Ask A Frustrated Nurse Episode 35
Yes Episode 35 in the video I discuss a LinkedIn post today. Not happy with Optum and United Healthcare owning physician groups. Then I find the article about Amazon buying One Medical for $3.9 Billion. Being in healthcare technology, they want to practice medicine as well. I am not a fan of the Walmart and Amazon being in the business of healthcare.
Like the doctors working for the big box health systems the Insurance companies and government and now Amazon. Telling them HOW to practice medicine.
Here is a reminder in the form of comic relief. Thanks to @Drglaucomflecken. https://www.youtube.com/shorts/FVAFfd3oCgA Prior Authorizations...
https://www.youtube.com/watch?v=hczdKshv8SY&t=1s United Healthcare Celebrates Doctors Day
https://www.youtube.com/watch?v=0URHKdXMmwo How to Get an MRI
And
https://www.youtube.com/watch?v=6JMf-U75fTg The Future of Medicine
https://www.youtube.com/watch?v=1LNf1vvuMVk Prior Authorizations For Everybody
Thank you Dr Will Flanery, His humor helps me get through the day.
Let's start the conversation. What are your thoughts, how does healthcare touch your life and what are your thoughts about having Amazon in the business of delivering your healthcare. Please like and subscribe and tell us what you think https://thinkhealthcaresolutions.com
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YT GAB RUMBLE Intro Video
Welcome to our channel. We are cleaning up and setting up 3 playlists to optimize your viewing experience. Making it easy for viewers to catch up.
Ask A Frustrated Nurse Series: News about the state of healthcare they may not want you to know about.
Healthcare Consumer Series: Lifestyle, Health, and options.
So Many Choices Series: We will showcase different companies that you may not be aware of and things you may need.
We will do some comparisons to help keep you informed as a Consumer of Healthcare.
Follow us on Facebook:
Join Us https://www.thinkhelthcaresolutions.com
https://www.choicesabouthealthcare.com
#health, #dpc, #healthcare, #healthcaretechnology, #healthcarechoices, #freemarket
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Intro Explainer Video
​@Choices About Healthcare This video is to introduce the relaunch of Think Healthcare Solutions and our membership platform that will be with you and your family every step of your healthcare and or Wellness Journey.
Think Healthcare Solutions is dedicated to empowering the consumer.
Our goal is to support you and your family no matter how and who pays for your healthcare. Insurance any type, share plans, self-funded, self-pay.
There is no perfect fit, your current health insurance may claim to support you with telemedicine, a Nurse Hotline even health coaches in some cases.
They may have a pharmacy benefit and on and on,
There are some Share plans (not insurance) cost sharing. That like insurance claims to offer many of the same. They offer to negotiate bills. Unfortunately, that sometimes is not enough. They use provider networks which can be difficult to support when you the consumer are actually paying for the services. There are several steps that should happen to protect how and how much you end up paying.
In addition to monitoring your payments and medical events, we support proactively any services you need along the way. Keeping track of any and all expenses. Defending charges when errors are found. Reporting at the end of the year. Doing the same thing for your pets and or service animals.
Then there is the Coaching, low cost support for your and your family.
Diet, Exercise, Relationships, Health Wellness. Supporting healthier choices and encouraging lifestyle changes, to become better stewards of our health.
Health insurances change from employers and job changes. We stay with you all the way.
There are also Self Care Lessons in the Healthitude Academy. A variety of lessons to meet your needs on the healthcare journey and optimum health.
With the Family Membership we can include your aging parents and monitor and support their bills and events with their medicare.
Giving you a better Patient Experience. No one is there for you like we are.
Your total Healthcare Navigation and care team. Healthcare coverage is not a One size fit all. We will walk with you everystep of the way.
Check out our updated website https://www.thinkhealthcaresolutions.com
The Healthitude Academy will be housed at https://www.thinkhealthitudeacademy.com and the https://www.choicesabouthealthcare.com will be our platform to give information on different options available to you that you may not be away of. Kind of a catalogue of options. Plus you can find us on youtube and Gab. where I showcase Healthcare news in Ask A Frustrated News.
Informing you of the beyond the scenes of health insurance, Hospital systems and government.
We are an inexpensive support to keep informed and educated. While making sure you spend no more than you should. I give a couple of classic examples of billing errors that added $1000 to a bill, billing error of the facility that the insurance okayed. Costing patient unneccesary expense. A Medicare patients account was credit back the Medicare payment and sending him a bill almost a year later.
I reflect the way a Dr Glaucomflecken in a comedic way makes great points about insurance and healthcare in general. Here are a few great clips I have posted in the past. But I can't state the facts any better.
https://www.youtube.com/watch?v=ngSTY2SPwRk
Flesh Covered Bags of Money
https://www.youtube.com/watch?v=6JMf-U75fTg
The Future of Medicine
https://www.youtube.com/watch?v=hczdKshv8SY
United Healthcare celebrates Doctors Day!
https://www.youtube.com/shorts/FVAFfd3oCgA
prior authorization for everybody
https://www.youtube.com/watch?v=1LNf1vvuMV
Prior Authorizations.
https://www.youtube.com/watch?v=0URHKdXMmwo
How to get an MRI
Please watch and learn how we can help. Both of the examples I give more than pay for our service.
Share with everyone and please like us on Youtube, Facebook, Gab.
Thanks for watching.
https://www.thinkhealthcaresolutions.com
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The Healthcare Consumer Series #3
We discuss the latest blog https://thinkhealthitudeacademy.com/all-things-healthcare/healthcare-coverage-how-to-make-the-most-of-it/ How to choose the best insurance plans and other alternatives. Don't trust insurance to pay your claims correctly and that 85% of all medical bills have errors.
Remember many insurances claim to take care of you offer wellness etc. Don't be fooled. There are great alternatives available. Make sure and have someone that is truly on your side. We can help save you money and maximize your healthcare dollars and how they are spent.
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Ask A Frustrated Nurse Episode 34
United Health Group buying healthcare groups, under reimbursing providers and yet they are buying up Medical groups and Mental Health practices. Still not a fan of Insurances owning our healthcare and paying for it too.
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Ask A Frustrated Nurse Episode 33
2 topics Anesthesia and Surgery Centers Anesthesia is one of the more difficult in pricing in relation to the amount. They are happy to take your money. But I don't really see a discount as to the price, particularly for pre-paid pricing. The anesthesia groups are changing management groups and evolving. Most are figuring price usually using CPT code and DX code. There are a few that won't do pricing as they use minutes. Which is traditionally how anesthesia is billed.
They are claiming since COVID it is a challenge to get Anesthesia staffed due to the trend of moving to locums which in turn can drive the cost of anesthesia up even more.
Now to the surgery center. My favorite facility on the planet. Once you have you (network provide if applicable) You then need to understand the facilities they do their procedures. Some Surgery Centers are better than others when it comes to their affiliation. Big box healthcare systems or private affiliate. We at Think will review your policy and make sure you know before you go. Helping to keep you out of high balances that you don't need when you can do things cheaper. Your provider may be in network. But they only go to a facility that charges more than you or your plan needs to pay.
If you have a high deductible and must spend $4000 or more toward your high deductible instead of at least half that or less. Let us help you watch your healthcare spending. You really don't need to overspend.
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Ask A Frustrated Nurse Episode 32
I have been watching old Dragnet shows and refer to JUST THE FACTS. I am resolved to shorten my rambling on video, Moving forward. 1 topic. AMA state that patients should be Leary of reports regarding pricing transparency from sources other than CMS. Claiming that organizations have come to widely varying conclusions on how the art of Price transparency is going. Because of the various ways, pricing is being reported. I personally have experienced variations from the posted pricing to calling and getting pricing. Things don't add up and are not clear. There are so many variables on how we get a bill at the end of the day. These lists are not the bottom line or cemented in stone.
2nd topic. Children's hospitals are ready to roll out vaccines. Not a fan No further discussion is needed. Florida will not use state money to vaccinate children. Parents that want to vaccinate their children can do so in the private healthcare sector.
Please like and subscribe for more updated healthcare news and information.
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Ask A Frustrated Nurse Episode 31
A Physician Group of clinics in Illinois reject the Blue Cross of Illinois Contract due to poor reimbursement and has continued to see their patients as they address their concerns. I am sure that the reimbursement is a ridiculous amount and one of the reasons is not being able to recruit staff physicians because of the poor reimbursement. While the Clinic is still negotiating the contract they are working with their longstanding patients to treat them while they are out of network. Group of physicians that care about their patients and the continuity of care.
The physician pleads guilty to fraud billing Medicare, Medicaid, and Blue Cross for billing Office visits that were not visited by her, but by her unlicensed office staff. It is one thing to go into the office for a dressing change, or wound check, but those cant be billed. However, these patients were receiving Prescriptions for controlled substances without a legitimate purpose. She has surrendered her DEA and will no longer be able to prescribe DEA meds. She pleaded to one count of medical fraud and a fine of $500,000. She can also be sentenced to up to ten years. United Healthcare Group is being accused of forcing physicians out of network to recruit them into an Optum Group. This claim is coming from the group Envision Health. More crazy contract negotiations and threats of poor reimbursement rates by yet another insurance provider. A surgery center in Florida files a lawsuit claiming United Healthcare has repriced and underpaid. Paying only $16,125 on a $193,000 total charges. It would be interesting to know the contract and what they should be paid. This surgery was pre-authorized. Finally, Optum (United Healthcare Group) received authorization to buy 30 locations with a price tag of $73 million, Increasing the offer to $223 million to include the charity work. They are 645 physicians included in the battle. LHC is a home health set to be purchased by Optum(United Healthcare Group) some board members are not happy with the sale. Again, I don't think Insurance companies should be the deliverer of healthcare. My humble opinion.
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Ask A Frustrated Nurse 30
United Healthcare is looking to purchase CHANGE Healthcare. This would put them in a monopoly on the revenue claims editing part of things They are buying Clinics, Home Health Agencies, and IT businesses like Change. I state my opinion on Insurance companies being in business other than insurance. United is battling with the Justice Department regarding the purchase. We will see how it goes.
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Ask A Frustrated Nurse Episode 29
More billing issues. Blue Cross of California fined $1.1 million and will also be reimbursing Members $9.2 million for out-of-pocket expenses they paid. Members were being forced to pay office costs as part of their deductible. Had someone like the US been reviewing those SMALL claims we would have known that there was an error. They were also fined another Million for other errors in billing and falsely charging members. $60,000 fine for not sending out an Explanation of benefits to members. These errors spanned the years 2015 thru 2020 to date.
United Healthcare continues to buy healthcare entities. Home Health. Clinics, Insurance should be just that, insurance. Not dictating our healthcare. I go on to reiterate our philosophy that all bills be reviewed prior to payment, Agreed to, or sent back for correction. Then paid and move on. There is too much time and money wasted on claims.
Let us help you do it right the first time. remember 85% of all medical bills have errors.
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Ask A Frustrated Nurse # 28
Juicy News 2014 a patient had surgery and just recently won a lawsuit. Back in 2014 had a couple of back surgeries and was left with a $229,129 dollar balance.
The original bill was $303,709. The insurance did pay $73,598, and the patient did pay $1000. Leaving a total balance of $229,129. Suing for breech of contract. St Anthony Hospital-Centura Health in Colorado. She was given an estimate that her out-of-pocket expenses would be $1300. After surgery, the hospital claims to have miss read insurance to find it was out of network.
Colorado Supreme Court awarded the win to the patient. As they should have. This was the fault of the hospital and the insurance company. If this surgery was pre-authorized then the insurance company should have caught the issue as well. If not the full fault is with the hospital billing office. It is one thing to have an issue with an inpatient outpatient procedure, then a high-dollar surgery done out of network.
The hospital later found out the insurance was out of network.
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Ask A Frustrated Nurse # 27
Continuation of the HCA saga. Buying hospitals and now we will discuss. There are other issues going on on the East Coast. There is another lawsuit in North Carolina accusing HCA of driving prices up after the purchase of hospitals there. They purchased Mission Health facilities back in 2019. HCA no has a monopoly in 7 counties and they are now accused of raising prices. Communities have addressed quality of care and pricing as concerns have grown. I have seen patient care staffing run marginal. Patient care costs dip into profits.
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Ask A Frustrated Nurse # 26
Following up on yesterday's episode 25 The AHA has responded to a request by the FTC regarding Anti-trust rules, used to evaluate hospital purchases. Looks like they want to relax the concerns of competition in a given area. Is the AHA satisfying the major hospital systems to take on hospitals no matter the local situation? Like as in Utah. No concern of monoplies. This would greatly affect the consumer if groups overcharge and balance bills. There would be a limited resource for care and reasonable pricing for hospital-based care and the self-pay or self-funded groups that do care about cost.
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Ask A Frustrated Nurse # 25
After a hiatus away from doing this series. I took time away from doing other projects and reflecting on our Mission and what we do and the direction we want to go with the future of Think Healthcare. Discussed our value in serving the patient and healthcare consumer. Check us out and all of the services we provide.
HCA buying 5 Utah Hospitals- I said when they announced the deal Somebody wouldn't like it. FTC filed a suit to halt the sale. The trial is in December. They are claiming that without the Stewart vs HCA there would be no competition. What about IHC? IHC through the fit when three of the hospitals were owned by the same group with most of the HCA facilities back in the 90s.At that time they sold off 3 hospitals, only to buy them back all these years later. I will admit. IHC does their own thing they have their insurance and do contracts with other commercial payers. But at the end of the day, there should be a 3-way competition, not 2. I know that the way HCA does their pricing and early increases is very strictly monitored and done once a year.
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Ask A Frustrated Nurse Episode 24
White House - Biden Executive order April 5th- Strengthening Access to affordable healthcare and coverage. Requiring Federal Agencies to take action on reducing the medical debt. This looks like another angle of look how we are taking care of you. The good part is that they are again trying to address medical bills and FICO scores. While I agree with that part of the move. I do discuss how many bills that are in error that people are held responsible for. The risk of medical expenses owed for High deductible plans. What you owe vs what is errored. Many consumers take the approach of I am just not going to pay it. Some providers are still balance billing above and beyond contracture payments and overcharging cash-paying patients. All bills need to be reviewed.
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Ask A Frustrated Nurse Episode 23
May recording of Ask A Frustrated Nurse #23
Becker News-Review I talked about United Healthcare (Insurance) planning on buying Change Healthcare which is similar to the platform they already own Optum.
They are looking to sell off pieces of both Optum and Change in order for the deal to go thru. Otherwise, the FTC may not like the deal or approve it. The Justice Department has filed to stop the acquisition.
I talk about the fact that United owns a group of ASC (ambulatory surgery centers). I state my disliking that I don't like that Hospital corporations and insurance companies have bought these ASC.
Why should insurance companies and Hospital corps be allowed and not physicians?
Again I wish that we could build a co-op group and have a standing in the competition. Driven toward a free-market alternative, that is more true to the ideals. Giving the competitive edge against the big-box corporations and the insurance companies.
Mayo Clinic predicts the rise of COVID by April 23rd (past)
Duke U Medical System is purchasing another medical practice. Many physicians are not happy.
MD Anderson is naming a physician as the Chief of Equity and Diversity and Inclusion Officer. I have no words, all my years in medicine. A patient is a patient and they don't need a label.
In my opinion, we are moving in the wrong direction. We don't need labels to be a patient or healthcare providers.
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Ask A Frustrated Nurse 22 Covid is up
This was recorded back in April. Discussing the Rise of COVID in a few states. The potential reaction if numbers continue to rise Covid is still being used by the government to manipulate the narrative.
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Ask A Frustrated Nurse Epidosde 21
This is from April 8, 2022
Covid updates
1. Ron DeSantis signs the bill -"No Patient Left Alone Act" Patients will be allowed, visitors!
2. Rise in Covid deaths up in 8 states in last 2 weeks. Where has the FLU gone?
3. Congress on spring break amid the COVID relief bill and Senate holding it up against the Title 42 border issue.
4. Fauci speaks again and mentions immunity with past infections and vaccinations. Plan on increased cases over the next few weeks and again in the fall. (duh) He doesn't state Herd but he calls it background immunity.
5. Study from the Commonwealth report stated 10 people with partial or no vax infected within 90 days. In my opinion- More numbers manipulation.
6. Reporting because of vaccinations we saved $889.4 BIllion. According to this Commonwealth Report. https://www.commonwealthfund.org/blog/2022/impact-us-covid-19-vaccination-efforts-march-update Not sure this is a neutral report. Researchers primarily from YALE and National Committee for Quality Assurance
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Ask A Frustrated Nurse Episode 20
Looking at Payor News- Insurances Healthcare is broken and even my best friend who is the polar opposite of both of us agrees and would do well to work together on changing and REDESIGNING our healthcare as we know it. United Healthcare is fighting to purchase Change Healthcare an AI company and billing type platform. Justice Department is concerned over the monopoly. The price is $13 Billion. The hearing is slated for August. Hope this does not go through. Uninsured individuals will be paying $195 for covid vaccines. Many Healthcare data breaches have occurred recently.
California's Universal Healthcare bill fails. Wow, that makes me pleasantly surprised. BCBS of Texas and Memorial Hermann sever contract leaving 100,000 members to find new primary care providers.
I encourage you to look at #DPC providers and don't trust your insurance to always do the right thing for you the consumer. They cost you more than you need to pay, a lot of the time. Consumer beware! Let us be there for you. Check us out and remember if you have incurred any expenses due to covid. We will evaluate for free, making sure you are charged correctly and the insurance is taking care of you and not leaving you with a bigger bill than necessary. https://thinkhealthitudeacademy.com https://choicesabouthealthcare.com
Please like and subscribe and stay informed. Ask us questions, and be empowered. Your healthcare should not be status quo. Remember, your insurance is not always there for you.
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Ask A Frustrated Nurse Episode 19
Healthcare in the news. You may not hear about otherwise.
Please like and subscribe and share. To stay informed. Six findings:
Long-term nursing home residents saw 15 percent fewer hospitalizations during the pandemic.
Short-term residents are seeing an 8 percent functional improvement during COVID-19.
Seventy-two percent of more than 110,000 infection control-focused inspections of nursing homes conducted from 2020-to 2022 were deficiency-free.
Nearly 60 percent of nursing home resident COVID-19 deaths occurred in the first seven months of the pandemic.
The risk of COVID-19 mortality for people 85 years and older is 340 times higher than for those 18 to 29.
High spread in the community is often correlated with outbreaks in nursing homes.
Residents were four times less likely to succumb to COVID-19 during the omicron surge compared to the height of the 2020 winter surge.
https://thinkhealthitudeacademy.com
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Ask A Frustrated Nurse Episode 18
In this video we discuss hospital corporation HCA buying more hospitals and 200+ Doctors leaving. This is in North Carolina. CEO sells out and takes a huge million-dollar payout and becomes an HCA player. Is Big Box healthcare the best Healthcare delivery? Between healthcare corporations, Insurance, and pharma. Where does that put the consumer? Please Like share and subscribe to stay tuned for more discussions and the state of our healthcare. Let us know what your thoughts are. Remember, this isn't even discussing the protocols that hospitals have been living by. Ignoring the health of the patient. It is straight-up business. Follow us,. Share your thoughts. Can we the people take back our healthcare. We can help show you how.
Please like and subscribe
https://thinkhealthitudeacademy.com
https://choicesabouthealthcare.com
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Ask Episode 17
This is a discussion about AI players like Google, Microsoft, Salesforce, Best Buy. becoming big players in your healthcare. While technology is great, along with healthcare advances. But your healthcare is becoming less your own. While the technology is good. How much of these big AI companies do you want in your private healthcare information. Where is the line drawn between your privacy and data mining? Who do you want driving your healthcare bus? Your doctor or Google? Please let me know what you think. Like and subscribe and stay tuned for more Healthcare News you may not hear about.
https://thinkhealthitudeacademy.com/
https://choicesabouthealthcare.com/
Follow us here on YouTube or on Facebook. !
PS It is a bad hair day. lol
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Consumer Fight Healtcare costs
Healthcare -what you may not hear otherwise.. We are going to begin peeling the layers off of our healthcare costs. And how we the consumer, can start to save expenses on our care. Insurance companies and the government are dictating our care. Stand up and take note. There are many ways you can still save money with or without your insurance.
A few facts on how we consume healthcare.
Read our Blog
https://thinkhealthitudeacademy.com/all-things-healthcare/consumers-fight-healthcare-cost/
Check us out at
https://thinkhealthitudeacademy.com
https://choicesabouthealthcare.com
Like subscribe and let us show you how we can help.