Dental care

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See, that’s what the app is perfect for.

Sounds perfect Wahhhh, I don’t wanna
assuredental
assuredental

Benefits of Dental Cleanings!

Most of the time its covered: If you have insurance dental cleanings are usually covered or its owed very little out of pocket. Take advantage of your dental benefits!

Prevent tooth Loss: Gum disease is a major cause of tooth loss. Its begins with plaque build up. If not cleaned it will get worse and may lead to tooth loss.

Prevent Cavities: This is probably one of the most obvious reason of why you should get your teeth cleaned. Clean all the plaque off your teeth to prevent cavities.

Good for your overall health: Getting cleanings can help lower your risk of diseases such as heart disease and stroke.

Prevent bad breath: Lets face it, nobody wants bad breath

Remember dental cleanings should be every 6 months! Stay on top of your oral health/hygiene for a beautiful healthy smile.

huffpost
huffpost:
“Why Is Therapy So Expensive?After a bout of breakup-induced anxiety and depression, 31-year-old New York City resident Emily Taylor decided to look for a therapist. But finding a mental health professional to accept her Anthem Blue Cross...
huffpost

Why Is Therapy So Expensive?

After a bout of breakup-induced anxiety and depression, 31-year-old New York City resident Emily Taylor decided to look for a therapist. But finding a mental health professional to accept her Anthem Blue Cross and Blue Shield insurance plan proved to be nearly impossible.

“I spent days looking for therapists near me that were covered by my insurance,” Taylor said. “For the very few I did find, I spent over five hours on the phone trying to get appointments, [only] to find that they were either not accepting new patients or the wait time was two months.”

Taylor was able to locate plenty of highly reviewed therapists available for private pay, however. But since the average cost of therapy in New York is $200 to $300 per session, according to one report, that wasn’t a practical solution.

Many people struggle to find talk-based therapy that’s covered by their insurance plans. Of all practicing medical professionals, therapists are the least likely to take insurance. Only 55 percent of psychiatrists accept insurance plans, compared to 89 percent of other health care providers, like cardiologists, dermatologists and podiatrists, according to a 2014 study published in JAMA Psychiatry.

That’s a big problem, since approximately 1 in 5 Americans will experience some sort of mental health disorder in a given year, according to the National Alliance on Mental Illness. Many will also seek counseling for divorce or grief.

Treatment is highly individualized, but experts agree that talk therapy is the gold standard for treating psychiatric problems. A 2015 study revealed that cognitive behavioral therapies were just as effective as antidepressants for treating depression.

So why is therapy so unaffordable for so many people? And why don’t more mental health professionals work with third party payers? It turns out several factors contribute to making therapy unaffordable ― many outside individual clinicians’ control.

Continue reading here. 

prokopetz
prokopetz

Okay, I don’t usually do the “wow, America” thing these days – heaven knows Canada has enough to answer for on its own! – but I just loaded up a YouTube video and was treated to a dramatic PSA-style commercial depicting a young black man being hauled off to prison in handcuffs while his assembled friends and co-workers stare with pity and loathing in their eyes and a stern-voiced narrator informs the audience that fraud is not a victimless crime, then at the end it’s revealed that the “fraud” this hypothetical dude committed was misreporting a pre-existing condition on his employer’s health insurance plan. Like… am I looking at a work of particularly unsubtle parody here, or…?

yumearashi

Medical billing errors

yumearashi

Had something happen the other day, I thought I’d bring this PSA back.

I just got a pair of medical bills totaling $700.  The things is, neither of them were correct.

My primary care doctor never even sent the claim to the insurance, they straight up billed me the full charge out of pocket, and couldn’t even explain why when I called them - they had my insurance on file and everything.

My dentist sent me a bill without processing the insurance’s response to the claim -  they told me that they didn’t receive it until after they sent me the bill, but the date on the insurance’s decision was a full month before the date on the dentist’s bill, so I’m thinking that was a big fat lie. 

What did I actually owe, after calling and getting all this sorted out?  $29.75.

Now, I spent 8 years doing medical billing, I have the experience to look at these bills and explanation-of-benefits letters and know that what I’m being charged isn’t correct.  What really appalls me is knowing that most people in this situation wouldn’t know that this wasn’t legit, and would probably just pay up - or end up in collections when they can’t.

The truth is, most medical billing in the US today is outsourced to medical billing companies - doctors’ offices and even hospitals don’t always have the manpower needed for the lengthy, complicated, difficult and time-consuming process of medical billing.  And a lot of these companies are poorly run and staffed by employees with minimal training who don’t know anything about the doctors or procedures or patients they’re billing for - meaning lots of errors.  Additionally, these companies operate on a profit model that demands maximum payment for minimum effort - if it’s not easy money, then it’s not worth their time.  They submit the simplest claims possible, and if they get paid, great - if not, then they mark the claim denied, assign financial responsibility to the patient, and move on to the next.  Chances are, they’re not going to contact the insurance company and find out why it was denied, much less revise and resubmit the claim, or file an appeal. 

If you get a medical bill that seems high, call the provider who sent the bill and tell them exactly that.  Ask them to please take a look at it and see if there were any issues.  Ask them to explain it to you.  Ask them about the insurance’s decision.  Have them walk you through it until you feel comfortable.  If you have to, call the insurance company to ask why they decided the claim the way they did. (always, always, ALWAYS be polite!)  It won’t always help - sometimes they’ll bullshit you, and sometimes medical bills are just high.  But you can at least ask whether every effort has been made to get you covered.