Good morning!!!!

[jbrumberg]

Good morning everyone. 11F early this AM.... Still 11F now. I am blessed to have been able to hear the "Life Stories" of many individuals both men and women during my 17 years working with the elderly of their experiences during some of the greatest "tests" of our great Nation. Some of the men still had evidence of PTSD. Certain meds can exacerbate/trigger the PTSD. It's so sad that wars can live on even after the combat ends.

"..... I'll be glad when we can wean off certain pills."- RIP It can be a long & slow & "uncomfortable" experience, but worth it. I wish you both the best.

"... my ins company is investigating my "injury". Wanting to know if it was workplace or automotive accident caused. No and no."- BuckeyeFarmer

The insurance companies waste all this money on an individual's claim history, hired private detectives, contracted "doctors" for secondary and tertiary investigation and review(s), hire lawyers, etc. rather than do the "right thing" and pay the honest claim an provide money/benefits for any required rehabilitative treatment. This P.O's me.

Riptides- Nothing PO's me more than what you and your wife are going through with your health insurance company. Personally I feel their practices are criminal. These policy "changes" can put your wife at serious risk from what I can surmise about her condition. They would be better served doing what is right and pay for the medications and even assist you with getting a vehicle that can safely and hopefully with minimal discomfort transport your wife. If one can not lift, pivot, or transfer they are in serious shape.

Now i am really P.O.'d. One has to go broke hoping to make it financially to meeting the criteria to make them eligible for the "donut hole" (catastrophic coverage) coverage. What a way to get a tax break. Rich people can invest offshore in some tropical island(s) or certain countries and the middle class/working poor need to go destitute from medical expenses.

No more rant today. My BP is rising.

 

[rswyan]

10F and sunny @ 09:15, high today should get up to around 28F - 30F. Five days of above freezing temps, with highs in the 30's, 40's, and 50's starting tomorrow.

Finished first cup of coffee, time for a refill.

Got all the running around done yesterday.

Plan today is get closet door in fish room framed in and hung, and hopefully do some sanding on the lumber for the racks and stand.

 

[Bird]

If you change, who bills you? Got to believe its still the distribution company.

I've now got my latest paper electric bill with all the details. As I said before it's $178.65 for 1851 kWh and 34 days. So the details are:

TXU Energy Smart Deal 12
Base Charge $ 9.95
Energy Charge (1200 kWh x $0.0640000) $76.80
Energy Charge (651 kWh x $0.0320000) $20.83
Smart Savings $15.00 CR

Sub Total $92.58

TDU Charges and Other Fees
ONCOR TDU Delivery Charges $71.91
Gross Receipts Reimb $ 3.28

Sub Total $75.19

Sales Tax $ 2.93

Service Address Charges Subtotal $170.70

Total Miscellaneous Charges $ 7.95

Current Charges $178.65

So I pay TXU Energy, but you can see how Oncor gets their cut from TXU. The $7.95 Miscellaneous is their optional surge protection insurance, for which I'm probably wasting money.

 

[Buppies]

13 this morning slept in off on snow removal

Prayers for Riptides Buckeyefarmer Toppop Ed and all other unspoken requests

 

[rswyan]

BEF,

Very cute kitty you have there ... :thumbsup:

The crew here are big fans of using us humans as a warm spot for a quick nap too.

 

[daugen]

My BP is rising. Perhaps you can complain to your carrier that they are ruining your health...

they will ask you those same questions over and over, then proudly pat themselves on the back for having this wonderful online
patient info system, where it shows all your meds, but they will ask you your meds over and over and over.
Actually Jay the insurance companies do want to do the right thing. I worked for one for many years and never saw an attitude of
screw the customer. It was always all about being fairly discriminatory, not unfairly of course. Being consistent so no one could play favorites.
Every insurance company will always ask you if the injury was due to a car accident or a work accident, because almost always those coverages are primary, not your health insurance.
It's why they ask this in the ER, they ask it everywhere. It's all about who to bill...

Of course in Property Casualty you had underwriters like me who could make exceptions, and I did regularly. And then I became an independent agent for a good part of my career
and again, from a corporate standpoint, they want the policy strictly adhered to, so the actuaries aren't fooled, and they want the claims paid within x days of receiving all requested documents.
Because without papering their files, insurance companies grind to a halt. This is contract law and you have to have documentation. It's been this way, and it always will be this way with claims over a certain dollar threshold. Insurance companies are almost as bad as banks, they have rules for everything and rules for their rules.

Where it all breaks down is when the local claims processing people act like one level above orangutans and take every bit of their allotted 30 days, if that is their number. The clock is always running on a claim. If you can help it, you never like them to stay open too long. But some companies I'm convinced intentionally delay payment as long as they are legally allowed, within some internal framework. Lot of money at stake for a big company.
Most problems I've seen have come from medical coding errors plus pre-authorization screwups.

Easiest claim is life insurance. Except for exotic exceptions. Some of the hardest are disability and any other areas where frankly folks can fake it.
If you catch enough folks faking it, you know where to look.
Health insurance is just an extraordinary paper chase along with some venal hospitals trying to take advantage of personal pay patients.
Plus today there is so much opioid abuse that anyone getting it legitimately winds up jumping through hoops at a time they least need to do so.
Not sure of the answer there.



And as soon as that claims threshold is made public, a whole industry of crooks will rise up gaming that threshold. Lot of 998 dollar claims...
As an insurance company underwriter and independent agent for almost 30 years, I could not begin to describe all the lies I have been told.
Including my best friend's father trying to cheat me on my first day of business. Insurance company has lots of money, let's just stick it to them.
Well the them is us because any smart person knows as claims go up, the rates go up.

I have to wonder how much money these health care insurers are actually making. They certainly always seem to cry poormouth when jacking up rates, particularly now when
politics is so entwined with the health care rulemaking.

I have spent the last three hours throwing out old bills and financial stuff. The amount of paperwork Medicare sends every month is awful. All those extra sheets of paper, I wonder when English won't be the first page...

Someone could make a living being a medical insurance concierge, handling all this paperwork and acting as a patient advocate.

 

[toppop52]

21 early, 26 now and 38 later, much warmer this weekend they say. I'm sitting here waiting on my tractor guy to call so I can go pick it up, got the trailer hooked up. It's been an hour and a half, no call and I can't reach him, not liking the vibes.
Hope everyone has thier best day and gets what they need if not what they want!

 

[toppop52]

View attachment 536272

One thing I like about scorpions, Rock You Like A Hurricane, oh wait, wrong Scorpions...nah, there's nothing I like about scorpions!

 

[toppop52]

Got my electric bill via email this morning...

 

[PJSprog]

14°F and clear skies this morning, going up to 39° today. Be glad to get back above freezing again.

Thought I posted earlier, but it seems to be gone. Guess it never arrived.

Thanks for all the great WWII stories. Amazing what some of those guys endured.

Got the bill yesterday for the propane refill earlier this week. $410 for 207 gallons. Not as bad as I expected. That should get us through the rest of winter for heat, and only our stove/oven uses gas the rest of the year.