Ellen Million (ellenmillion) wrote,
Ellen Million
ellenmillion

Fridaily



  • I approved the second digital proofs of the new coloring books today - I got the first round about 10 days ago, and decided it needed one tweak. I should get the physical proofs in a few days, then we can do actual printing, horrah! I am hopeful (but not holding my breath) to have them on hand when I re-open the webpage.

  • I managed to overcome one of the major coding hurdles I was working on yesterday, and the interlinking is becoming more and more seamless. A few tweaks still to make, and some work on the credits/karma handling, but we're into things I'm *comfortable* with, so it should go quickly from here. I think I've leveled up again this week.

  • If it is not raining tomorrow, I will be doing a few hours of chalkpainting in the park with Liz and Jennie (and others?)!

  • Catie is crowdfunding her next novella for moving expenses

  • On the TV front, I'm almost finished with Buffy, and Jake and I are enjoying the cheese that is Roswell. I adore Netflix streaming. I don't think I will ever watch broadcast TV* again - even just the Stanley Cup (go Hawks!) was enough to make me appalled all over again with commercials.

  • Dance rehearsal last night was silly and fun, though I wasn't in a particularly silly or fun mood. Still sore, but my endurance is definitely improving.

  • Reminder! Torn World's Muse Fusion is next Tuesday, and EMG's Sketch Fest is Fri-Sat!

    I did a pile of invoicing, bills and miscellanea today, mostly for house and health things. One of the things that came over my desk was a statement from the insurance company which about gave me a heart attack - a bill for a surgery assistant was set at $5100, and the insurance company said they'd only pay about $1400, which sticks me with $3700. As we'd made our deductible (loooong since) and hit our out-of-pocket cap, this was a $3700 surprise that we weren't really prepared to deal with. I called the surgeon and explained the situation, desperately hoping that they'd billed something using the wrong code or something else easily fixable. "Oh," they explained to me, "you don't owe that, don't worry - that's how we bill these things."

    See, each insurance company has a different idea of what is reasonable and customary for a surgery assistant. The standard operating (pun not intended) procedure of medical offices is to bill them the full total for a surgeon, accept whatever the insurance company will pay, and the adjust the remaining bill so I only have to pay $50.

    Now, $50 is a helluva lot better than $3700, and I was obviously very relieved and hung up the phone feeling mollified.

    But on reflection... does that seem BROKEN to you? Rather than setting a standard price for a necessary service, they charge whatever the market (in this case, an insurance company) will pay - then add $50. Now, first of all, I'm paying for insurance to cover exactly this kind of thing. We pay a lot for our insurance and it's very good. Once I've hit my cap, why should I pay ANOTHER $50 - not because that's what it cost, but because they know they can charge that?

    And doesn't this feel like a reason that insurance companies are struggling so badly? Because they're being charged the moon for services. So, the burden is on them to figure out what's normal and customary, and basically a patient is just along for the ride. Seriously. The Torn World licensing system feels reasonable compared to this.

    I had another rant I was going to rant about - about being afraid - but that will have to wait until another day.


    *With the obvious exception of PBS.
  • Subscribe
    • Post a new comment

      Error

      Anonymous comments are disabled in this journal

      default userpic

      Your reply will be screened

      Your IP address will be recorded 

    • 5 comments