SATURDAY — Navigating the billing maze

Sunday had only Taize’ in the evening; Monday SAIL exercise; Tuesday, started the morning by attending the final project presentations for Intermediate GIS, a class I used to teach.  Will do the same for the rest of the week.  This is the last week of classes for Winter Quarter, with finals next week and then Spring Break.  It snowed some this morning, but was all clear by the time I got out of class, so I came home and got John and we went back to town for lunch and to Yakima to pick up a package sent from Arkansas to the Wal*Mart store there.  It is a neat inverter to provide an electrical outlet  (AC) from the cigarette lighter (DC) in the car.  It was about half the price anywhere else.  While there we put a few gallons of gas in the Subaru, and took a run through Costco.  There is always something there new and interesting.  That’s part of Costco’s business plan – they want you to go often so you don’t miss special things and they hope you will buy other stuff while there.  They may only have an item once and when sold out it is never seen again.  John found a small bag of “fingerling” potatoes from Colorado. There are several colors and they are about the size of medium dog-do.

http://www.mvproduce.com/

I have been frustratingly busy the rest of the afternoon dealing with billings from medical providers, Medicare, and the insurance company.  This is a constant struggle.  It raised my blood pressure this afternoon trying to figure why the same service is charged at different rates ( John and me) at the eye doctor and at the Heart Center (me on two occasions for an identical service).  Makes NO sense.  The deductibles are a challenge too.  One time last month I was told the Group Health deductibles started Oct 1 instead of Jan 1.  Today that was reversed by a different agent.  Medicare pays some things and Group Health picks up some, sometimes, and not others.  Go figure.    I’m still confused, frustrated, and ticked off.  I will check tomorrow with the actual doctor’s office accountant and then call back Medicare and Group Health for interpretations.  For us, the medical care providers (doctors, nurses, and technicians) have been fantastic.  The government is involved so the billing, paying, and paper work is unbelievably cumbersome.  It reminds one of the saying “I’m from the government, and I’m here to help.”  This was one of Ronald Reagan’s favorite sayings.

http://politicalhumor.about.com/cs/quotethis/a/reaganquotes.htm

Tonight was playing & singing music with The Connections (a religious group) at Hearthstone.  Now I’m coming home at 8:00 p.m. to eat and to head to bed sooner than normal because of another early morning at CWU.

Wednesday.  Today is our neighbor’s 85th birthday so tonight we are going to a party. First, there is the class at school, and then SAIL exercise at 1:30, too bad I don’t have something at noon.  Actually I came home and worked on talking to the insurance company about conflicting things with my medical bills.  Most of it revolved around required deductibles needing met ($250 for each of us).  Yesterday I had actually found an error with one of the bills and will be refunded $17.39.  After my exercise class I stayed with two other gals and played 4 games of pool.  I haven’t played pool in over 40 years.  It was fun and we will be doing that again, I’m sure.  Came on home and spent the time on the phone again before going to the party about another bill for me for my care in 2010.  One thing I found and still cannot explain is an $80 charge that I owe nothing on but for which Medicare paid $142.  That sounds fishy and strange and no one could explain it.  I haven’t received an accounting from Medicare yet for that, so will wait to see.  Then I questioned a June 2010 time at the hospital for my ICD implant.  The total paid was over $10,000 for everything from the surgery to using the surgery room, the recovery room, pharmacy, and supplies.  All were paid except for two pharmacy charges.  The response was that those are drugs (self-administered) that Medicare won’t cover.  Well, nothing can be self-administered in a hospital, and so I cannot imagine what it might be.  It is over $130 that I owe, and it is not covered by my supplemental insurance either.  Gee whiz; WHY?  So I noticed that Medicare had paid the bill and Group Health had paid nothing.  I called to ask and was told to pay the bill from the hospital and then get on line and download a form to fill in and submit for their review of the meds that were not covered, and that “possibly” Group Health would reconsider and pay.  Okay– I’ll play the game, but WHY?  What’s the sense of having supplementary insurance if they don’t pick up a small part that Medicare doesn’t.  $130 is a pittance when you consider the $10,000 Medicare paid.  This whole system is crazy, but I will continue to question.  It pays off often enough to make it worthwhile.

Another thing I found out this morning was that my eye doctor billed Medicare for $142.00 for the same thing John had done for $30, on the same day with the same doctor.  Also, they charged a separate $44.00 for “refraction” which neither Medicare nor Group Health would pay.  Turns out that means a charge for providing a prescription for glasses, neither of us needed.  I don’t because I have intraocular lens giving me 20/20 vision, and John’s current glasses were fine.  The “refraction” part was tacked on without discussion – apparently it always has been, and been paid for when Group Health was the primary payer.  Now they are “secondary” and Medicare is “primary” and nobody pays.  Go figure!  So it seems to us this is a “stealth” charge in the eye exam.  John’s was accidentally left off, but mine was there.  Attention to detail?  Something is not right with this picture!  We have decided NOT to have a refraction done next time we have an eye exam if it will be charged above the exam fee (already $154), and I have also decided I’m not going in for an eye exam until I have some concern with my eyesight.

Friday.  John got up early and checked for news via the Internet and learned of the earthquake in Japan — awful news.  We don’t have a working antenna for the TV so we watched live “feeds” on the BBC on the Internet.  I left early for two hours of final presentations for Intermediate GIS.  There were 23 reports starting Tuesday this week, and I enjoyed being a part of it–more so this year than last when I was still very weak, using a walker and John had to drive me.  Both other events for the day were cancelled, so I have the afternoon free to catch up on bill paying and organizing.  Thus far half the afternoon is gone and I have been emailing the entire time.   John got a nap, so that’s good.   I never did.  He fixed us a great dinner, and I did complete some of the things on my list of to-dos.  Now I’m tired, and ready for bed, but it’s only 8:00 p.m.  Thank goodness tomorrow is not an early start day.

Saturday.  Today is only playing music at Briarwood Retirement Community, but, they will feed us something at the end at 3:00 p.m. — strange time and one that matters at home for both lunch and supper, but that’s the schedule.  We play from a little before 2:00 till 3:00.

Saturday.  We have spent about an hour so far this morning following the events in Japan from the earthquakes and tsunami. Most folks are unaware that a similar event is possible along our Washington State coast although the WA coast is less populated.  There was a 9.1 quake (the Japan one is said to be 8.9) on January 26, 1700 at about 9 p.m. that shows up here in the physical landscape and was documented by written reports of a tsunami (then of unknown origin) in Japan. A summary is here:

http://en.wikipedia.org/wiki/1700_Cascadia_earthquake

Longer materials are here:

http://pubs.usgs.gov/pp/pp1707/

This is called “the Orphan Tsunami” and the materials are very large files so don’t click on any of the downloads unless you have a broadband connection.  The link above shows the cover illustration and lists all the parts of the book.  Part 3, near the bottom of the listed items is most relevant to the evidence from WA’s coast.

The National Geographic folks have produced a television episode about this to be shown this Sunday:

http://channel.nationalgeographic.com/episode/mega-quake-5563/Overview

Maybe we can find someone to visit where we can watch.

Suppose I will stop this now and give to John to put on the blog.

Hope you all have a good week.

Best regards from Nancy & John and all the critters.