lizard217.bsky.social

lizard217.bsky.social

@lizard217.bsky.social

124 followers252 following177 posts

The problem with Dems trying to use constituent pleas to change the mind of republicans, is that they have already sold their moral soul to a man who will never reward or thank them for it. Trying to appeal to the moral-less is a losing battle. They need to be reminded that Trump won't remember

their names (He probably doesn't even know them now) but the mother burying her child will. The family of the veteran who pulled the trigger because they cut his benefits will. The widow burying their spouse, because they cut his benefits will. The child starving in school because they cut their

food benefits will. What are they willing to be remembered for? That man does not care about anything but himself, and no amount of groveling via a vote will change that. They have sold their morality, for one deeply immoral man. And that is what their legacy will be.

I've been thinking about Star Wars lately. The Kylo Ren years. Thinking of the slimy general who we find out was secretly a mole for the rebellion. He was so stinking slimy that you still didn't like him even though he was a secret "good guy."

I wonder if it was revealed that there was a secret "good guy" today, would we feel the same? I've got my money on who it would be, and I think he'd still turn my stomach if we found out he was part of a secret resistance.

One of my staff just got a call from a recently famous health insurance company. We have been trying to help a patient fight a claim decision. The rep told us they have no record of the claim, and we need to just "submit it."

She explained that the claim had already been submitted, processed, paid, and applied to patient responsibility by said insurance company, so they must have record of it. If we resubmit it's just going to get denied as a duplicate. He said, "That doesn't matter." She explained that the

claim will NOT be adjusted unless THEY initiated a reprocess. Nothing is going to get fixed for the patient. The rep said, and I quote "At the end of the day it doesn't matter. It's not your money." I think I want to have this framed and put on the wall to perfectly describe American Healthcare.

Cannot WAIT for this article to come out. The amount of bogus denials we go through every year is ridiculous. The amount of Appeal denials that are obviously done via AI is ridiculous. Most recently, a patient was denied out of network. I appealed with a copy of the in-network notification

from her insurance company. They denied it again stating the patient has no out of network benefits. I appealed again stating that the issue is not the lack of benefits, the issue is we are not out of network. They denied again and set it to final appeal status which means I can no longer fight it.

Gave it to the patient to try and figure out. The amount of resources I have to deploy to investigate denied claims sometimes outweighs the reimbursement. I think they hope you will do a cost analysis and just give up.

A thread on the ridiculousness of working with insurance. Claim gets sent to insurance in October. Get a remittance TODAY denying the claim. Explanation essentially "You didn't give us the information we requested." Interesting. I've never received a request for information.

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about Providers having to be a credit bureau hits the nail on the head. The resources spent trying to locate the denial for this claim alone cost more than the claim payment we will receive. And that's their game. They hope you don't have the resources and will give up. THAT is why healthcare is

A thread on the ridiculousness of working with insurance. Claim gets sent to insurance in October. Get a remittance TODAY denying the claim. Explanation essentially "You didn't give us the information we requested." Interesting. I've never received a request for information.

View full thread

Since there was a payment made on this remittance (for other claims) I can actually view the remittance.I download it, and wouldn't ya know it, there is my claim with the message "We need the member to contact us to see if they have any other insurance." An hour. I spent

A thread on the ridiculousness of working with insurance. Claim gets sent to insurance in October. Get a remittance TODAY denying the claim. Explanation essentially "You didn't give us the information we requested." Interesting. I've never received a request for information.

View full thread

The View remittance button is greyed out with a note saying I can't view remittances for zero dollar payments. Cool. No other information about this claim anywhere for the patient on the insurance portal. Time to pick up the phone. Automated Claim details give me an electronic remittance

number for a bulk check that the claim is included in. I input this number into my system and itpulls up the remittance. Fantastic! I scour the remittance for the patient claim I'm looking for. Nada. I go back to the insurance portal, enter in the Electronic remittance number.

A thread on the ridiculousness of working with insurance. Claim gets sent to insurance in October. Get a remittance TODAY denying the claim. Explanation essentially "You didn't give us the information we requested." Interesting. I've never received a request for information.

Log into Insurance Portal, look up claim. Same reasoning, except it includes an added note, that I can find the information they want by logging into the Insurance Portal. I thought that's where I was, but okay. Another line that says I can access more details by viewing the remittance.

I want to post about followers too! I've been on X forever. Never post anything worth anything, usually just snarky replies, have zero followers. I've been on Blusky for a couple weeks, never post anything worth anything, just snarky replies and have 12 followers! My snark is appreciated over here!

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