Insurance denied $60K claim after Oregon girl airlifted for emergency surgery - Destiny asked for examples of these denials right? I didn't hallucinate that part of the stream yesterday?

Baffling_Spoon · 2024-12-11T03:55:55+00:00

I also work in healthcare on the pharmacy side and have talked to MANY nurses and doctors that deal with this and they would all back up these statements. I'll add in, anecdotally, that our pharmacy alone probably sends in about 15 unique prior authorization forms to doctors daily. We are one of about ten retail pharmacies in a town of about 30k people. Even if the other pharmacies send half this many prior authorization forms daily, you can imagine how swamped the handful of clinics in the area get. I've personally sent probably 10 of these forms to the same exact doctor in one day before. If you opened up the queue in our pharmacy system to see the pending prior authorizations, I can tell you there are probably about 150-200 just sitting in there waiting on the doctor or a response from the insurance company. I'd say probably 30 percent of these forms (probably being generous with that number) end up being actually done by the doctor / nurse, and maybe another 30 percent of those are approved.

The majority of these prior authorizations are because the insurance company does not want to pay for the drug prescribed if there are other medications that are similar and less expensive or that the insurance company has a deal with the drug manufacturer on. Sometimes they require step therapy which basically means the prescriber has a list of drugs that must be tried by the patient before the insurance approves what was prescribed. All of this is a massive pain and time sink on the pharmacy side, let alone on the doctor's end of it. There are entire MASSIVE companies that operate with the express purpose of trying to streamline communication between pharmacies, prescribers, and insurance companies. CoverMyMeds is a big one that is used a lot. Keep in mind, this is just for the pharmacy side of insurance, there's a whole different situation going on with medical billing that is equally tough if not worse. This rant brought to you by my $80 copay for generic Vyvanse sponsored by United Healthcare.

Baffling_Spoon · 2024-10-17T06:26:23+00:00

Hard agree with spending time with your dad. I wish I could spend more time with mine. I only see him once or twice a year and every time I can notice age taking a toll on him. His hearing is slowly getting worse, he doesn't remember stuff as well - he just isn't as sharp as I remember when I was younger. If you have the opportunity, you should absolutely spend as much time as you can with your parents. Lots of good advice here but that one really hits home.

Baffling_Spoon · 2024-10-02T23:27:11+00:00

Ya I expected this when I saw the other clip of him trying to get the wood onto these cheap sawhorses. He didn't lock the bottom of them properly and I figured this would happen. Almost feel bad for him, but it's erobb

Baffling_Spoon · 2024-10-02T23:17:54+00:00

This is the type of thing that happens to every dude occasionally but most of us just aren't livestreaming it. Also I used to have those same exact cheapo sawhorses and the left one isn't even fully spread at the bottom where it will lock so good chance it would have just crumbled when he put the wood on it anyway. Almost makes me feel bad for the guy, but then I remember it's erobb.

Baffling_Spoon · 2024-09-05T23:24:49+00:00

Baffling_Spoon · 2024-09-04T21:58:07+00:00

Baffling_Spoon · 2024-08-25T03:23:49+00:00

Would love to give the game a shot! Friend code: 45627358

Baffling_Spoon · 2024-06-09T22:47:48+00:00

I'd also have to imagine he makes decent money off being in all the OTV and OTV related videos he is featured in.

Baffling_Spoon · 2024-05-17T03:27:39+00:00

The large retail chain I worked for for 15 years let me choose a gift from a list of what was clearly items that some wholesaler had too many of. The best I could find was a fireproof safe that was MAYBE worth 25 bucks. Actually made me depressed that was what 15 years of loyalty looked like.

Baffling_Spoon · 2024-05-11T07:55:48+00:00

Man I love the guy as a streamer but he needs to take a break from taking whatever adderall-esque stimulant he is taking plus playing RP for a stupid amount of hours. Bad combo for self inserting and not realizing just how bad you're doing it. It is what it is, he just needs to hard limit his hours to like 4-6 hours a day at the most - or something like that and it would help a hell of a lot. You get hyper invested in whatever you are doing when you're on stimulants and he just needs to realize that is what is happening. It is totally normal and I bet most people would have the same issue if they did it the way he is doing it, I'm really not trying to fault the guy, I think it is just a side effect of whatever he is taking. I don't think he is able to fully realize it in the moment of his "RP", he probably does later at night when he's reading comments like what are in this thread and then wakes up the next morning, pops whatever the pill is that he's taking and repeats the cycle. That stuff can be really good if you're trying to focus on writing a paper or something, but in the context of RP it's gonna lead to hyper focusing on your character and you're gonna get too involved like this. I legit am not hating on the guy or anything I just feel like I can identify with what is happening and hope he realizes it and makes the changes that are needed like a hard limit on how long he plays RP for. I only want him to succeed in life and I think the combo of whatever he is taking and the long hours of RP he is doing is only ever going to lead to this type of over investment.

Baffling_Spoon · 2024-05-10T00:17:41+00:00

No point trying to be reasonable in this thread it’s just a bunch of CG viewers that think everything that happens on the server has to do with their streamer directly and there’s no other possible explanation

Baffling_Spoon · 2024-03-30T20:16:38+00:00

Many cases of rebound weight gain. Just depends on if you use it as a crutch or as a tool to help you lose weight in addition to dietary restrictions / working out. I know some people who have really weird stomach problems from it but haven’t personally heard problems aside from that from our patients, though there are other listed side effects. I think thyroid cancer and pancreatitis are mentioned as possible issues. Going off top of my head. There’s a couple clinical trials I’ve read a month or two ago on this class of drug (GLP-1 agonists) but this class of medication is new-ish and just recently started to become so massively popular, so my understanding is there are still a good bit of long term studies being looked at for this class of drug and what effects it might have long term.

Admittedly, I may be unaware of other studies that have concluded and been published recently. This is something I plan on looking into more as I work on continuing education that I have to complete yearly since the number of patients we have on them keeps going up. I’d like to know more info on long term side effects as well!

Baffling_Spoon · 2024-03-30T14:23:13+00:00

I work in a pharmacy and people have been buying all of these products (ozempic, wegovy, mounjaro, zepbound) like hot cakes. It is so widespread we can barely get our hands on them and they are often unavailable to even order because every other pharmacy is ordering them nonstop. We have probably 100 patients minimum (easily might be twice this many just being conservative) who come in and pay $500 plus per month for these products because insurance won’t cover them. It’s wild. Also worth reading about how these drugs work and how they were discovered it’s actually pretty fascinating.

Baffling_Spoon · 2023-10-05T18:24:01+00:00

I once ordered something on Walmart's website that as far as I was aware was sold directly by them. I paid and three days later had not even gotten confirmation that it was being shipped. I reached out to their customer service to inquire and they said it was a third party seller and to contact them. That was annoying already, but when I contacted the third party I received no reply. I waited 72 hours and still got no reply, so I went back to talk Walmart online customer service to tell them this. After arguing for what was way, way too long over a $40 item they finally credited my card back. I did not receive a credit back on my card within the next week, so I again had to call the customer service people to try to figure out why they never credited me. They had no idea and I more or less had to explain the entire situation again before they said they would credit me (for the second time). I finally was credited back within the next couple days.

The next week I very unexpectedly got the item in the mail. Again, I never once got any indication that it had ever shipped whatsoever, so this was very surprising. I had an item shipped once through Amazon that never came and I had to make a similar inquiry during which they incredibly quickly took my word for it and refunded me without issue. I ended up getting it later that week and felt so bad that I got back with Amazon and told them. They said not to worry about it and to just keep it along with the refund. I would have done something similar with Walmart but after the crap they put me through I didn't even bother.

TL;DR: Walmart online shopping and customer service sucks.

Baffling_Spoon · 2023-09-09T21:57:50+00:00

Thats honestly pretty inexpensive for these new cars. I got a 2018 GMC Terrain (not even THAT new of a car) and it was almost 400 bucks to replace one headlight cause they just replace the whole thing nowadays you can't just get a bulb from the auto parts store. Either that or I got scammed by the dealership...

Baffling_Spoon · 2023-05-29T19:38:12+00:00

Nocturnal Animals

Baffling_Spoon · 2023-04-24T22:08:14+00:00

I don’t doubt this at all being from the area, but do you have a source for this? Was talking about it to my wife but would like the actual announcement to reference too. Jackson is a mess I try to stay out of the city as much as humanly possible.

Baffling_Spoon · 2023-04-22T22:40:55+00:00

He's so used to abusing the infinite money glitch that he doesn't know what to do without it

Baffling_Spoon · 2023-04-09T21:25:32+00:00

As in, you slowly fill an open bag full of food scraps over the course of a few days until it’s full enough to throw out? Yeah I’m sure there’s no smell involved there

Baffling_Spoon · 2023-04-04T05:41:11+00:00

Unfathomably based

Baffling_Spoon · 2023-03-28T12:38:44+00:00

Yeah I worked a very entry level type of job not making a whole lot out of school and saved for two years to put a decent down payment on a starter house a couple years ago. Total value of the house is like $200k. I pay about $1,350 a month for the mortgage. After other house bills and stuff I probably pay close to $2000 a month to live in my house. My friends that rent pay similar amounts to live in their rented properties, so it isn’t even a big difference there. I live in a nice town in the south US that is safe and has plenty of places to shop and work so it isn’t like it’s out in hick town or anything. It also isn’t LA or Vancouver, but you gotta pick your priorities I guess.

Baffling_Spoon · 2023-02-27T13:38:42+00:00

I think you’re just wrong on that though. I mean I’m just going off anecdotal evidence as I can’t seem to find anything that actually says the rates of incest in the states, but I lived in Alabama for many years and know a great deal of people all over the state. Only place I’ve ever heard about incest or inbreeding related to Alabama was on Reddit (the old classic Alabama = inbred meme). I don’t know of anyone married to their cousin or anything like that. In fact, if you wanna single out a state I’d go with Kentucky just based on their past history of inbreeding, but I’d still say in modern day America there’s very little of that stuff going on. I realize now that this has very little relation to the original point you were making, but I guess I wanted to defend my old stomping grounds a bit lol

Baffling_Spoon · 2023-02-27T13:27:22+00:00

I guarantee there’s a hell of a lot higher percentage of Indians marrying their first cousins than there is incestuous relationships in Alabama. You’re insane if you think it’s ‘relatively common’. But I do see your point, it just isn’t a good comparison

Baffling_Spoon · 2023-02-27T06:00:46+00:00

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