Tuesday, May 18, 2010

Preventing and Solving Medical Billing Errors

Basic information you should know on preventing and solving billing errors

Have you ever had a bad experience with a hospital bill and just didn't know how to fix it? Didn't you wish you were more knowledgeable in this area so that it could have been resolved easier? Some common problems with billing are outdated insurance cards,incorrect insurance cards, failure to obtain pre-certification, failure to supply secondary insurance and not being familiar with your benefits. All these are legitimate causes for billing errors. The most common and number one cause of billing problems is an outdated insurance card. Health care benefit plans are constantly being changed, revised and procedures often being updated. In addition, people often change jobs, so, you can understand how easy it is to use an outdated insurance card. When you receive a new insurance card, throw away the old one by destroying it first, and be sure to replace it with the new card immediately.

Failure by the consumer or the physicians office to obtain pre-certification before a procedure or an admission into the hospital is another common reason for billing problems. If approval is not obtained prior to procedures or admission into a hospital, insurance companies will not pay for services already rendered. Usually 24 hours notice to insurance companies is the designated time frame necessary for pre-certification.The phone number is located in the back of every insurance card.

If you are covered by more than one insurance carrier make sure you give the provider all important and relevant information. This often applies to the elderly population who have Medicare plus a supplemental insurance or secondary insurance. In addition to their primary insurance, patients can also be covered by their spouse's insurance. Some secondary insurances are B/C & B/S, AARP or a miscellaneous insurance. Be sure to present this information prior to any services, procedures or hospital admissions, so that you will be billed accurately.

Be familiar with your benefits plan, it could be difficult and confusing to understand what procedures you are covered for. Consumers need to read the manual associated with the benefit plan thoroughly. Be aware of terms such as "medically necessary" and "exclusions". If you are elderly and need assistance, have one of your children help you or a friend. If you are still having difficulty understanding the benefits, or if you are an employee, call the benefits department or go to the employees benefits manager for clarification.

Read all bills as you receive them and keep records of all your bills. If you notice a problem, call the billing department of your insurance carrier immediately. If you have been billed incorrectly or have been denied coverage, you have the right to appeal the decision and must receive an answer within 90 days. If you receive a bill from the hospital and it is a "self pay bill" or the secondary insurance information is missing, contact the hospitals billing department immediately and furnish them with the correct information.

Consumers can also experience confusion over multiple bills they receive during a single hospital stay. Expect to receive a bill from each provider--such as the admitting physician as well as the primary physician, consulting physician, emergency department, radiologist, and the list can go on. Get acquainted with the physicians that treat you while in the hospital. Write their names and specialty on a pad, then when the bills arrive, there will be less confusement.

Here are some pointers on how to prevent billing problems:

*Make sure your bill is indeed a bill and not an EOB (explanation of benefits).

*Always pay your bill to prevent your name from being turned over for collection and possibly having your credit ruined.

*Keep and file all bills, receipts, invoices, copies of check in chronological order and always be sure to get the names of every person you speak with.

* Carefully read billing statements from doctors, hospitals and insurance companies. Don't assume the insurance carrier will take care of it.

*Call immediately if you notice a billing error has been made, or if you don't understand the bill.

*Make sure you get the name and phone numbers of all the people you speak with in hospitals, doctors billing office and insurance companies.

*Be persistent, there is a time frame for answering disputes.

Declaring War on Obesity

Saturday, May 23, 2009
Declaring War on Obesity

Most health care professionals agree that men with more tha 25 percent body fat and women with more than 30 percent body fat are considered obese. Nowadays when you go to the doctor for a physical they check your Body Mass Index (BMI). The BMI is an accurate measurement of your overall fitness. BMI calculates your weight in kilograms divided by the square of your height in meters. BMI determines whether or not you are obese.

Body fat distribution is a major concern in the health care profession as well as how much is being distributed. Excess abdominal body fat is a major risk factor for disease. When fat accumulates in women around their hips they have a "pear shape" appearance. In men the fat accumulates mainly in their bellies and have an "apple shape" appearance. Look up "diseases of the abdomen , associated with obesity" in the internet. You won't want to overeat anymore.

Obesity occurs when a peron is consuming more calories than the body is burning off. Do you know you only need enough fuel to get you to your next meal. A person should not eat until they are stuffed and cannot breath or move. Eat slow, don't fill your plates with huge portions of food, take small portions at one time and before filling up your plate again, evaluate whether you are still hungry or not. You should always leave the table still a bit hungry, eventually your stomach will shrink and be able to only hold small amounts of food. Try it, it really works, Declare War on Obesity!

Obesity tends to run in families today because parents teach their children all the wrong eating habits or just do not teach their childen how to make smart and healthy eating choices while they are young. Instead obese parents share with their children lifestyle habits that contribute to obesity. The saddest thing to see besides an obese adult is an obese child. Mothers, teach your children how to make smart healthy eating choices while they are young and still growing.

I have seen obese children on television and have heard their stories about how they hated their lives growing up. The peer pressure was unbearable, they were made fun of because of the sizes of their lunch boxes and lunch. They spoke about being lonely because no one wanted to hang around with them. Romantic Relationships were few and far apart and most often for all the wrong reasons. No one asked them to the prom because they were embarrassed to be seen together. What a way to rememer your childhood, what a memory to have to live with, what a sad way for a child to grow up. It dosen't end there, you go through the same vicious cycle as an adult and it is worst because the bigger you get, the bigger you look. Declare war on Obesity!

Being obese has many disadvantages as we all know. We may have a closet full of clothing but nothing fits us anymore or we don't like the way it looks nor the way the bulges hang out. Obese people are not permitted to go on amusement park rides, must be a certain weight, can't go on elevators because they can only hold so much weight, can't go on an airplane because it can only hold so much weight. Can't fit into certain cars and not too many people want you in their car, for fear they might get a flat tire and or side will be tilted because of all the weight shift on one side.

If you become ill and have to be admitted into the hospital, you might have a abd experience. A special overweight bed will have to be ordered. When you need to be transported anywhere an emergency team of about 4-5 staff members will have to be uttilized or the test will have to be performed at the bedside. You will have difficulty performing activities of daily living by yourself and would need some assistance with activities of daily living, something to think about. And the list goes on and on and on, and we keep getting bigger and bigger and bigger. Declare War on Obesity! There is this quote I always use, because I live by it and I grew up by it, "It is not our fault the way we were raised, but it is our fault the way we turn out".

There are so many programs out there for us to get help if we are obese or on the way to becoming obese and want to end the war. Sometimes we just loose control of our eating habits and feel we are too far gone and there is no help for us, not true. Declare War on Obesity! Go into the internet and look up "The Ph Factor and the battle of the bulge, a good way to start is by reading up on obesity. If you feel you are losing control or have lost control, there is always "Weight Watchers" and it could be for life if you want it to be.

Weight Watchers is a safe scientifically proven measured way of losing weight at a safe rate and reaching your estimated goal and keeping it off. You not only lose weight but learn to eat healthy and make smart choices for daily living and eating. Those fast diets don't work, they are not realistic and not always safe.

Another smart way to go is the "Mediterranean diet, eating fruits and vegetable and less meat, low caloric foods and eating in moderation. Whatever method you choose to lose weight, and keep it off, make sure it is a wise and healthy way and works for you. Remember, whatever way you choose to lose weight you must first consult with your primary physician and seek his approval, very important. Remember always "Declare War on Obesity!" Become a Winner!

Vilma Vaccaro
Preferred Homecare Plus
99 Main St, Suite 106,
Nyack NY 10960