Apc medicare paymentpc medicare

First time for everything. .

2024.05.14 18:50 Head-Independence937 First time for everything. .

The patient presented with what appeared to be normal H but insisted she had a severe HL... OK, fine. Got her into the booth, hooked her up, and presented at 40 DB. Red... dropped to 30 Red, dropped to 20 Red, dropped to 5 red... at that point, decided just to do the main 4 and turn it into a screening. Got the patient out and said, "You're great! No issues, congrats!" She then said, "Oh no, no, I thought you said to push when I didn't hear anything??"
I said, "What? No, you did it correctly. You pushed it at every tone. You're fine. "
She then continues, "No! I didn't hear anything, I swear. Can you retest me?"
At this point, I'm just thinking ... OK crazy..
Get her back in, present at 40. Nothing. Move to 50 nothing, 60, 70 (at this point she's contortions her face, 80 red.) Responding validate and she's all over the place. Yes, no, yes, no
Classic malingering. At 3K, I stop the test and tell her she's done. She's getting out of the booth, and I begin to counsel her on what appears to be going on. I ask, "What's the deal here? You clearly would not benefit from any treatment, so tell me why you insist on needing a hearing loss?"
Finally, after round 6 of the discussion- she admits (long story short) that her grandmother raised her, she's going to college in a few months, and grandma can not hear. She's worried about this, and because she is on state insurance but grandma only has Medicare. She was hoping to give her these. I counseled her on individual loss, why her RX would not fit Grandma's, and law and ethics.
She was devastated. I invited her back WITH Grandma, and I plan on gifting her the new top of line series. But never have I seen something like this. If anything, it's the opposite. Spoilt adult children whining that their small should be there inheritance is being wasted on preserving cognitive abilities in Mom or Dad.
submitted by Head-Independence937 to audiology [link] [comments]


2024.05.14 18:21 kevinmh222 SSDI And Medicare

For any 100PT guys in here also receiving SSDI, did you take the full medicare deduction of $174 or opt for the reduced plan for $10. Im up in the air about it. It would be nice to be able to see any doctor i want outside the VA.
submitted by kevinmh222 to VeteransBenefits [link] [comments]


2024.05.14 18:21 Quackers_2 Dad keeps talking about buying his own house, four hours away in another state.

I have been trying to talk to my dad about assisted living facilities where you give an initial deposit and they use your Medicare+pension towards monthly expenses. He gets Big Sad about it and shuts down. I get aging is hard to talk about. But he wants to put me on the deed because he thinks it will help me out. He’s 70. Won’t see a therapist and won’t tell his doctor he’s having memory issues or trouble with his anger, etc.
He has no life insurance, no will, no trust. About 80k in retirement. Only has a DNR. I am partially disabled and will be looking after a developmentally-disabled sibling once our parents are gone. My mom currently does all her care taking.
My eldest sibling is off the map and police are considering listing him a missing person if they can’t locate him.
I am broke and skilled but not well-educated enough to be a top earner. I have no idea what I am going to do with my dad if he buys a house in another state, especially if he keeps insisting on adding me to the deed. He says he wants to be closer to his friends, which is fine, but I’m not going to be able to visit him once he ends up in a nursing home four hours away and I won’t be able to afford moving him to this state once long term care is required.
I’m so exhausted doing all of this on my own lol
submitted by Quackers_2 to dementia [link] [comments]


2024.05.14 18:04 foremma_foreverago Have Questions about Wellmark Iowa Med Supp App

Hi, guys! I am helping a friend apply for a Medicare Supplement in Iowa. I am doing this in an unofficial capacity since I am not licensed to write in Iowa. The Iowa application is not as straightforward as the other states I work with.
She is eligible for Medicare 6/1 due to permanent disability. Since she is newly eligible, she is in her initial enrollment period. Section C and D of the application are really throwing me. Looking at the application I am checking yes on C2, but I can't check yes on C3 since she is NOT 65 and not turning 65. If I go down to section D after that, I don't see any of the situations that clearly state- I am newly eligible for Medicare so I can apply now.
She is currently on her husband's work insurance and they will be terminating that once her supplement is approved. I would appreciate any help that can be offered!
submitted by foremma_foreverago to HealthInsurance [link] [comments]


2024.05.14 18:04 Possible-Resolve2799 Setting the stage for financial success starts now, Millennials! Time to roll up our sleeves, dust off our calculators, and conquer budgeting for the upcoming event

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submitted by Possible-Resolve2799 to Secure65healthplans [link] [comments]


2024.05.14 17:58 Equivalent_Ad_8413 International Coverage

I know that Medicare international coverage is (almost) non-existent. I haven't looked at every plan, but none of the plans I've looked at have decent international coverage. Are there any Medicare supplemental plans that have decent coverage overseas? If not, I'll just get travel insurance with coverage that gets me back to the States if I get sick or injured.
submitted by Equivalent_Ad_8413 to medicare [link] [comments]


2024.05.14 17:47 ikusababy I Got Disability!!!

i received shocking news on mother's day- i won my disability case! on the first hearing! i remember coming to this sub searching for advice when i first applied. it seemed mostly just others asking the same questions i had or talking about being denied, so i figured i'd post about my rare case that got approved (in the US.) i can't give legal advice of course, just share my experience and hope it helps someone.
my migraines became chronic october 2020. i quit my job after being denied fmla leave. i had only worked on the record for 3 years at minimum wage jobs. the income was just enough so my husband (bf at the time) and i never really had to worry about bills. i first applied for ssdi in november 2022 (i wish i had applied sooner, i just was so stressed and didn't think i had a chance anyway.) got my first denial letter i think in april 2023. my MIL gave me the info of a few good local lawyers from her local MS facebook support group. i googled some of the names, checking reviews of some of them. called the first one on my list, was told they wouldn't represent me since i'm under 60 (or maybe 50? point being: 26 is a bit younger.) fair enough, so i called the next on my list. answered some basic screening questions and got a phone appointment set up.
i applied for migraines but also listed my mental health diagnoses. usually my mental health is manageable, but with the migraines it started to decline. i had the feeling this lawyer thought i was more likely to get ssdi for my mental health rather than migraines. but i maybe i was reading that wrong and he had to ask more about the mental health since it's a bit more complex to understand than migraines for some people idk. regardless i was honest and he agreed to represent me and was really upfront about how the process works. he told me i'd likely lose the first and maybe 2nd case, but he thought i had a shot. that gave me some hope since he had a lot of positive reviews and i'm sure wouldn't take me if he thought it was hopeless!
still, i stressed a lot because i struggled to find a doctor willing to make a disability statement. it was mostly an issue for me because i had just been forced to switch insurance (turned 27 yay) which made me have to find new providers that don't know me well. luckily my psychologist said he was willing and gave a letter of support! and so timeskip after some more denials, i'm set for a hearing over the phone. my lawyer called me the day before to go over everything; checking that i'm not exaggerating answers, pointing out possible things they could ask about, stuff like that. (not like coaching, moreso just checking that i can give clear answers and not panic lol.) he said he knew the judge and thought she was very fair.
i was super nervous but the hearing seemed to go well from what i could tell! it was so gratifying to hear the job expert say exactly what i've been saying; that i only have experience in low-med labor jobs and those jobs won't hire someone who must be absent multiple days a month. the judge mentioned possibly asking a doctor about applying a special rule they use for seizures to my migraines that would classify me as disabled. the judge was very nice and at the end gave me a "sorry you have to go through this" that felt very genuine tho idk if that's something all judges say. my lawyer called afterwards to say he thought it went really well, i answered things well, and the job expert seemed to agree with us. things seem like they could go either way, but my lawyer sounds more hopeful now too so i'm cautiously excited.
so then mother's day i get a call from my lawyer. i rush to pick up because my social security online account status updated to final review 2 days prior so i knew a decision was coming. and my lawyer tells me, "congratulations, you won" !!!! I contain a scream and say in disbelief, "oh my god, i didn't expect to win my 1st at all!" he explained that actually the judge had written to the doctor about my migraines and the doctor disagreed. my lawyer wrote to the judge that he disagreed with the doctor's descision as he was off about some facts in his report, and the judge agreed with my lawyer!!! so i won for the migraines! he told me about how much i can be expecting and that i'll have to switch my primary insurance to medicare soon.
so i think the moral is: roll a nat20 on lawyer and judge selection and you're good! jk. kinda. i know i'm incredibly lucky to have gotten approved and i know there's so many of you out there that absolutely deserve it but have to fight til the end of the legal system. i mean even my dad was told by his doctor to stop working after a heart attack, but he had to go to the final hearing (in which that judge apologized to him that he wasn't approved earlier.) but if you're considering applying or going thru it and are scared now, just know it's not impossible! i was an anxiety-ridden mess right before my trial and even had a mild migraine during the whole thing, but it went really well! and soon i'll be able to pay off my debts and once again contribute financially!!
submitted by ikusababy to migraine [link] [comments]


2024.05.14 17:36 neel2415 SSDI & Medicare Coverage?

SSDI & Medicare Coverage?
I just got my Medicare Health Insurance coverage card in the mail & I have a few questions if anyone can help?!
Part A (Hospital) says I don't have to pay anything. Part B (medical) says there is a standard premium. I submitted my Champva application a few months back. I don't see why I would "need" Part B. However, I was reading the info they sent me and it says "Most people keep Part B. consider keeping Part B if you : Have Champva coverage or Tricare retiree coverage--You must keep part B to get your coverage. Review the note below."
My question is, do I have to keep Part B? My husband carries health insurance through his work for our family + I am waiting on the Champva application to be processed. I was originally under the assumption that I could drop part B but after reading the info I am slightly confused. Does anyone have any info or experience on this?
submitted by neel2415 to VeteransBenefits [link] [comments]


2024.05.14 17:12 _May26_ "Every American deserves access to quality, affordable health care as a basic human right. Medicare for All is the solution to our broken health care system." - Ilhan Omar

submitted by _May26_ to Political_Revolution [link] [comments]


2024.05.14 17:07 StageNo5209 Mom

My mom talked to her doctor and was told glp-1 could be good for her. She's 70, 5' 240lbs She's on Medicare/Medicaid. No coverage for her. Limited income. Lives on her own, but adopted a dog 6 months ago. Very Limited mobility due to not having kneecaps anymore. Bone on bone. Walks with 2 canes, BUT very much one to do things on her own. BTW, I live next door. I started trizeptide compound while I hunt for Zepbound because I met my deductible and it's $25/ month now. Well, knowing he doctor said okay, I started her on her journey, picking up most of the tab I already struggled with for myself. I started Jan 20 and am doing great. She seems to be a slow responder and that's okay. What isn't okay, as I struggle to find medicine and money, is that she isn't helping herself. I have explained the importance of protein and water. I told her how dangerous not going to the bathroom can be and to not let it go too long. She's not an idiot and she knows what she should be doing. I'm venting because I feel I'm trying harder for her than she is for herself No water yesterday and hardly any food, hummus and tomatoes. Not enough protein. She's up a pound and disappointed. I finally said "that's on you". She agreed, but that doesn't make this okay. I bought her a large bottle so she doesn't have to think about it. I bought her protein bars and drinks. I give her the shot every Monday. I'm paying for all this so she can enjoy her grandkids coming in from Germany this summer, with a little more ease and enjoyment. Why is she not taking advantage of this incredible opportunity I am trying to give her!??? I know she can do better, but I'm already tired after 1 month of babysitting her on this. Advice, please!!!
submitted by StageNo5209 to Zepbound [link] [comments]


2024.05.14 16:29 Brown_LLC Fraud can have serious consequences! 🚫 Whether it's Medicare, Medicaid, PPP loans, pharmaceuticals, or customs, criminal charges may be involved. And if you're involved in the scheme, you could be held accountable too! Consult with a whistleblower lawyer to know your rights and options.

Fraud can have serious consequences! 🚫 Whether it's Medicare, Medicaid, PPP loans, pharmaceuticals, or customs, criminal charges may be involved. And if you're involved in the scheme, you could be held accountable too! Consult with a whistleblower lawyer to know your rights and options. submitted by Brown_LLC to Whistleblowerlawyer [link] [comments]


2024.05.14 16:27 HarriBallsak420 Is there a point of diminishing returns?

I hit my number and went part time from home a couple of years ago to keep health insurance. Dividends alone will cover 90% of my expenses. I still have guilt about no working full time to make more money due to fear of running out and a lifetime of earning and brainwashing. Is there a point of diminishing returns. If you have a higher retirement income, it effects taxes, medicare, etc.
submitted by HarriBallsak420 to Fire [link] [comments]


2024.05.14 16:22 thecynicalone26 Ethics of referring out when it’s not for the client

I’m about to get credentialed with two insurance plans in my state, and I’ve also opted out of Medicare. I was finally able to get some answers from a biller yesterday, and it turns out that when a Medicare client has a secondary policy that I’m in network with, I am forced to bill that secondary policy if the insurance company has it as part of my contract, and many do. The biller said a lot of times they will only cover about 20% of the allowed amount, and legally we have to accept that as full payment. I saw in a Medicare consulting group that someone was forced to accept $4 as full payment. I already have a sliding scale policy, and I have all the low paying clients I can afford. I cannot have my full paying Medicare people be switched to paying practically nothing. If I give them ample time (like two months), do you think it is ethical to refer them out due to the fact that I just can’t afford to have my pay reduced so much?
submitted by thecynicalone26 to therapists [link] [comments]


2024.05.14 16:13 VapinVader Seems like a loophole...

So my wife had to go by ambulance (ambulance service is 3rd party from hospital) and she was having a diabetic emergency. She also has issues with her back and felt it hurt to lie on the stretcher, do she sat up on their padded bench. Fast forward one month, we get a bill for $730.50 for them to pick her up. (558.07 for the ambulance, 182.43 for a 15 mile trip at 11.62 a mile) I called to see why it wasn't covered by Medicare or Medicaid, and the lady said it was because she didn't lay on the stretcher. I then asked why wasn't she made aware of that, and she said "We aren't allowed to because it looks like we are forcing or compelling a patient to do something against their will". So, gonna fill out a form so they can file it for insurance to see if insurance will reconsider. It just seems stupid and a loop hole so they don't have to deal with insurance. Either way, ut will not be paid. Can't afford to. They can stick those stupid policies up their bureacratic asses.
submitted by VapinVader to medicare [link] [comments]


2024.05.14 16:08 Regular-Procedure544 Psychiatrist that accepts Medicare

Hello! I’m having trouble finding a psychiatrist that isn’t fully booked up / takes Medicare. I’ve called probably 30 places in the last few days & haven’t had any luck. Wondering if anyone else had any luck. Looking for help with managing adult anxiety/adhd I have high mark whole care as my insurance ! It just seems like every single office I call only takes commercial insurance.
submitted by Regular-Procedure544 to pittsburgh [link] [comments]


2024.05.14 15:32 juan_llama Moved my mom in with my family…

Earlier this year we lost my brother suddenly to a seizure. He lived next door to my mom, and for the past 20 years has been looking out for her. She (77) had a major heart attack in ‘99 where it went into v-fib, and her coworker saved her life with CPR. The amount of time it took to resuscitate her left her brain without oxygen, and she has had memory issues since. She’s not the same person that raised me. She lived in a single-wide that was rough, and despite the work that we’ve been doing on it, she couldn’t stay there. She also has some hoarding tendencies. I bought my house a few years ago with a guest room and bathroom on the main floor so that eventually she could move in with us, but was not planning on that until necessary. Well, now it’s necessary. It’s hard. It is a pretty big change to the way our household runs. My wife and I both work full time, and have kids in high school. She LOVES to watch TV, and swears she’s happy just doing that, but I know she needs activity out of the house. We have neighbors her age that want to connect with her, but she has no desire. I’m getting internal and external (her siblings) pressure to get her into card games and senior activities, and I’ve scheduled times to go to events in the community, but she bails day-of. She wants to go to the store all the time, but lacks some motor skills and walks so slow that everything is such a frustrating experience. (Last night at Walgreens, she dropped a 2-liter of Diet Coke and it shot up to the ceiling and across the store like a high school science project, spraying it literally all over the store. ALL. OVER. THE. STORE.) I’m struggling. I lost my dad, brother, and my dog in the last 9 months. I don’t have the patience or energy to deal with this. My wife is struggling too, but she’s silent about this situation. We’re stuck. We feel stuck, and I know that this is the best it’s going to be as she continues to (slowly) go downhill. Her mom and grandmother both died of dementia in a home, and I’m pretty sure that’s the way it’s going to go with her. The signs are all over. I’m still trying to get the land and house out of her name, so that when the time comes for memory care Medicare will foot the bill. From what I’ve read ( I know - a lawyer is the next step) we have to wait 5 years after we get the land out of her name. Wife and I are solid, but just so tired from daily life. It just doesn’t stop. Not really looking for advice, just needed to put this out there. I’ve been a pretty stoic person all my life and don’t complain. Never had to grieve anything really in 44 years, so this past year has been a kick in the balls. I was smoking pot heavily, but quit that this week to help my mental state - so far it hasn’t helped.
submitted by juan_llama to self [link] [comments]


2024.05.14 15:30 Brown_LLC What's Up Doc? Examples of Upcoding Bleeding Medicare

What's Up Doc? Examples of Upcoding Bleeding Medicare submitted by Brown_LLC to Whistleblowerlawyer [link] [comments]


2024.05.14 15:28 healthmedicinet Health Daily News May 13 2024

DAY: MAY 13, 2024

submitted by healthmedicinet to u/healthmedicinet [link] [comments]


2024.05.14 15:15 maquinas501 AmeriLife Marketing Group and RB Insurance Partner to Deliver Enhanced Value to the Medicare Marketplace

AMG's partnership with RB Insurance Group provides access to a network of 450-plus brokers licensed in 36 states, giving a competitive advantage in the Medicare market.
The partnership between AmeriLife Marketing Group and RB Insurance Group will bring significant meaning to the companies as they join forces to empower and protect the health and well-being of countless individuals served by the comprehensive Medicare network. The alliance aims to navigate the complexities of the healthcare landscape, ensuring that valued customers receive the highest quality of care and support.
Read More https://newsramp.com/curated-news/amerilife-marketing-group-and-rb-insurance-partner-to-deliver-enhanced-value-to-the-medicare-marketplace/588eb033714dcd11251d61baa64d1f24
submitted by maquinas501 to newsramp [link] [comments]


2024.05.14 14:54 SPAC_Time Talkspace Expands Access to Tele-Mental Healthcare With Medicare Launch - TALK TALKW

Talkspace Expands Access to Tele-Mental Healthcare With Medicare Launch - TALK TALKW submitted by SPAC_Time to Spacstocks [link] [comments]


2024.05.14 14:45 throwawaye1712 How do I go about picking an supplemental insurance provider?

I've decided that I'm going to go with Medicare A, B, D, and supplemental insurance plan N.
How do I go about purchasing a plan N? Do I just call up each insurance company and ask for their premiums and enroll over the phone? My understanding is that the coverage benefits are all the same: Company A's plan N will be the same as company B's plan N.
But are there any other considerations such as customer service or reputation or something like that?
The two insurances that are in my area is Humana and United Healthcare. Does anyone have any experience with them: good or bad?
submitted by throwawaye1712 to medicare [link] [comments]


2024.05.14 14:28 DISANews National-debt interest now costs more than Medicare or defense

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