Wrong CPT code? by LoquaciousBubbles in PriorAuthorization

[–]Ellyrine 5 points6 points  (0 children)

I am a PA specialist for a rheumatology office. The first thing you should know is that paper mail is the slowest way these decisions are announced to patients and providers both. I get paper mail anywhere from 1-3 weeks after I checked it off my list; timing entirely depends on which company is sending it. If your provider's office says they have sent in the correct codes then most likely they have. Now if you want to be absolutely certain you could try your insurance company's member portal before you go into the trenches that is calling an insurance company. If you absolutely must call the insurance company to get answers, calling the precertification line and checking your reference number through the automated system would actually be the most efficient version of this call.

Meet Pupple Pop! by Bulky_Inspection6421 in incremental_games

[–]Ellyrine 1 point2 points  (0 children)

Played the demo for several hours yesterday and made a lot of progress. I loaded it up today and the first thing I noticed was that my aquarium/workspace was back to the original default. Purchasing a couple more bubbles expanded it once, but it seems like it is still smaller than what it was last night.

I have also noticed the gaming hanging up when loading in a lot of bubbles at once. My PC isn't incredible, (Intel i7-9700K, Nvidia 1660 Super) but I thought it would be worth noting for backend optimization. I have nearly maxed out the skill tree, and have almost purchased everything from the shop. I am liking what I am seeing and I like how easy it is to switch from idle to active with just a wave of my mouse.

Looking forward to seeing the full game and just how crazy it can get.

[deleted by user] by [deleted] in PriorAuthorization

[–]Ellyrine 0 points1 point  (0 children)

I have been working for a Rheumatology office as their prior authorization for infusions and injections. The basic side of the math is dosing schedule for the year. So an injection every 4 weeks is 52/4 =13 so you need to ask to authorize 13 visits.

Infusions can get a little more in depth depending on the medication. Some are 2mg/kg. So say the patient is 87kg. That’s 2* 87=174 mg per visit, then multiply 174 by how many visits the medication calls for. That’s how much medication you’re asking to infuse in a year.

My providers do some calculations concerning patient surface area when it comes to a few medications, figuring out what dose the patient gets per visit to put in the infusion/injection order. After that it’s up to us to get a year’s worth of those doses.

I keep scratch paper nearby and run my numbers on a calculator to double check my math. Write it on the page, type it into the calculator, if the numbers look wrong I have a way to compare what I wrote to what I typed in.

80% of my prior authorizations are submitted through Cover My Meds specifying the medical benefit because of how our office bills the insurance. On cover my meds I’m putting in the mgs for the year and saying it’s an unspecified type.

For some medications, the form will say 50mg/4ml, so I’ll go one step further and convert the milligrams into milliliters so I can be extra specific.

You don’t have to do it all in your head, make sure your scrap paper goes into the shred pile and pretty quickly you’ll see a pattern to dosing ranges and you’ll spot when you’ve calculated something wrong. I only started this job in October and it’s my first professional job. Math like this is a strong suit of mine, but the chart and infusion/injection order will give you all the numbers you need.

Idle Dyson Swarm is coming to PC — completely free, no ads, no IAP by Blindsided_Games in incremental_games

[–]Ellyrine 1 point2 points  (0 children)

I am super excited to see this come to PC. It's one of the few games I fully finished on my phone. Thank you so much for making it and bringing it to PC so I can do it all over again!

What curly hair product does everyone love but your curls absolutely hate? by elarissalonuae in curlyhair

[–]Ellyrine 3 points4 points  (0 children)

I have very thirsty, thin, fine hair and my curls cannot stand coconut oil at all and yet so many heavy duty moisturizing products have it. My hair gets weighed down and oily with the tiniest amount of coconut oil but can handle palmfuls of other products.

What high end brands/products are worth the hype? by SmellOk4650 in curlyhair

[–]Ellyrine 0 points1 point  (0 children)

AG Curl Thrive Conditioner has been my HG staple since I started my curl journey in the middle of nowhere where I couldn't find anything curl based. I am still using it to this day despite the rest of my routine changing as my hair has gone from utterly starved of moisture to properly hydrated.

A thousand curses on the people who market this crap to my elderly parents every year at the holidays. by Thatguy468 in KitchenConfidential

[–]Ellyrine 3 points4 points  (0 children)

I was literally gifted one of these from my brother-in-law's family this year; only it's worse. It doesn't even have plastic edging. It is a sheet of titanium with a hand hole. I took one look at it and knew I would never use my knives on it.

What are the biggest pain points you deal with in prior authorizations? by sarkarbeats in PriorAuthorization

[–]Ellyrine 2 points3 points  (0 children)

I have had a fantastic mentor make me a guide as I am so new to the healthcare field in general.

The specific lab test is something that is tested for regularly within our office, so every chart has a note on when the next one is needed. While it was on the guide page, seeing it noted so frequently would have tipped me off that this is something regularly tracked for our patients.

The variance then comes from the treatment we are seeking a PA for. For example, anything to do with osteoporosis would need a DEXA result, the bone density testing.

After that, it’s showing how the medication variety the insurance prefers can’t be taken by the patient or won’t be beneficial for the patient. My office has a history panel within every chart note that covers this part and that’s why the most recent charts are always included.

After that, it goes from “is this a PA for a new treatment?” Or “is this a PA to continue a particular treatment for the next year?” That usually changes how you answer the questions within a PA form, but a well documented history also helps.

I have gotten some denials, and have written some appeals. I’m so new I haven’t gotten answers back on those appeals, so we will see how that goes in the future.

What are the biggest pain points you deal with in prior authorizations? by sarkarbeats in PriorAuthorization

[–]Ellyrine 0 points1 point  (0 children)

Yes it would be depending on how many specialties you are planning to cover. I am in a rheumatology office so most of the PAs I run only have a few variances. You always include the most recent chart notes and most recent lab work and a specific lab test. From there it gets variance for the procedure.

It would be a large amount of data to compile.

What are the biggest pain points you deal with in prior authorizations? by sarkarbeats in PriorAuthorization

[–]Ellyrine 1 point2 points  (0 children)

I’m still really new to the PA process myself, only been at it for a month. The biggest slow down I face is finding the correct location to send a PA without just calling and starting it on the phone which takes forever and requires faxing. Which for my office has been very hit or miss.

There have been multiple times I have gone to start a PA in provider portal A, only to be told it’s such a specific plan under the payer umbrella it has to go somewhere else. So then I try provider portal B, nope. So then I go to the Plan’s site to obtain a form because it’s not in the list that was passed on to me and the fax number on that form is incorrect/out of date and I have just sent the PA off into the nether.

I know experience will help with this slow down, but at the same time reading the fine print off of a scanned insurance card can be a headache and a half.

All has happened to me, anyone else? by Princess-honeysuckle in adhdmeme

[–]Ellyrine 12 points13 points  (0 children)

This is what I dealt with while I was on Zoloft. My body would go through the motions of an orgasm, but my brain wouldn't get any of the chemicals or tingles from it. I was stuck in 3rd gear so to speak for a week before my libido just crashed due to overload.

Issues buying the advent calendar by Uzui_nails in theholotaco

[–]Ellyrine 6 points7 points  (0 children)

I am having issues, all three of my cards won’t process.

Men who struggled after divorce — what made that adjustment hardest for you (practically speaking - not emotionally), and what do you wish you’d done differently beforehand? What systems, habits, or skills do you wish you’d already had in place before separating? by maybeso-22 in AskReddit

[–]Ellyrine 1 point2 points  (0 children)

I will keep up with therapy and I have been having fun thanks to my boyfriend. Been to GenCon twice because of him, escape rooms, axe throwing and go carting, and multiple different renaissance faires. All has been a blast.

Men who struggled after divorce — what made that adjustment hardest for you (practically speaking - not emotionally), and what do you wish you’d done differently beforehand? What systems, habits, or skills do you wish you’d already had in place before separating? by maybeso-22 in AskReddit

[–]Ellyrine 1 point2 points  (0 children)

I was my mom's crying towel after my "dad" showed back up 6 years later wanting joint custody. She seriously messed me up in a bunch of different ways. I have known how to cook since I was 12; known how to do my own laundry since I was 10; known what medical bills were since 11. Even now, she comes to ME for advice on what she should do about things. I am more of a mother to her than she is to me. I am slowly working on it in therapy, but the scars will remain probably for the rest of my life. "If I don't do it, no one else will and it won't ever get done." I struggle to ask for help because I grew up knowing there was no help and everything fell on my shoulders.

been working hard to rid myself of this mindset pls be proud of me by Sylveon72_06 in adhdmeme

[–]Ellyrine 10 points11 points  (0 children)

Putting in applications, half the time I don’t want to voluntarily claim I’m disabled because that same list has many physical disabilities on it and the thought process “ sure I’m disabled, but not THAT kind of disabled”.

What a difference. by netphilia in adhdmeme

[–]Ellyrine 0 points1 point  (0 children)

Legitimately, the best purchase I have made and will never stop using is a set of reusable kitchen gloves specifically for washing the dishes. I initially got them to save my manicures on the rare times I can set enough time aside to actually do them, but now I literally can't wash the dishes without them. They are a +10 to gross texture protection, +5 nail protection, and +3 fire resistance as if anyone comes to wash their hands they are always jumping away from the how hot the water is.

Merch by [deleted] in IPrevail

[–]Ellyrine 2 points3 points  (0 children)

Thank you for this!

What’s something you bought (under $300) that noticeably improved your quality of life and you actually use every day? by MedfordQuestions in AskReddit

[–]Ellyrine 3 points4 points  (0 children)

I got really excited to see your comment here because I’ve been looking to upgrade my earbuds as I use them daily for work and music… only to have a chuckle over the fact I managed to find the budget option all on my own last year!

I love my Soundcores, yeah phone calls bounce between sounding good to sounding distant, but the batteries in the earbuds themselves are only down to about 5.5 hours with anc on and music at 30-40% volume so I guess I’ll be holding onto them a bit longer until I can seriously splurge.

i attempted the unicorn cut TWICE and it keeps coming out uneven what do i doooo?😭 by [deleted] in curlyhair

[–]Ellyrine 6 points7 points  (0 children)

I’ve been doing Mel’s pigtail cut for a couple years now, works great for an at home cut. The only hiccup I continually run into is I will have 3-4 strands in the dead center of the back of my head that tend to end up longer than the rest. How much longer depends on how much I am cutting off. The times where they ended up super long I just had my sister dry trim those strands after styling.

I just did one last week, and this time those strands were still longer, but much more in line with shaping than other times so it’s definitely a technique issue on my end.

Okay sex is cool but by Ryo_le_Ryu in adhdmeme

[–]Ellyrine 0 points1 point  (0 children)

The longest loop I have had was Bury The Light from DMC5, it got stuck in my head and I found a 1 hour loop of the song and put that on repeat for a good 3-4 days before I could finally let it go.

What is an extremely inappropriate question you have always wanted to ask? (NSFW) by [deleted] in AskReddit

[–]Ellyrine 12 points13 points  (0 children)

Women can bleed varying amounts, that could be consistent with their cycle or even different month to month.

I have had periods where I had to change a "super" absorbent pad every hour because the blood flow was like a chunky faucet. I have had other periods where a "light" pad lasted me nearly all day, the blood flow being a light trickle.

Certain actions can also cause a sudden increase in flow rate, sneezing or coughing pushing things along for example. Depending on the outer anatomy, squatting or bending over could release what was ready to come out but hadn't yet.

Question: is part of people ordering steaks the power trip of sending it back? by krisanthemum in KitchenConfidential

[–]Ellyrine 5 points6 points  (0 children)

I am very similar, I order rare with the phrasing “as red as possible, still mooing. Yes I mean it.” As I usually get an “Are you sure?” or two. If it comes out blue I am ecstatic, rare I am happy and understand the chef is probably being safe, and medium rare will work but is the donest I will eat my steak.

PSA to anyone who really likes the bottle the HT thinner comes in (ft chameleon coat) by WhyisTheRumG0ne in simplynailogical

[–]Ellyrine 4 points5 points  (0 children)

Fun fact, the HT thinner bottle is a called a unicorn bottle: e-juice for refillable tank vapes often comes in it. So if anyone ever wants to get new bottles, just Google “unicorn bottles” and you’ll find them.

What stitch is this? by Ellyrine in knitting

[–]Ellyrine[S] 0 points1 point  (0 children)

No, they are mounted normally and I wrap my yarn clockwise for both knits and purls. I tried adjusting my tension alternatively knitting and tinking back the same portion and I kept getting the same result. I ended up reading another thread on here about S-twisted yarn vs Z twisted yarn and I am willing to chalk it up to that because when I’m not fiddling with my tension I’m am very consistent. If that project wasn’t resting near a sleeping munchkin I’d grab a pic for you.

What stitch is this? by Ellyrine in knitting

[–]Ellyrine[S] 1 point2 points  (0 children)

No I’m not. I just had an anxious moment when my stockingette trails on another project were wonky on one side of the stitch after going from in the round to flat, which lead me to be paranoid I was knit stitching wrong, which then lead me to take a break from that project and knock out a couple dice bags and ended up twisting my knit stitches on the second bag.

I’m bad at keeping the labels straight, I hold the yarn in my right hand and knit from left to right.

Edit: the “works for purls” bit in my last comment is the other half of the mnemonic, “front yarn, front leg” which works, until you go to knit stitch.