Showing posts with label health insurance. Show all posts
Showing posts with label health insurance. Show all posts

Thursday, October 27, 2022

Disturbing phone calls and scams

The Message went like this:

Urgent! Return your absentee ballot today! Did you know that whether you voted is public information?
Your neighbors will know if you voted!
Don't let your neighbors know you didn't vote.

IF you don't vote in the November 2022 General Elections, You're telling your neighbors that:...

[yadda, yadda, yadda, propaganda stuff...]

Your neighbors will know!

The next day we got a flyer with the same message.

Both parties are calling like nimrods and leaving dire messages on our landline.

Another disturbing phone call is the Amazon Scam. Not done by Amazon, but by scammers who repeat the calls every 15 minutes telling us that Amazon has gotten a suspicious charge on your account, in the amount of --- choose your amount --- please call 1-888-XXX-XXX and press one to talk to an account service rep.
I had to unplug our phone to stop the repeated calls. 

Yes, we have a land line because my cell doesn't have any bars in our house. I have to walk outside and away from the house to make or receive a call.

Then I got an email saying that I had a suspicious charge on my PayPal account. Yeah, that was pretty funny. Paypal has an expired card on file. No worries. I only used PayPal 7 years ago...once. Since I never used it I deleted the account and had them remove my data.

I can easily check any charges pending on my charge card and those that have been posted. If the credit card company gets an odd charge they will notify me in a way I won't explain here. However, it works and is very efficient. Charges above my norm or in a place that is not usually used by us are flagged.

There is also a very easy way to dispute charges which has been very successful.

I do wonder how many people fall for the scams that are via phone or email? 

Speaking of that, on another note. 
I had to do some investigating on an insurance claim for hubby.

He is a Veteran with Community Care that is local. His ER visit was billed to the VA and not Community Care. The VA said the claim could not be processed as it was to go to the CCN [Community Care Network]. The Hospital instead billed Medicare -- WRONG! -- I called them on it and explained the process to the billing department.

A month went by and the Hospital Billing Department said 'It just wouldn't go through'.

Which to me translated to: We won't make the effort to rebill the proper Insurance.

Today while waiting for an oil change I called the CCN folks at the Madison VA and found out that payment through the CCN Insurance had been authorized in July the day after the ER visit.

So I used Secure Messaging to pass that on to the Billing Dept and the specific person who told me I was wrong. Note this, Secure Messaging becomes a part of a patient file, no hiding by saying -- I didn't get the message!

I provided the Auth number and suggested they pay Medicare back and bill Optimum UHC. It would be considered fraud to bill the wrong insurance and get paid. Even worse when it is Authorized Care for a Veteran, he/she should NOT be billed.

So I often wonder, how do some of our elderly deal with these issues? The world is scary and invasive. Rotten phone calls that feel like threats. Scam phone calls that are confusing.

Hospital billings that are incorrect.

And I wonder.
How on earth can we stop it?

Last note.

A few years ago the VA system offered me a job as a Patient Advocate. You know what? That would be a great job. However, right now I have my hands full advocating for my own Veteran.

Tuesday, May 03, 2022

Crisis? What Crisis?

I had an interesting conversation with a friend of mine who lives in the southern part of the US. [She lives alone with her 3 dogs. It was her love of her Dachshunds that actually brought us together.] 

What price do we pay in becoming elderly? What price did the Pandemic take on those folks who have health issues and have taken precautions since March 2020? 

If being elderly wasn't bad before hand, it certainly is more so now. Isolation is one part. Older people are shunned by younger folks. I was as guilty as the next guy. 

I started to understand how difficult it is for some to age in place when my MIL started to fail at recalling things and moving around. Her issues were mostly invisible until she had a fall.

I realized that my husband would not be able to be on his own if I were not here to take care of him. It is a sobering thought. If something happened to me, what would happen next? [Working on that.]

My friend in the south has no one. Her husband is gone, her son is gone, and her cousins she was close with are now gone too. She lives on her own and has dealt well with her health issues and is trying to keep up with life. She has no advocate to help her deal with working around her medical issues.

She has no one to help her deal with her insurance plan either. Sometimes the effort to work around the ins and outs of a medical plan is confusing and difficult. Reading an insurance plan is as clear as mud. 

Years ago, I thought I'd start a private business in just helping others with their insurance billings and resolving issues. What I discovered was dealing with my husband's health was a full time job. It taught me a lot about dealing with doctors, getting approvals, and dealing with medical billings.

Thank goodness I had a degree in Medical Billing and Coding [it is obsolete now since so many things have changed, however it gave me insight as to the difficulties doctors and clinics face too].

I would love to see insurance simplified, but I don't have the answers.

So how is a person who has an insurance plan from the state of Massachusetts get coverage in the southern US? The words 'out of network' pop up. What does that means to the patient? How can that patient find out? 

How does that person make an appointment in their local area to get treated for a pressing issue? Do they put it off because it is too complicated to get an answer? If they do, does that make their risk of a fall or risk of living independently so much worse? Where do they go for help?

I've found good help in working with ADRC who directed me to the county social worker for my MIL. That started the ball rolling that eventually helped with issues she had. I couldn't deal with all of her care at the time and deal with the care my husband needed too. 

My brother was extremely active in caring and assisting my father as he aged and did an incredible job at being his caregiver. 

People need advocates. Caregivers need breaks or they suffer horribly. Compassion Fatigue is real. 

Yet there is no obvious help unless a person digs for it.

Elder care is exhaustive and difficult. Here is long, but very good article here at Vox. The subject is not a popular subject and the discussion surrounding elderly care is an uncomfortable one for many people. 

So when my southern friend stopped talking to me on Sunday...and I could hear her crying I felt totally helpless. My heart strings broke. I was her weekly contact. She was lonely, she was

lonely...

And I could not fix it.

I did get her laughing before we signed off on our phone call and I asked her to please find out where the nearest senior center was to at least go and find some company. 

No person should suffer that loneliness. 

This crisis is growing. And I have no idea of how to fix it.

I've been told that I 'was' so 'lucky' to be able to quit work and stay home to care for my husband. 

Hmmm. But my thoughts on that are for another day.

Let us not forget how to care....