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bigplay

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Everything posted by bigplay

  1. Missing or incorrect provider numbers has been a long standing battle with Drs and hospitals. Sometimes its the software vendors issues sometimes it the insurance company or Medicaid software issues. What you see on your screen is not always what is submitted. Years ago, I found an issue with an HBO software product whereby Medical Records recorded the patients death properly, but the software billed the claim as a transferred patient. The billing code for deceased was 20, the transfer code was 2. The software was dropping the 0. What happened, the hospitals received a partial payment fo
  2. If they are applying for insurance, then they don't qualify for Medicaid. Medicaid expansion has occurred in various different forms. They have expanded for children whose parents couldn't afford health insurance, it has expanded for women with jobs but are within 200% of the poverty line, it has expanded for families within 250% of the poverty line but are employed. Basically, Obamacare was designed to ratchet down these expansions and force insurers to provide a coverage to families that is all encompassing. So rather than putting them on Medicaid, they put them on Humana or Kaiser, but
  3. Expanded Medicaid would have helped some, but as I mentioned, some of them just don't have the proper patient population to stay afloat. Plus many are poorly managed. The best result would be for the nearest large regional hospital to take these over, assess the staff, refurbish the facilities to provide the appropriate level of care needed for the community. Now to do this requires cash. The large regional hospitals may feel the outlay is not worth it. I won't suggest subsidies here, but if a community is steadfast on having a hospital than municipal bonds may need to be floated to conv
  4. You make solid points that I agree with. The one I don't is the complexity of Medicaid. When it comes to billing, all payor types have their own idiosyncrasies. Insurance companies are a pain in the ass on upfront documentation. "Referred to as medical necessity". Medicare maybe the simplest to process, but the issue with Medicare is they are always tweaking the system, so hospitals and Drs need to stay on top of billing changes. Medicaid is not much different than Medicare, but with a couple blips in the system. 1-they employ many of the lowest trained folks in the country. Why, many were
  5. Sorry you are incorrect. Medicaid in the traditional form still exists. Some states have gone to HMO models, but many have not. There are still thousands of Medicaid employees processing these claims. Though I would not say they are totally competent doing so, but they employed to do so. As for the physician, billing costs can be minimized if they were properly trained. A physician is a business owner. Any profitable business owner needs to manage their business well to make money. If they can't do this then they should go to work for someone else. That's why you are seeing more physi
  6. Oh yeah, I forgot to adrdress issues related to insurance companies and drug companies. Drug companies are the biggest crooks in the world. Until recently, they paid physicians to push there drugs. So many of you have probably been over prescribed for years because of this relationship between Drs and Drug companies. Talk about a lack of integrity. Insurance companies are run by a bunch of pencil pushing geeks who nowadays are required to meet certain risk assessments on their balance sheet. Of course these risk assessments are developed by actuaries who have no clue how healthcare works
  7. Ok, I am a former hospital controller so I understand many of the comments here. Obamacare has its good and bad like many have said. One of the key components to the bill is the requirement to enroll for the insurance. Hospitals really pushed for this piece. Why, those hospital bills that run $50,000, but payment is only $6,000 are the result of years and years of bad debts, which forced the hospitals to continuously raise their charges. The raised charges are only paid by insurance companies who pay the hospitals on a percentage of charges basis. This is a very small percentage of their b
  8. The closest range I know of is in Marietta. You can hit and putt at Creekside.
  9. Sorry ahead of time, but don't forget the finger li??ing good Husband commercial. Ok I know. The door was open and couple beers made me do it.
  10. A few years, I took my son to opening day Braves game. They had a silent auction and I got a great John Smoltz autographed jersey framed and all. Man, I was really excited, until I carried that thing to my Volvo C70 in the light misty rain. The Braves wrapped it good, so no rain damage. It didn't fit in the trunk or through the door. My son looks at me and says now what. I go, we might have a wet ride home. I then lowered the convertible top and he is mortified. Luckily, once the top was down, I was able to wedge it in the backseat and still put the top back up. That would have been a mes
  11. Grew up in Michigan and a local restuarant would specialize in Muskrat! Believe it or not it wasn't bad.
  12. Hey folks! I know most of us hate asking each other to buy kids related fund raiser stuff. I am as bad as anybody. So why am I posting, I know some of you guys/gals actually like the discount cards that various organizations sell. This year the South baseball team is selling the cards, but with a twist. The card interacts with a mobile phone app, so if you don't have the card you can still use the discount. Yep, no more, dang I forgot that stupid card. Obviously if you have no interest stop reading now, but below is the list of advertisers on this years card Good for Multiple Visits unt
  13. Enjoy this one. My wife don't fly but just maybe to visit she would. http://healthypets.mercola.com/sites/healthypets/archive/2014/11/06/lanai-animal-rescue-center.aspx
  14. Hey BubbaDoo! The packaging is simply a reassurance to patrons that the chicken was not marinated and/or coated with any gluten products. All fresh meat is gluten free, but once you marinate, glaze, fry or obviously bread, gluten is usually contained in the added ingredients. Simply saying it is a fresh chicken doesn't always reassure the Glutenites that they can consume without itching or running to the bathroom.
  15. bigplay

    Daytona

    So dropped off the wife in Daytona to spend time with family. Wifey is a hotel princess, so had to find something outrageously reasonable. Raceweek prices crazy. Normally Hilton, Marriott , etc. Well found a local place that I can recommend. Ok, before I give the name I will say, if you are looking for the prom queen stop reading. If you are looking for a great date this is the place. Perrys Ocean Edge Resort. If you google their website, the pictures are totally accurate. It is an older complex, but well kept up. Our room looked exactly like the pictures. Great for families with younger ki
  16. An novel item I found years ago Hawaiian Lei Company. Fairly inexpensive last for a good bit. Of course the jokes buy a lei to get a lay. Buy a bag of the loose orchids and keep them in the fridge for those days she could use a little sweet smell to brighten her day. Worked for me.
  17. I did the Michigan trip to LA via south route 35 years ago. Don't ask the the names of the roads. I did the night driving 40 hours straight. We hit Arizona at sunrise. Wow! Oh yeah, this was to watch Michigan vs Washington Rose Bowl. Said screw it, gave up my tickets to watch WOMEN go to the beach in Manhattan Beach! Drinking San Miguel beer, still not sure who won. On the way back, we did the Vegas stop. Picked up another frat brother. He says, I have $20 bucks. We laugh, then he asks, I need to keep $5. Again we laugh. We get to Vegas, check in a hotel/casino, again who rem
  18. Ok, I have traveled to San Fran numerous times, but I was working closer to Santa Cruz. Plus I have worked between LA and San Diego. Here are a couple restaurants I would suggest. South of Santa Cruz in the city Capitola - Paradise Beach Grille San Clemente - The Sugar Shack, or Rose's Sugar Shack These are two I always stop at, when I am in town. Have fun. There will be some awesome views. Oops, the Holiday Inn Express in Monterey is a quaint place. If you are into a little after dinner entertainment, Sly McFly's in Monterey has some great bands and quite often they have an
  19. I talked to the emissions guy next door and he said most of the staff is the same, but new owners. He said breakfast was good. Second hand, so who knows.
  20. Congrats to the Ohi cheerleader trampling Buckeyes. http://espn.go.com/blog/ncfnation/post/_/id/107459/lets-go-o-h-i-as-buckeyes-enter-the-field-final-flag-does-not
  21. County development has been a crazy bull that no one can ride. At one point, there was a moratorium on all residential building. I assume the moratorium was eventually lifted, but not real sure it ever was. Past boards changed various types of housing codes. These boards go farther back than the current crew. There has always been the debate about sewer no sewer. I really don't think anybody knows what to do and how to do it. Simply a mess. If any families are impacted by this situation, then someone better step up and do the right thing.
  22. Can't argue with the facts and logic. Since I was a club seat holder already, I can say I liked the option to purchase SEC champ tickets, NCAA Final Four etc. My buddy had them too and turned a good bit of profit over the course of the years selling the tickets. Especially to the crazy Bama fans. Personally, I sold them to friends at face value. Why, most of my friends can't afford scalped tickets so once I made the decision to sell at face, I was not gonna sell at higher prices to friends who could afford higher prices. Friends are friends. PSLs are a way of paying for the stadium,
  23. After reviewing terms again, I believe the PSL prices are actually more than reasonable given they are a 30 year investment which at some point will appreciate. I still have a problem with the ticket prices. People buying these club seats will be able to purchase concert tickets and more then sell those tickets for a profit. Since I am a horse racing gambling bum I can provide an example. Churchill Downs sold PSLs for the majority of their clubhouse and prime grandstand seats. Ticket brokers in turn pay the PSL owners for access to their Derby tickets. The same will happen for concerts
  24. I have had club seats for the last 6-8 years and this was my last year on my contract. Each seat cost about $2500 and tickets for the games were included in that number. Game ticket face value was $165 I think. So 10 * 165= $1650 so I paid roughly $850 a year for the equivalent PSL. So taking $850/year times 30 (the lease term) = $25,500. Hence the PSL is not outrageously priced. The biggest issue is the price of the ticket. $353 or so. They are doubling this costs which stinks. Glad I am out.
  25. I need to know which Walmart and is this scam limited to once a day or is it 24 hours. That last minute shopping may take a while.
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