April 21, 2011

EOB = Explaining our Bull**** (I have many more)

    (Disclaimer) Health care is such a hot topic button right now.  I truly do not know which side of the argument I am on as I see faults and benefits to both.  Do we need reform?  Most definitely I just don't think there's a proposal out there yet that isn't too far one way or the other.  I have very little knowledge outside of personal experiences and those of friends.  I honestly can say I am not 100% against socialized medicine.  It absolutely baffles my mind the amount of people I know personally without health insurance ~ and these are not people on welfare or without full-time jobs!  I have a friend who lives in Canada so my info comes from her experience with socialized medicine.  She had no complaints whatsoever.  Waiting for an appointment is par for the course but she also impressed on me that they don't run to the doctor for every little ache and pain like Americans do.  If there is an emergency she gets in immediately.  She knows all her doctors and gets to see who she likes.  She also got paid to stay home when her children were born AND housekeeping was provided for the first 6 weeks.   With all of that being said onto my happy relationship with Blue Cross Blue Shield of Florida.
EOB= Expenses on Bren

     In November of  2007 we had a car accident and there were massive medical bills that followed.  Law suits were filed and all medical bills including BCBS were paid (oh did they take a mighty chunk).
I mention this because it seems that here now in 2011 BCBS believes that my stroke is related to a car accident and therefore are denying payment on all bills.  Yes I've heard that shopping in BJ's is very similar to a car accident when it comes to where your stroke occurred.  ARE YOU KIDDING ME???? In what reality does this even make sense??

EOB= Economic Opportunity BLOCKED

     The 10 day stay at the BCBS approved Orange Park Medical Center was just shy of 100K.   The hospital would like to know when they can expect payment.  I spoke with the billing office explaining that there was an error with BCBS gave them the name of the person I spoke with.  This was not enough for this person she wanted a 10% down payment which she would be happy to refund once they received monies from BCBS.....uh how about just my co-pay?  Well she couldn't be sure if BCBS would approve everything from THIS bill.  THIS bill are there others? 

EOB= Eyeing Our Bottom-line

     Well don't you know there are others.  They aren't exactly from OPMC but from their contracted doctors and providers.  This is the new way to get around "everything" being included in your hospital benefits co-pay.  Now we've had these before (Patrick racked up 30 days of hospital stay in 2006/2007) but never to the extent like this.  As far as I know the 3 MRI's I had occurred within OPMC.  Granted I can't share much about those first few days but I think I'd remember going somewhere.  Well they are within the hospital but in the X-RAY wing.  3 more co-pays. Plus the doctor who read them have their own co-pays as well. (they each billed $150 ~ my share is $75, BCBS paid $0.38 and the $74.62 gets written off!)
EOB= Enemy's Order of Battle 

    Most of us have had experience when it comes to doctors bills during a hospital visit.  You know the ones from a doctor you barely remember seeing who has just charged you $200 for his few minutes of time.  You are going to love this.  I received a bill, well no I haven't received the bill yet just the EOB, for $518 from a Dr. Diaz.  Have no clue who this man is.  I'm pretty confident you're sitting down but just in case you're not please do.  The EOB states "Benefits are provided for diagnostic and treatment services as specified in your benefit brochure. (Here if comes) Benefits are NOT AVAILABLE FOR TELEHEALTH SCREENING OR ASSESSMENT SERVICES."  Do you even have a clue what that means?  I sure didn't.  Hello BCBS ~~ Liset was so nice.  Even she couldn't figure out what was what and gave me the number of both the referring doctor and Dr. Diaz.   Well no wonder I couldn't find the man when I googled him.... HE'S FROM MIAMI!!  Can someone please explain to me why a doctor from OP who has access to what is called the Medical Corridor of the SouthEast right in his area code consult someone in Miami?  There are 88 neurologists right here in Jacksonville!!  The University of Florida/Shands hospital has 6 different departments with Neuro in their title.  Well it gets better.  Seems I was billed over $500 for what amounted to a skype session.  They apparently brought a TV in my room with a camera so the doctor could sit in his house in Miami and assess me.  This was done on Sunday morning and I have absolutely no memory of it but can assure you the conversation was one way. 

EOB= End of Bren

2 comments:

  1. Bren, funny you blogged about this today, I have been on the soap box,Here our autistic kids were entitled to "free" medical insurance, known as Arizona long term care, having an autistic son & granddaughter, this was of great comfort, well our Republican Governor,honestly, I don't have a party, I go with the best for the job ticket,decided to sign a bill that SOME of the autistic kids, will get coverage and some won't BECAUSE we NEED to cut things, well let me tell you special needs & mental health, AZ is not the place to expcet good coverage, good services or anything else,I will be blogging soon about this, and your blog was very nicely put!

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  2. With all of the things getting cut how is it that public officials never cut anything that personally effects them? I challenege the Congress to change their pension plan... talk about waste. In what other position do you only have to work 4 years to be fully invested for retirement?
    Kim It will be curious to see how they draw this line in the sand!

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