an office with mostly Caresource patients, he would be in the hole. No Dr will work for $20.00 an hour nor should they.

I get these statements from Medicare - they pay first. Then I get statements from my secondary insurance. I really can't believe the amount of time that passes between visit and final payment. No wonder some doctors get fed up and don't want to deal with Medicare.

I also see what Medicare will pay for diabetic supplies. Not near enough to reimburse my supplier.

HOWEVER, Richard, the money does not come from the President, be it Obama, Bush, Clinton. All this was in place long before any of them even thought of becoming president. Remember, LBJ - back in 1965. Why I bet you were just a young whipper-snapper back then?

[Edwina's Secretary]

That would help explain it...when we first moved to California five years ago I went looking for doctors here. I could not understand why so many of them said they were only accepting new patients who were on Medicare.

It was confusing to me at the time....

[Grace]

You are correct, Medicare does pay fast and they pay well. Better then most insurances. That is why Dr's love it. Also on Medicare you have one year to file a claim with Anthem or Blue Cross you have 6 months, with United Health Care I believe it's 90 days.
As for those dreaded secondary insurances, someone has to send the Explaninton of Benefits from the primary usually Medicare to them on paper, sometimes if we are busy 5 or 6 months can go by before we get to some. It is not the insurance company that holds it up it is the Dr's office. The secondary sometimes only pay $5.00 or $6.00 so it isn't on the top of our list to do. We are trying to get the surgery claims out first that is where the big bucks are.
Dr's are not so fond of Medicaid or Wellcare or Caresource as they are very hard to collect form and they pay very little.
Where Medicare might pay $100.00 for an office visit, Caresource will only pay $20.00 for same visit. A Dr cannot run an office with mostly Caresource patients, he would be in the hole. No Dr will work for $20.00 an hour nor should they.

I think you misread my post. I did not state that Medicare paid fast, nor do they pay well. I also stated that I now understand why some physicians will not take Medicare patients.

Medicare takes it own sweet time; then my backup takes over. My backup insurance is fantastic - it's the same thing I had when I was working.

And did you not see where I said this - I also see what Medicare will pay for diabetic supplies. Not near enough to reimburse my supplier.


Before I turned 65, my private insurance would pay pretty much all my diabetic supplies. Medicare is a disgrace as far as supplies go.

And don't even get me started on Medicare prescription drugs. We both have insurance that covers prescriptions, and both of them are far better than Medicare.

[Edwina's Secretary]

Then why would doctors only want Medicare patients?

Sincerely asking....

[Grace]

Then why would doctors only want Medicare patients?

Sincerely asking....

Is this addressed to me? I didn't say that all doctors take Medicare, nor do all doctors refuse Medicare patients. I have read that doctors refuse to take Medicare patients because of the time involved, and reimbursements. Why some doctors seek Medicare patients - I have no idea.

For example (and this isn't about doctors, but supplies) - I purchase strips to use with my meter, to test my blood glucose. I buy 100 strips, that cost $100. However, Medicare will only reimburse the supply company $53.94 of that $100. So who is paying balance of $46.06? My secondary pays part, but the rest is lost. So the medical supply company has to eat the loss.

[Edwina's Secretary]

But that is true with "private" insurance as well. My Explanation of Benefits show the "full price", the discount price my carrier has negotiated, the amount they will pay and what I must pay.

The difference and there is always a difference - is "lost" as you say.

When I see my PCP doctor my copay is a percent of what the insurance covers. As the doctor does not know how much this is...I pay nothing at the time. My doctor send the bill to the insurance company - they decide what they will pay - send that back to my doctor and them he must send me a bill for my percent of the bill.

I have tried to pay something at the doctor's office but it cannot be done that way. I must wait...and so must my doctor!

[Grace]

But that is true with "private" insurance as well. My Explanation of Benefits show the "full price", the discount price my carrier has negotiated, the amount they will pay and what I must pay.

The difference and there is always a difference - is "lost" as you say.

When I see my PCP doctor my copay is a percent of what the insurance covers. As the doctor does not know how much this is...I pay nothing at the time. My doctor send the bill to the insurance company - they decide what they will pay - send that back to my doctor and them he must send me a bill for my percent of the bill.

I have tried to pay something at the doctor's office but it cannot be done that way. I must wait...and so must my doctor!

Before I went on Medicare, my copay was always the same amount. My husband, who is not on Medicare, continues to pay the exact same amount for copay each visit. It's written into our policy.

What you describe, is the way it is for me now, with Medicare. The copay may vary from one visit to another.

Interesting.