Partial U.S. Government shutdown

[RICHARD]

I don't think the paper BS is just from the government. I'm guilty of having generated plenty of it while working for health insurance companies. They can't spend time caring for patients because there is so much administrative work to do. Phone calls, letters, reports, documentation. I could go on and on. It's just a mess.

My upstairs neighbor is having a total knee replacement, I'm not exactly sure when. Her surgeon is a maverick. He doesn't accept insurance, he doesn't accept Medicare. He only takes patients who are willing to pay upfront. This is what the fee is, take it or leave it. He's also really good, so he can get away with it. You pay the fee (in full, before you go to the OR), you submit the documentation to your insurance(s), and they do their thing. If that doesn't work for you, here's a list of surgeons in the practice who accept Medicare and/or insurance. The hospital where he operates takes Medicare and most insurances. I asked my neighbor's husband what happens if the doctor makes a mistake and she ends up needing more care? Who pays then? He promised to find out for me.

The paperwork must get done. I know, I made and pushed 30 years worth.

The government BS is DRGs.

I have done this before but everyone needs to know this.

A Diagnosis Related Group/ICD are codes assigned to illnesses that the government standardizes. The hospital bill according to those codes. Each code has an assigned average as to how many days a patient, with that illness, can stay in the hospital.

If you have an appendectomy the hospital bills for two days, If you get peritonitis, you get more time, but it that peritonitis is really bad, they have to code another illness to make sure they make money on that stay. Otherwise, they lose money.

The doctor signs an attestation saying that his diagnosis and other stuff is correct and the forms that I remember had the "This needs to be correct our we are going to fine you......."

The doc is under the gun to make 'sure' you are out of the hospital no longer than deemed necessary. The hospitals lean heavily on them to get people out. (I remember seeing people being discharged, then coming back in to the hospital a few days later, to start a new billing for their sickness, all because the docs could not keep them in the hospital.)

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At one point, physicians were asked not order tests, as a cost saving measure. One doctor leaked the memo and people were very upset with that news.

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Knee replacements? Holy poop!

Some Ortho surgeries are a scam.

Our hospital deemed it a good thing to rent all the drills and saws. When one broke, we had to send it out to be fixed and the 'salesperson' would bring a replacement in and charge for the repair of the tool, bringing in a new one and bringing the repaired implement back.

Do not talk about the cost of pins, screws and rods. Suture sales people are also scammers.

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Look at your next hospital bill and ASK FOR A DETAILED BILL.

These days a hospital charges on an "average admission".

A computer tracks all the supplies for an admitting diagnosis and prints out a 'pick list' as to what they assume you will need.

So, If you deliver a baby and go home in a few hours? You will be billed for the supplies that the use on average for a delivery.....




So, the influx of 50 million people, into a system that is barely slogging along, is very disconcerting and not a very good idea.

[Bonny]

The paperwork must get done. I know, I made and pushed 30 years worth.

The government BS is DRGs.

I have done this before but everyone needs to know this.

A Diagnosis Related Group/ICD are codes assigned to illnesses that the government standardizes. The hospital bill according to those codes. Each code has an assigned average as to how many days a patient, with that illness, can stay in the hospital.

If you have an appendectomy the hospital bills for two days, If you get peritonitis, you get more time, but it that peritonitis is really bad, they have to code another illness to make sure they make money on that stay. Otherwise, they lose money.

The doctor signs an attestation saying that his diagnosis and other stuff is correct and the forms that I remember had the "This needs to be correct our we are going to fine you......."

The doc is under the gun to make 'sure' you are out of the hospital no longer than deemed necessary. The hospitals lean heavily on them to get people out. (I remember seeing people being discharged, then coming back in to the hospital a few days later, to start a new billing for their sickness, all because the docs could not keep them in the hospital.)

--------------

At one point, physicians were asked not order tests, as a cost saving measure. One doctor leaked the memo and people were very upset with that news.

---------------


Knee replacements? Holy poop!

Some Ortho surgeries are a scam.

Our hospital deemed it a good thing to rent all the drills and saws. When one broke, we had to send it out to be fixed and the 'salesperson' would bring a replacement in and charge for the repair of the tool, bringing in a new one and bringing the repaired implement back.

Do not talk about the cost of pins, screws and rods. Suture sales people are also scammers.

--------------------

Look at your next hospital bill and ASK FOR A DETAILED BILL.

These days a hospital charges on an "average admission".

A computer tracks all the supplies for an admitting diagnosis and prints out a 'pick list' as to what they assume you will need.

So, If you deliver a baby and go home in a few hours? You will be billed for the supplies that the use on average for a delivery.....




So, the influx of 50 million people, into a system that is barely slogging along, is very disconcerting and not a very good idea.

You mention the government standardizes what goes down as how far the doctor can go treating a patient with codes, is this for people who don't have any insurance? We have a supplement insurance along with medicare. I have seen where the hospital must of overcharged & ended up writing if off.

[Lady's Human]

What truly amazes me in all this is that people have allowed the Federal Government so much control and influence in their day to day lives that this is a crisis.

The Federal Government was never supposed to be the overarching solution to people's problems in the United States, but rather a solution of last resort. When the Government taking a few days off is a crisis, we really need to look deeply into the problem, and get beyond the hysteria.

Had the Senate and the House been able to do their Constitutionally mandated job and pass a budget without the hyper-partisan poison pills that BOTH sides immerse into the legislation, we wouldn't be here.

NO BUDGET for 4 years is an unacceptable situation. There shouldn't have to be any continuing resolutions, shouldn't have to be constant debt increase crises, but both sides prefer to score political points rather than enact a semi-permanent solution.

Unless most of the Congressional incumbents fail to win reelection, they've proven that the voters of this nation are fools. As it is, they have single digit approval ratings, but a 90%+ reelection rate. The proof is in the election results. As a nation, we're irate with the status quo when polled, but we're too damned lazy to DO anything about it.

[RICHARD]

MOFF,

I was watching a little TV before I went to bed and, because the cable system was being worked on, I got to watch some guy talking about the healthcare act and how it affected a University Hospital here in the state.

He said that because of the HCI, the hospital was looking into having a primary physician do PHONE INTERVIEWS with their patients.

I don't know how much I put into a hearsay 'report' like that, but I thought about you and this scenario popped into my head.....

A robocall a few days before your 'phone appointment'?

"You are scheduled to speak to your primary physician on Oct. 12, The will contact you between the hours of 8 am and 6 pm. Please be available during those hours on Oct 12. If you need to cancel or change your appointment, please all the automated system at 1 800 555 1213 at least three days before your appointment....."

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Bonny,

The ICD 10 and DRG codes are a standard that everyone uses to code illnesses and surgical procedures. EVERY doctor visit and hospital stay is coded and that info is reported to the government.

Those numbers are used for reporting to the CDC, to figure out what kinds of illnesses are on the rise/decline, what codes need to be revised, average hospital stays.........It's a giant numbers gathering system that is used in every way possible.

If you are concerned about the 'numbers' the government keeps on you, with the electronic medical record, that info will be available to them faster and more accurately.

The EMR is another disaster that no one wants to talk about.

Back in the mid 90s the idea of an EMR - for individual hospitals and providers- was shopped around.

It was touted as a faster, cleaner and paperless way to keep records. Buy a system, get rid of the paper, file clerks and train a nurse to be a data entry clerk....

So software companies rushed out to sell systems to physicians/clinics and med centers.

Two problems, the old paper charts needed to be scanned into a patient's charts or you keep the old paper chart until that patient leaves your system. A new patient with paper charts, needs to either get his chart to go to a new physician or the new phys has to get the old chart, himself.

The next problem?

Because each system is owned by a company and the codes are proprietary? The do not 'talk' to each other.
So, if a system was purchased, you must update it to meet the requirements of the universal EMR.

More money for the companies that are rewriting the codes to meet the new requirements - your records need to be available across the new system.

So, physicians, med centers and clinics have to shell out more money to meet the requirements of the HCI.

ALL PROVIDERS/CLINICS/HOSPITALS NEED TO BE ON A EMR SYSTEM W/IN 5 YEARS.

That way, all your medical info will be available on-line by the year 2017.

[momoffuzzyfaces]

One problem I have encountered recently is just because the dr tells you to come back for a recheck in 3 months that's not a good enough reason for them to see you.

My dr likes to see me every three months to keep on top of my blood pressure and arthrities and stuff. Last time I called the receptionists asked why I needed to see him. When I said he told me to come back I was told that was not a good enough reason to see him.

so, I just rambled off my entire list of ailments but still only got to see his nurse practioner.

[blue]

Un staffed National parks now closed and guarded, National Parks website no longer updated, road side views of Rushmore also closed, Amber Alert System shut down.

Lock em all out.

[RICHARD]

Un staffed National parks now closed and guarded, National Parks website no longer updated, road side views of Rushmore also closed, Amber Alert System shut down.

Lock em all out.

So, what is the difference between right this second and the usual government?

Nothing gets done anyway?