Preferred Homecare

Preventing and Solving Medical Billing Errors

2010-05-18T22:41:00.002-04:00

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 Some common problems with billing are outdated insurance cards,incorrect insurance cards, failure to obtain pre-certification, failure to supply secondary insurance and not being familiar with your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 The most common and number one cause of billing problems is an outdated insurance card.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 In addition, people often change jobs, so, you can understand how easy it is to use an outdated insurance card.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

2010-05-18T22:31:00.000-04:00

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
845-675-7870

Why Organic?

2009-02-26T12:34:00.018-05:00

Why organic? Why not organic? Eating grassfed versus conventionally grown foods should not be a hard decision. Choosing to eat clean and healthy protein is essential to our well being and necessary for the prevention of disease. Organic foods are foods that are grown without synthetic chemical pesticides or fertilizers.

Pesticides are systemic, which means they are inside and outside of fruits and vegetables. No matter what you spray your fruits and vegetables with and no matter how many times you wash them, they will still contain pesticides. A healthier choice would be to eat organic fruits and vegetables where pesticides are not used. Instead they use bugs that eat other bugs and are not considered harmful.

Some things are more important to buy than others. Certain fruits and vegetables need less fertilizer or certain fruits have tougher skins than others and absorb fewer pesticides, while others are sprayed with more and absorb more making it difficult to entirely wash off this deadly agent. Pesticides are well known as one of the "foods that kill".

Buying organic food is just a good way of easing your mind over the concerns of drugs, hormones, additives and synthetics in the meat sold in supermarkets. Your children, starting from birth as well as your entire family should be eating organic food. You can never put a price on good health, and we all know good health is vital.

Organically grown chickens are raised in Pennsylvania Amish country on family farms. These organic chicken are free range, and have plenty of room to roam and live "stress free" lives. These chickens are free of antibiotics and are fed a natural diet, which makes a huge difference in the way they taste. They are constantly being moved from one spot to another and the area is raked and the waste used as fertilizer. This prevents the chicken from eating it's own waste.

I read an article in the "fear factor" by Laurie Tarkan, about the cruel way chickens are treated. They wrote about the conventional chicken found in supermarkets, how they are mass produced and of negligible health value. The chicken are injected with hormones and antibiotics and they get so fat their little legs cannot carry them to water for a drink and many of them die young.

They are not free range and are raised in extremely cramped quarters where they can barely move. They are transported in over- crowded cages where they have to eat and defecate all in the same place. Their beaks are cut off so they cannot peck at one another and cause damage. All of this creates stress in the commercial chicken that can lead to disease changing the taste and total health value. These chicken are clearly unhealthy for consumption.

You want to eat organic chicken that has the USDA(United States Agriculture Department) stamp of approval, certifying that the meat is 100% certified organic. The chicken is certified by both the New York and Pennsylvania certifying organizations. You might have to spend a little more money but it is worth knowing you are eating healthy, delicious, clean protien.

There is an article on "Healthy Eating", which lists "the most important foods to buy organically". They are: baby food, strawberries, rice, oats, milk, bell peppers, bananas, green beans, peaches and apples. Why organic? Why not organic?

Vilma Vaccaro
Preferred Homecare Plus
99 Main Street, Suite 106,
Nyack, NY 10960
845-675-7870

Alzheimer's vs Dementia

2009-01-22T17:35:00.052-05:00

When does forgetfulness become something more.....When do Alzheimer's and dementia become evident....when do they become part of the picture???? As we become older, many of us will have problems with our memory, this is normal, it is part of the aging process. But, going for a walk and not remembering or knowing where you are going is not normal and becomes cause for concern.

As Alzhiemer's progresses memory loss and the inability to make decisions occur. Alzheimer's disease is the most common form of dementia. Dementia is a term used to describe a number of brain disorders. Alzheimer's disease is a nuerological disorder, a progressive disease of the nervous system. The person will start failing to recognize familiar people and places. Preparing meals becomes difficult, losing things and getting lost occurs more frequently.

They are cognitively aware that something is dreadfully wrong, but they don't want anyone to know they can't comprehend anymore for fear they will be abandoned, so, they remain silent and become withdrawn and depressed. Depression is one of the first signs of Alzheimer's disease, and sleeping most of the time is another.

Alzheimer's disease affects the parts of the brain that control the thought, memory, and language, and usually begins at 60. They begin to have spacial problems, when watching T.V., they feel that what is going on in the T.V. is going on in the room. Rugs, they feel like they are going to fall into a hole.

Memory goes back in time, they see themselves in the mirror and don't recognize themselves. They see themselves as 21 years old. They continually repeat stories and/or ask the same question over and over. Alzheimer's is a 2 victim disease, loved ones grieving all the time for the person that used to be there, but is not there anymore. Unfortunately, in the Severe stages institutionalization becomes necessary.

I attended an Alzheimer's convention and the speaker mentioned that Alzheimer's disease is caused by plaque in the brain, the cause is unknown. Doctors and nutritionist say the best way to eat is the Mediteranian style. This diet consists of extra virgin olive oil, yogart, plenty of fruit and vegetable, fish, hummus, and not too much red meat. Excercise at least three times a week and keep the brain actively busy. Read, learn a new language, play an instrument, challenge your mind. This information was very helpful to me, I hope it will be as helpful to you.

Vilma vaccaro

Preferred Homecare Plus

845-675-7870

What every family caregiver should know about Respite Care

2008-12-11T20:42:00.096-05:00

If you are a caregiver for a family member, than you know the cost of love. You are most likely...... using vacation time to care for a loved one when help is not available, missing your childrens important school functions and activities, having to leave work early, and arriving late. More times than not, family caregivers have to pass up opportunities for advancement they've worked a lifetime for because they cannot make a committment. There is no time to take care of their own needs and they are tired all the time. Most importantly, less time becomes available to spend with spouse, relationships become jeopardized.

Caring for a family member who is ill or frail can become a 24 hour a day job, usually neglecting your own needs and health. The caregiver becomes drained by the ongoing, every day, responsibility of delivering care, yet, feels an obligation to continue. Caregivers are at an increased risk for becoming depressed and stressed. Anxiety levels rise and as a result the caregiver may subconciously express and verbalize feelings of resentment towards their loved one.

Respite means taking a much needed break or rest from caring for a family member, who cannot care for themselves, before stress and anxiety occur. Respite is the primary mechanism a family caregiver has from the everyday, ongoing, never ending, sometimes,unrewarding job of caring for a family member 24/7. It has been estimated that caregivers provide an average of anywhere between 15-20 hours of care per week in addition to trying to hold on to a job and caring for family.

Respite provides relief from the overwhelming and tiresome task of caring for a loved one who is ill or has special needs. The family caregiver becomes resentful and the family member feels like a burden and therefore experiences guilt feelings, which most often can lead to depression. With respite, caregivers can have a more optimistic outlook about their ability to continue providing care because they were able to have some time for themselves..

Respite care can delay institutionalization of a loved one, thus, eliminating quilt feelings which are often associated with this seemingly selfish act of desperation. Caregivers are overcome by this desperate, helpless, hopeless feeling that it can only get worst and feel their only alternative or way out is institutionalizing the family member. Even though we really know deep down inside that our family members prefer the familiarity of their own home to being institutionalized.

What every caregiver giver wants and and needs the most is respite relief or a break from the everyday chore of caring for a family member. Studies have proven the value of respite to caregivers and their loved ones, it is quaranteed to take the edge off your tension. Respite benefits both the caregiver and the family member by renewing energy levels, reducing tension and strengthening relationships.

While on respite, spend time with family enjoying activities that had to be put aside. Spend time with spouse making up for lost precious moments and try to restore an almost lost relationship. Take a relaxing bubble bath, watch a movie, get a relaxing massage, take a warm soothing bubble bath or just do nothing. Whatever you do on respite make sure it reduces tension and stress and makes you happy.

Many homecare agencies and Assisted living facilities offer respite services for a fee, certain organizations will give you a few hours or sometimes days free of charge. If you have any questions or need more information, please feel free to call me or e-mail me at "info@preferredhomecareplus.com .

Vilma Vaccaro

Preferred Homecare Plus

845-675-7870

Home care vs Home health

2008-11-29T19:46:00.002-05:00

Have you ever wondered what the difference is between home care and home health, companions vs health aides? They are two types of support services you can receive in your own home. They sound similar but are actually two very different services. Home health care is ordered by the physician, usually at the time of discharge, following a hospital admission. It is medically focused and it is covered by Medicare and and other insurances.

Home health care is usually short term, is prescribed as follow up care or to monitor a health problem. It usually involves both a visiting nurse and home health aide. The nurse will assist the patient with changing bandages, monitoring a wound, assessing blood pressure and monitoring glucose levels. The physician writes what is called doctors orders at time of discharge and the skilled care nurse carries them out.

The home health aide assists the patient with their activities of daily living(ADL's), prepares and serves meals, medication reminders and is only there for about three-four hours a day, two-three days a week. Home health is controlled by insurances and are usually short term.

Homecare is not ordered by the physician and is not covered by insurance. It is considered a non-medical homecare service or custodial care. Homecare services are usually paid out of pocket or through a private insurance.

Companion/homemakers assist the adult or elderly population, needing minimal assistance so they can remain at home. Home care is an alternative to Assisted living facilities and Nursing homes. Afterall, we all know "There is no place like home".

Services include, cooking, cleaning, grocery shopping, caring for personal laundry, errands, transporting clients to doctor appointments, hair/nail salons, medication reminders, walks, conversation and companionship. These are just a few of the services provided by home care companions.

Respite relief is available for those family members who are caring for a loved one and need to take a break or time off. Home care services can either be long term ot short term, from a few days to indefinitely. You are assigned two caregivers, one for everyday and the other as a back up.

Whether you choose Home care or Home health, make sure the workers are bonded, have insurance, have background screenings and drug test performed and have references checked. Ask to meet the caregiver prior to services being rendered, find out some information about them by asking questions.

You want an agency that supervises and monitors their workers, provides quality homecare and has quality assurance checks performed on an ongoing basis. Make a list of your needs and then decide whether you need home care or home health.

Vilma Vaccaro
Preferred Homecare Plus
845-675-7870

Preferred Homecare

2008-10-29T15:58:00.000-04:00

This is my blog about the healthcare industry.