cellio: (lilac)
Monica ([personal profile] cellio) wrote2004-05-28 06:44 pm

quickies

Is my health-insurance provider the Wall-Mart of the medical world, or are conventional rates really that wacky? I got a statement from them today (from a recent doctor visit) that said things like "[some test], provider's fee $92.50, our allowance $17.47, you owe $0". While that line-item was the most extreme, for most items the "fee" was about three times the "allowance". Does this mean that the insurance company is gouging doctors so much that they end up stiffing the uninsured, because it's fiscally fatal to not accept insurance, or what?

Even though I park in a garage at home and under a bridge at work, the trees have been having mad tree-sex and dumping the output all over my car. (Thanks [livejournal.com profile] amergina for that imagry.) How do they do that? I don't find myself covered in pollen just from walking down the street, so I don't think there's enough "just in the air" to do this.

The person I was supposed to go to services with tomorrow (at Chabad) called to say she has a cold and is going to stay home. Lunch is still on, but services will have to wait for another time. Oh well.

Earlier in the day we talked about logistics. Their services start at 10; ours end at about 11, so I proposed walking down the street and joining them in progress. (We have a new torah reader tomorrow and I want to be there for him.) This is perfectly normal in the Orthodox world, by the way -- not like Reform, and not like churches. Orthodox morning services, in my limited experience, are over 3 hours, so this seemed logical to me -- I figured I'd get there about the time they hit barchu, or at worst the beginning of the amidah. She said if I got there by about 11:15, I'd catch the start of the torah reading. !! She said they're usually done around 12:15 or 12:30.

The congregational meeting was last night. My name was mentioned several more times than I expected it to, and people commented on it. These mentions included one from my rabbi, who ackowledged about a dozen people individually starting with me. Wow! (Oddly, I heard three different pronunciations of my name; obviously not everyone speaking actually knows me well. :-) )

[identity profile] ginamariewade.livejournal.com 2004-05-28 04:10 pm (UTC)(link)
Is my health-insurance provider the Wall-Mart of the medical world, or are conventional rates really that wacky? I got a statement from them today (from a recent doctor visit) that said things like "[some test], provider's fee %92.50, our allowance $17.47, you owe $0". While that line-item was the most extreme, for most items the "fee" was about three times the "allowance". Does this mean that the insurance company is gouging doctors so much that they end up stiffing the uninsured, because it's fiscally fatal to not accept insurance, or what?

I think there's some kind of formula where the insurance pays only a percentage of what the doctor charges, and so the doctor charges 3-4x what they actually think is the going rate so that they'll get full payment from the insurance company.
A lot of doctors will offer a cash discount to the uninsured, that if you pay up front, you only have to pay half or a third of the going rate.

It's a mess, and just further proof that we need a single-payer health insurance system NOW.
geekosaur: orange tabby with head canted 90 degrees, giving impression of "maybe it'll make more sense if I look at it this way?" (Default)

[personal profile] geekosaur 2004-05-28 05:29 pm (UTC)(link)
Quickly (actually I'm a few minutes late...) --- my understanding is that this is correct, the numbers quoted to the insurance companies are artificially high because the insurance companies will only pay some small fraction of it, so doctors have to overclaim to get anything. It's an absolute mess. (Although [livejournal.com profile] lefkowitzga will probably have the last word on it after Shabbat. :)

[identity profile] ichur72.livejournal.com 2004-05-29 06:50 pm (UTC)(link)
I sympathize re: the pollen. It gets really bad in Atlanta in the spring, to the point where there are actually miniature drifts of yellow dust blowing all over the sidewalk. All I can say is thank G-d for Claritin!

On another front, my experience with Chabad services (and with many other Orthodox minyanim) is that the shaliach tzibbur will go through the preliminary stuff & psukei d'zimrah at a very zippy pace, so it doesn't surprise me to hear that they would get all the way to the Torah reading in just over an hour. My husband and I occasionally go to a minyan that starts at 9:30, and it usually finishes in just about 2 hours.

[identity profile] ichur72.livejournal.com 2004-05-31 09:30 am (UTC)(link)
I guess I'm lucky -- I'm fine with Claritin, Allegra and Zyrtec all. My only limitation seems to be that I can't take the -D versions of these drugs for more than a few in a row -- after 3-4 days of Claritin-D, I begin to feel slightly unhinged. Gotta love that pseudoephedrine. :P

I wish I didn't have to take allergy drugs, but I'm much better off if I do. My spring allergies tend to take the form not of sneezing and such, but rather of feeling feverish and ill, and I do prefer to avoid that.