Tuesday, February 16, 2010

Health insurance woes....

You open your mail to find a letter from your health insurance company. Their correspondence always confuses you, so you set it aside and move on to another task. The letter sits there for days, unread. Then, you receive a call from your doctor's office, telling you your insurance company is requesting information from you before they will pay for your services. What?! They've not asked for information from me! And then you remember the letter you opened and set aside...

In my ten plus years as a patient account representative and insurance clerk for a multi-specialty physician medical clinic, I see this scenario over and over. Today I had this very same incident happen to one of my patients. Many do not understand the confusing world of health insurance, and to some, ignorance is bliss. However, such ignorance can lead to many problems in the future at your doctor's office, where all of a sudden, a $1,000.00 bill for services is owed by YOU.

Here's what can happen: You have nagging wrist pain that has been bothering you on and off over the past six months. Finally, after many twinges and annoyed looks from your significant other, you finally decide to see your doctor. He examines your hand, orders x-rays, additional testing, etc, in order to make a diagnosis. You leave his office that day with a million other things on your mind than whether or not your health insurance will pick up those charges.

Then, a week or so later, you receive that fateful letter in the mail that you cast aside. Then, the call from your doctor's office saying your claim has been denied because of additional information requested from the insured. When you get home to read said letter, titled "Accident/Injury Questionnaire", you learn they are wanting to know how you injured your wrist. They have enclosed a long form that you need to complete, asking everything from where it hurts to who has treated you for it in the past. Confusing? Yes indeed! Why? Because if someone else is liable, your health insurance company may not pay. However, it's very important to complete that form and mail it back to your insurance. Most medical offices then send you the bill, because there is nothing they can do to make you turn in this information.

So, you send in the form, and voila! Bill paid! Now, remember this important lesson, and don't cast aside health insurance letters again! But remember, there are other reasons you may receive a letter from them, wanting information. Other health insurance information, for example, your spouse has coverage and so do you. This is called Coordination of Benefits information or COB. In the case of families with two insurance carriers, many health insurance companies need the information so they know who is primary, and who is secondary, so they do not pay out of turn. There's also the birthday rule that can take effect, meaning whoever has the first birthday of the year will be the primary carrier for the child. Confusing? Oh yes, but important. Many times a quick phone call to your health insurances will straighten that mess out. Also, you may receive a letter asking if your twenty-one year old child is enrolled full-time in college. Many health insurance companies will not insure children after a certain age if they are no longer enrolled in school.

Many times I see people frustrated to the point of anger because of their health insurance not paying their claims. But, with some simple steps, starting with a call to them if necessary, most problems can be worked out fairly easily. Just remember, knowledge is power in the case of health insurance. The more you know how it works, the better, and less confused you will be. Check out your health insurance carrier on the web, and get to know how their site works. The larger companies have enormous websites that offer help in understanding your benefits. Many companies allow you check the status of claims online. This is a great tool that is underutilized.

Next up, deciphering your insurance explanation of benefits, or EOB, and terms that go along with it!

Monday, February 15, 2010

Epiphanies and responsibilities....

As I was showering this past Saturday morning, I experienced an epiphany of extraordinary, and somewhat embarrassing proportions. First, let me explain...

As an English Major I have a class called Topics in English, where I choose a subject I want to research, ask one of my instructors to work with me on it, and then write a hugely huge paper, thus ending my tenure as a college student. Sounds easy, right? Really? Yeah, not so much. The possibilities with an English major are endless, so while I have over a year to begin this exhausting process, I started worrying about the second my advisor told me about this class. This is obviously not a paper I can procrastinate on and complete at the last moment.

So over the past month now, two websites I frequent have been having two different arguments ongoing- one website is discussing the responsibilities of a fiction writer to his or her readers, and the other is attempting to have a intellectual discussion regarding the phenomena of the Rape Romance genre (which is fairly extinct at this point). While they may not relate to each other at first, there is a subtle connect between them that astounded me.

The discussion regarding the responsibilities of a writer is frequented by many published writers, all posting their opinions eloquently and backing them up with their own experiences. The other side of the argument has those who may be authors (I'm not sure, but I think at least one is) and claim that commercial fiction can be irresponsible because it leads a reader into a world that in no way resembles reality, and therefore is dangerous to those who cannot differentiate the two. That it's untruthful. Interesting...yes? Check out this blogpost by published UK author Rosy Thornton about her views, and make sure you read the comments! She has an interesting view about the "alpha male" that I find intriguing and I both agree and disagree.

The other discussion is attempting to understand the Rape Romance genre. The subject of rape produces heightened emotions anyway, but when you speak in terms of it being romantic then many have trouble wrapping their head around such a book. This thread attempted to discuss why some women read these types of books,and emphasized that those who do read them aren't promoting rape as romantic. They are reading a work of fiction. This has ties with the responsibilities of a writer, because many condemn those authors for romanticizing rape. Ah ha...see where I'm going?

So, the epiphany was to write my hugely huge research paper on those responsibilities in regards to women's fiction in general. What kind of impact does it have on readers, and do they have trouble with telling them apart from reality? I am an avid romance reader, but trust me, I can definitely tell the two worlds apart. I see it as an escape from the real world, with its ringing phones, crying babies, deadlines, etc. But can everyone? Should writers make an effort to put some "truth" into their fiction and make it more realistic to world we live in today?

I plan to interview, interview, interview! No one will be spared, so watch out!

Tuesday, February 9, 2010

A Snowy Rant....

I live in the Midwest, meaning we can go from 32 degrees and snow, to 50 degrees and rain with a drive of about 5 miles to the South. I'm used to the crazy weather here, and sometimes it's kind of nice, in a weird, Midwestern sort of way. At least we have all three seasons.

However, what is not nice are the people who drive 4x4 vehicles and think they are invincible. I drive a Honda CR-V, and no, it's not 4-wheel drive. It gets around well and I feel relatively safe driving my 8 month old around in slick road conditions. This only applies, though, when others aren't around me, specifically, the aforementioned 4-wheel drive drivers. Don't get me wrong, my rant does not include all of these people, but who it does include are those who insist on driving 50mph or faster on snow packed roads, and then when you aren't going their desired speed, they ride your bumper as you drive the normal 30-40mph speed. More than once I have found myself pulling over into the snow-covered shoulder while so and so blows around me, obviously relieved that I've gotten out of their way. It's not only irritating, but dangerous to others.

I used to drive a 4-wheel drive Jeep, and I know that when in 4-wheel high, you have amazing traction on snow-covered roads and are less likely to get stuck somewhere. However, I never drove in such a reckless manner on slick roads, nor road someone's bumper until they got the hell outta my way. I was cautious of myself, and those around me. Isn't that what we learn in Driver's Education? Wait, did all these people take this course? Umm....probably not I imagine.

Now, I have many friends who drive 4-wheel vehicles, and they insist they are driving safely at such speeds. However, being a passenger in one of these vehicles convinced me otherwise, so I simply nod and smile, not wishing to get into a silly argument about the safe speed to drive on snowpack. Winter will be over soon enough.

Oh wait, Punxsutawney Phil saw his shadow, didn't he? Crap.

Saturday, February 6, 2010

Writing Children's Stories....oh dear...

This term I am taking a children's writing class as part of my Creative Writing minor. I've never had any ambition to write a children's story, so when I learned I would have to not only write, but attempt to illustrate or at the very least write illustration notes...panic set in. Literally. I love children's books...that other people write. I'm hoping the amazing textbook for this class will give me some ideas to start with. All I came up with is fairies. That's probably been overdone...right?

Baby Contests....they're everywhere!

So a few weeks ago, my mother asked if she could enter Caris in the Regis and Kelly Beautiful Baby Contest.  I entered this picture: because I didn't hear from her and wondered if she had changed her mind.  Then, she tells me she entered this picture: *sigh*  Both are fine, of course, but I hope entering her twice didn't cancel each other out.  Oh, and don't bother searching for her in the gallery of children's photos, because she's not there.  It does say it's random, but I was hoping, just a smidge, that she'd be there.

There's another contest that I discovered in the free American Baby magazines you get in the mail.  This one lets you enter 6 pictures!  Dear God, which pictures will I enter?!  My hands rub together in eager anticipation of the thought of going through the mountains of photos on the hard drive (because I AM the paparazzi, Lady Gaga eat your heart out!) and choosing 6! It will be impossible!

Am I a bad mom for entering my child in a contest that is based solely on how cute she is?  Am I promoting self-image over being true to ones self?  Should I shut up because Caris is 8 months, and won't remember that I poured over millions of photos of her, trying to find the best, most beautiful, adorable pictures of her?  Am I on the road to being one of those horrible showbiz moms that put their toddlers through spray tans, hair extensions and stage make-up?  Surely not!  I hope...right?