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Post by howard lee on Sept 12, 2024 6:48:02 GMT -5
Good morning.
Another day of retirement. Paperwork I didn't do yesterday, laundry, a long walk.
Retirees here who are on Medicare: Do you get statements from Medicare about payments to health professionals that were either not approved, or that amounted to way less than than the approveed amount, informing you on what you may owe, even with your supplemental plan? I just received a statement from Medicare citing several doctor visits I had over the summer. Don't you love the alphabetic code they use for reasons? I hadn't really anticipated something like this. My deductible for the year has been met, if that means anything here. The form also informs me that additional charges have been submitted to my supplemental plan, so might that have happened, been paid out, and this mail is just the Fed being way behind, time-wise?
Wishing everyone a less confusing morning than mine.
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Post by kenlarsson on Sept 12, 2024 7:14:20 GMT -5
Good morning. I can't speak to medicare issues. Tricare covers anything medicare doesn't in my case.
Woke up to back spasms this morning. Over did yesterdays exercise routine. Things are settling down after some stretching so we'll see how the rest of the day goes.
Have good ones folks.
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Post by Cornflake on Sept 12, 2024 7:21:42 GMT -5
Good morning. Howard, I also get those, but I've never been asked to pay that "amount I may owe." I don't understand it either.
It's in the 70s here and almost cool, which is welcome. Since this is the desert, and we get big temperature swings between day and night, it'll be hot in mid-afternoon. It should be pretty pleasant all morning. I'll have my Zoom social meeting and a run for groceries.
All's well. Enjoy your day.
It took me a while to get any traction in Wordle. Wordle 1,181 5/6*
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Post by drlj on Sept 12, 2024 7:30:06 GMT -5
I am awake again. This happens every morning!
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Post by howard lee on Sept 12, 2024 7:48:49 GMT -5
Good morning. Howard, I also get those, but I've never been asked to pay that "amount I may owe." I don't understand it either. It's in the 70s here and almost cool, which is welcome. Since this is the desert, and we get big temperature swings between day and night, it'll be hot in mid-afternoon. It should be pretty pleasant all morning. I'll have my Zoom social meeting and a run for groceries. All's well. Enjoy your day. It took me a while to get any traction in Wordle. Wordle 1,181 5/6* ⬜🟨⬜⬜⬜ ⬜🟩🟩⬜⬜ ⬜🟩🟩🟩⬜ 🟩🟩🟩🟩⬜ 🟩🟩🟩🟩🟩
Don, I think it's just a delayed action from Medicare. As a Federal gov't agency, Medicare is running at the back of the pack. The statement also indicates that the extra charges had been submitted to my supplemental insurer. Some of the office visits date back to June. I have gotten one or two bills from the providers for charges not paid out, but most of the charges have been covered.
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Post by Rob Hanesworth on Sept 12, 2024 8:06:42 GMT -5
I am awake again. This happens every morning! If some morning it doesn't, be sure to let us know. |
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Dub
Administrator
I'm gettin' so the past is the only thing I can remember.
Posts: 20,471 
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Post by Dub on Sept 12, 2024 8:10:22 GMT -5
I’ve assumed everyone on Medicare gets those statements. I switched mine to electronic form only.
Medicare is always the “first payer” for any claims. Since claimants May or may not have supplemental coverage and those supplemental policies vary greatly, Medicare makes no assumptions and doesn’t track what any supplemental policy may cover. The private carrier tracks those things and we get yet another statement from them. I also opt to get my supplemental statement electronically.
I think I’ve had to pay some leftover amount twice in the last seventeen years. Once was under five dollars and the other was fifty or sixty dollars on a $20,000 claim.
If you ever need to pay anything, “they have ways” of letting you know. They don’t rely on your reading the statements and reacting to them.
At least these have been my experiences.
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Dub
Administrator
I'm gettin' so the past is the only thing I can remember.
Posts: 20,471
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Post by Dub on Sept 12, 2024 8:11:21 GMT -5
I am awake again. This happens every morning! There may be a song in there somewhere. |
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Post by Marty on Sept 12, 2024 8:28:43 GMT -5
I am awake again. This happens every morning! There may be a song in there somewhere. Every morning when I wake up if I don't smell candles and white lily I thumb through a copy of Playboy to get my heart started and then get up. Red Skelton. |
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Post by factorychef on Sept 12, 2024 8:31:39 GMT -5
3 people I personally know in Vinton have come down with a bad case of covid. There are more cases then that here. Watch out!
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Post by Hobson on Sept 12, 2024 8:32:22 GMT -5
Howard, do pay attention to the reason why something wasn't paid. It could be a wrong coding by the provider's office. In all the years that Mr. H has had Medicare and I have been reviewing his claims, I think there has only been one time when that happened to him. He had his first ever colonoscopy and the doctor's billing department indicated that it was due to symptoms. No symptoms, purely routine. I have messed up a couple of times and agreed to getting vaccinations at the doctor's office. Don't do that. If it's covered under Part D, your drug policy will only pay for covered providers, which does not include doctors.
When we have had a payment problem, the people at Medicare have been very professional and efficient. Yes, really.
I have also had several instances of Medicare fraud, which I caught myself because nobody knows what's real except me. I reported every one of them by phone. Quite a process, but I ended up with a new Medicare number.
Dub's explanation is good. Also, even if you get paper statements, you can log on and download the electronic version. Before long you'll learn how to read those things. I keep a spreadsheet for dates, what was billed to Medicare, what they allow, what they paid, copays, deductible, what our supplemental insurance covered, etc. Of course, vision care and dental are mostly not covered at all by Medicare and usually won't even show up on Medicare statements.
Speaking of such things, 2 appointments for Mr. H and 1 for me today. I need to get moving so we can get our walk done, have a light breakfast, shower, etc.
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Tamarack
Administrator
Ancient Citizen
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Post by Tamarack on Sept 12, 2024 8:34:46 GMT -5
Yikes! Several people I know around here have gotten COVID recently, not serious - just felt shitty for a few days. Time for COVID boosters.
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Post by howard lee on Sept 12, 2024 8:37:40 GMT -5
Howard, do pay attention to the reason why something wasn't paid. It could be a wrong coding by the provider's office. In all the years that Mr. H has had Medicare and I have been reviewing his claims, I think there has only been one time when that happened to him. He had his first ever colonoscopy and the doctor's billing department indicated that it was due to symptoms. No symptoms, purely routine. I have messed up a couple of times and agreed to getting vaccinations at the doctor's office. Don't do that. If it's covered under Part D, your drug policy will only pay for covered providers, which does not include doctors. When we have had a payment problem, the people at Medicare have been very professional and efficient. Yes, really. I have also had several instances of Medicare fraud, which I caught myself because nobody knows what's real except me. I reported every one of them by phone. Quite a process, but I ended up with a new Medicare number. Dub's explanation is good. Also, even if you get paper statements, you can log on and download the electronic version. Before long you'll learn how to read those things. I keep a spreadsheet for dates, what was billed to Medicare, what they allow, what they paid, copays, deductible, what our supplemental insurance covered, etc. Of course, vision care and dental are mostly not covered at all by Medicare and usually won't even show up on Medicare statements. Speaking of such things, 2 appointments for Mr. H and 1 for me today. I need to get moving so we can get our walk done, have a light breakfast, shower, etc.
Thank you, Renée. I appreciate your taking the time to explain this. You too, Mark! And thanks to drlj, who texted me a little while ago.
I think I get the gist here, and my wife has been dealing with this for her parents (now 97 and still sharp as tacks!) for a few years, so I'll remain vigilant and do close reads of these documents.
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Tamarack
Administrator
Ancient Citizen
Posts: 9,557
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Post by Tamarack on Sept 12, 2024 8:42:33 GMT -5
A pleasant, albeit dry, September morning.
All summer we have be saying "We'll do that in September". September is here. There is a line in a Stan Rogers song "So this won't be barren ground, when September rolls around". There is a lot of barren ground on our 1/10th acre spread, so I will be seeding so that new grass will contrast with the crabgrass. Then there is the bathroom to be painted, old carpet to be ripped up, hardwood floors to be refinished, and stuff to be moved to storage. All of this before daughter and granddaughter move in in early October.
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Post by Marty on Sept 12, 2024 8:54:56 GMT -5
Good morning.
60F-85F sunny.
It will be another nice day that I will spend inside. We did sit on the neighbors deck last night and play Farkle. Shawn made wonderful drinks using a plum syrup he made from the tree that grows right outside my side door. Until he moved in that tree just dropped little green plums all over the place, the birds liked it, I hated it. Now he gathers every plum before it falls.
As of yesterday I have a Gibson LG-2 to work on. It needs a new bridge plate and a cracked bridge fixed. This is due to Gibson incorrectly placing the bridge plate in the first place. They put it so far forward that the back end just barely covers the pin holes. With no support for the string balls they just cracked the plate and pulled right through the plate and top bearing on the bridge and cracking it. I will carefully remove the old plate to use as a template and when I make the new one will shorten it on the front end and lengthen it at the back. I can fix the cracked bridge while it is still on the guitar.
EDIT: 9 days to Kauai.
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Post by Marty on Sept 12, 2024 8:59:05 GMT -5
A pleasant, albeit dry, September morning. All summer we have be saying "We'll do that in September". September is here. There is a line in a Stan Rogers song "So this won't be barren ground, when September rolls around". There is a lot of barren ground on our 1/10th acre spread, so I will be seeding so that new grass will contrast with the crabgrass. Then there is the bathroom to be painted, old carpet to be ripped up, hardwood floors to be refinished, and stuff to be moved to storage. All of this before daughter and granddaughter move in in early October. I would get that floor done, can't do it once they move in. |
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Post by Russell Letson on Sept 12, 2024 10:08:32 GMT -5
We've been watching for the new vaccine rollouts--they ought to be available quite soon ("early September" was the last I saw), and now there will be three flavors to choose from. But the standard advice has been for the already-vaccinated to wait for the new formulations that have been tweaked for the new variants. FWIW, here's a Yale med summary of advice and background: www.yalemedicine.org/news/updated-2024-2025-covid-vaccines |
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Post by epaul on Sept 12, 2024 10:44:57 GMT -5
Morning!
On Shannon's recommendation, I picked up a Taylor 417 Grand Pacific. Man, what a guitar. Deep powerful bass, angelic trebles and the King's Choir in between. Magic!
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Post by epaul on Sept 12, 2024 10:46:30 GMT -5
Oh, wait, that was a dream. Didn't find a new guitar in the house. Great dream, though!
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Post by John B on Sept 12, 2024 10:51:21 GMT -5
I think I get the gist here
Check with your healthcare provider - I'm pretty sure there's a new vaccine available for that. |
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