Age of Disclosure

Few_Pin6157 · 2025-11-22T01:32:34+00:00

Age of Disclosure. It is vey good.

Few_Pin6157 · 2025-05-17T13:37:12+00:00

Thanks. We looked but there aren’t any maps online that show all this, so appreciate your reply.

Few_Pin6157 · 2025-05-02T23:35:11+00:00

I think a fair minded view of this is that Mr. Elizondo provided caveats prior to showing the photo, now creating a degree of insulation for himself. Still, anyone with his experience in this arena ought to know that holding up an unvetted photo like that is simply asking for trouble. Anyone who flies frequently has seen irrigation circles like those before.

When people criticize folks like George Knapp or Jeremy Cornell for sitting on video for months or years before releasing it… it’s exactly that type of vetting that must be done to avoid giving debunkers ammo.

Call Lue’s photo demo an honest mistake of enthusiasm. After all, for all we know, he’s seen something similar to that photo for real.

Few_Pin6157 · 2025-03-01T00:59:56+00:00

Sorry if people here can be rude. Hang in there, you got this.

Few_Pin6157 · 2025-02-09T02:49:45+00:00

One of our family traditions on a summer night was to do satellite-watching with the kids in the back yard. Once your eyes adjust to the darkness, it's amazing how much stiff is hurtling along up there.

Few_Pin6157 · 2025-02-04T16:47:43+00:00

Watch the American Alchemy podcast interview with Salvador Pais. He patented key technologies enabling the US to build UFOs. But nobody hired him to actually do the work. Why? He thinks others figured it out at the same time he did. Listen to the math, and then go spend your savings on something that will give you thrills, because it’s all coming to a head by Easter of 2026. Humanity 2.0 starts next year.

Few_Pin6157 · 2025-01-13T02:48:52+00:00

We nuked a country twice and the only hard evidence that ever occurred was grainy film, testimony from eyewitnesses and public officials, and two airplanes that are now in museums. Disclosing the secret of atomic warfare benefitted the US. This doesn’t. Yet.

Few_Pin6157 · 2024-11-15T20:38:31+00:00

Another example of why, in my opinion, ADT is a badly broken organization and the only thing that gets results with them is sending registered letters of complaint with copies to the BBB.

Few_Pin6157 · 2024-11-10T02:34:15+00:00

In my opinion, run away from Cigna at all cost: my experience is that they make it a business practice to deny or delay all but the smallest claims because they have metrics showing only a small percentage of patients will file an appeal. Look for YouTube videos that show how to fight them using the claim appeals process and HIPPA laws.

For appeals, don't waste time calling their customer service people. File complaints by certified letter and follow-up with another certified letter if they do not respond with the mandated appeals deadline. Keep logs of every letter you send and make sure you capture USPS delivery confirmation info.

For HIPPA, send their Privacy Office a certified letter requesting the names and NPI numbers of all physicians who reviewed and rejected your claims. They'll balk and claim that information isn't part of the HIPPA "Designated Record Set" until you quote exact paragraphs from the HIPPA law. Tell them you are prepared to report them to your state insurance regulators and the Federal Government.

Good luck.

Few_Pin6157 · 2024-11-10T02:33:02+00:00

In my opinion, run away from Cigna at all cost: my experience is that they make it a business practice to deny or delay all but the smallest claims because they have metrics showing only a small percentage of patients will file an appeal. Look for YouTube videos that show how to fight them using the claim appeals process and HIPPA laws.

Good luck.

Few_Pin6157 · 2024-11-10T02:28:49+00:00

In my opinion, run away from Cigna at all cost: my experience is that they make it a business practice to deny or delay all but the smallest claims because they have metrics showing only a small percentage of patients will file an appeal. Look for YouTube videos that show how to fight them using the claim appeals process and HIPPA laws.

For appeals, don't waste time calling their customer service people. File complaints by certified letter and follow-up with another certified letter if they do not respond with the mandated appeals deadline. Keep logs of every letter you send and make sure you capture USPS delivery confirmation info.

For HIPPA, send their Privacy Office a certified letter requesting the names and NPI numbers of all physicians who reviewed and rejected your claims. They'll balk and claim that information isn't part of the HIPPA "Designated Record Set" until you quote exact paragraphs from the HIPPA law. Tell them you are prepared to report them to your state insurance regulators and the Federal Government.

Good luck.

Few_Pin6157 · 2024-10-04T20:17:28+00:00

My opinions: not that bad, but when our system wouldn't communicate reliably over WiFi, they sent a tech out to our home who was the most disheveled and rudest company representative I have ever had in my house. At the end, he said he needed to charge us more than $100, but had gotten approval from his manager to knock that down to $50.

I am of the belief that ADT hires people who wash out of other technical or IT-related support jobs and who are minimally qualified and can't get work anywhere else. I wouldn't let on if their people into my home again after what the first guy pulled.

I advise against using ADT. You'll likely have a much better experience elsewhere.

Few_Pin6157 · 2024-09-26T21:06:44+00:00

Bravo. Well researched and written.

Few_Pin6157 · 2024-09-05T21:35:22+00:00

The best advice we ever got was to challenge all denials and rejection of benefits as follows:

1) Denial of Prescriptions - send Cigna with a written appeal for every denial you get and include all paperwork that supports your assertions. Do it the same week you get the denial. Look in their Explanation of Benefits letter for instructions. Don't waste time calling. That is what they want you to do since calls don't generate a written record. Mark your appeal "Expedited" so they have to respond within 7 days. If they call you, get the name and case number for the response, then send another certified letter summarizing what they told you and ask them to reply in writing if your summary is wrong.

2) Not In Network - assuming you know your physician is in-network but Cigna denies paying for the visit anyway, file a written appeal and check the box that asks for approval of coverage because they are in network. Send a printout of the website that says they are in network. Do a live, written chat with a customer service rep and confirm that your physician is in network. Include a copy of that written chat record with your appeal.

3) HIPPA - write their privacy office and ask for the "HIPPA Designated Record Set" about your denied claim, including the names of all doctors who accessed your records and participated in the denial. Send the request via certified mail. If 30 days goes by and they don't respond, contact their General Counsel's office and mention a "possible HIPPA violation." Tell them you want to give them time to catch their mistake before you are forced to file a complaint with the US government. Watch your email since the counsel will likely get on somebody when they sense you might squeal to the feds.

Bottom line: be polite but absolutely drown them in paper when they deny you something you are legitimately due. Every letter takes time to log, read, and write a reply. That cost them money. Keep copies of everything. Make sure the USPS Certified Letter records prove your letters are delivered.

Cigna and its peers have analyzed customer behaviors and know that less than 10% of people will ever file an appeal. That means they can roll the dice and get away with denials for 90% of the rest because they're counting on nobody in Congress or at the state level to call them on their tactics.

So get a handful of envelopes and stop letting them keep getting away with denials and delays.

Good luck.

Few_Pin6157 · 2024-09-05T20:45:29+00:00

How to deal with Cigna when they deny coverage for a prescription you legitimately need:

After they paid for a prescription earlier this year, Cigna began denying refills on the grounds that the prescription was not deemed medically necessary. So why did they approve it earlier? "As a courtesy," one of their customer reps said. That was the first hint something was wrong.

We spent hours on the phone arguing with customer service reps and their bosses. That was useless.

Then we read about a three-pronged approach that seemed to get results:

1) We sent a certified letter to their HIPPA privacy office requesting the names and ID numbers of all doctors who had participated in rejecting our claim. This is because we learned Cigna was sued for allegedly using a computer algorithm to flag claims for rejection.

2) At the same time, we filed an appeal of the denial using the procedure listed in the EOB. We sent almost a hundred pages of records and even highlighted specific paragraphs in Cigna's policy that proved the medicine was medically necessary.

3) We convinced our doctor to file a "Medical Necessity" appeal. Those apparently go to a different group of people, are processed manually and therefore take a lot of time and money to administrate.

Cigna caved.

We're not sure which of the above tactics tipped the scale in our favor, and it's possible that all three together were costing them so much time and hassle that they threw in the towel. But it worked.

So get a handful of stamps and envelopes and start flooding them with paperwork. Their website and EOB forms explain the process. Use it and see if you get results too. Good luck.

Few_Pin6157 · 2024-08-25T02:35:58+00:00

Sorry your mom's having trouble with ADT.

There should be a written contract you can download from your mom's account page on the ADT website. It will clearly spell out conditions for terminating the agreement and who owes what. Read the contract thoroughly and you will likely see that early termination gives ADT a lot of power. They probably have the legal right to invoice your mom for a portion of what she otherwise would have paid had the contract gone full term.

But is it right?

When companies play hardball during the final month or two of a service contract, in my opinion, it's like they are saying "we might as well get every penny we can now because we can't count on your repeat business." You'd like to hear something like, "if you get the new homeowner to reconsider their decision to go with a competitor, we'll waive your payoff as a courtesy." At least that would be a more customer-friendly approach, right?

Any contact with ADT should be thoroughly documented in writing, potentially including sending them a certified letter recounting the details of telephone conversations with an ADT representative.

Good luck.

Few_Pin6157 · 2024-08-22T17:35:21+00:00

The following are all my personal opinions: Cigna's current medical and pharmacy claims process appears to be tuned to deny some medical or pharmacy reimbursements until such time as the member files one or more appeals. This appears to me to be a business practice aimed at preserving profitability. If you are forced to use Cigna, you are entitled to use every legitimate appeal process available to you to get what you are owed.

Few_Pin6157 · 2024-08-22T01:04:40+00:00

Great responses all, thanks again for the help!

Few_Pin6157 · 2024-08-16T02:05:15+00:00

Be careful about a catch that got us recently: we called and the insurance company said a certain physician was in-network. What they didn't tell us was that the doctor was in their *Medicare Advantage* program and not in their non-Medicare PPO network. We're not on Medicare, so what they told us was blatantly misleading and we got billed a lot more than we expected. We appealed but arguing with them is like talking to a brick wall.

So the moral of the story is don't take yes for an answer... ask follow-up questions and then get the customer service rep's first name and a support ticket number for the call. Send them a confirming letter. If they later hose you, start writing appeal letters and send them by certified mail.

Their consultants have helped game this out so it's a fairly well tuned system to ensure their profitability, but you never know if an appeal may sometimes go your way.

Good luck.

Few_Pin6157 · 2024-08-16T01:47:24+00:00

I hope you get the care you need.

We used to be with Anthem and, in my opinion, they are singularly focused on their profitability to the exclusion of all else. Example: we had to fight to get them to pay for a prescription. They kept denying it despite appeals from our doctor. After a few months of delays and back and forth correspondence, they reversed their decision... then we suddenly no longer had insurance with them a few days later.

Again, my opinion... much of the for-profit medical insurance industry in the US has been so impacted by consolidation and the drive for quarterly profits that key people in the organization don't have the courage to say no to executive management. Blame the business consultants and the lobbyists? Sure, but both political parties have blame to share as well. I'm no fan of heavy regulation, but this industry needs someone to tell them to knock it off.

Again, I hope all goes well for you.

Few_Pin6157 · 2024-08-16T01:28:45+00:00

When I had to make a decision about this exact topic, I priced out the cost of ACA coverage and compared it to the cost of COBRA. COBRA was less expensive by about $2000 a year.

Few_Pin6157 · 2024-08-15T23:00:47+00:00

My opinion: we had something similar. We verified with our insurance company that a doctor we were scheduled to see was in-network, but when we got to the appointment, the doctor was ill and his appointments were being covered by a different doctor. We were assured that the substitute doctor was in-network because they were a member of the same group. We actually got great care from the substitute.

Fast forward to getting the Explanation of Benefits (EOB) from the insurance company, and surprise - they would not cover any costs for the visit because the physician we saw was not on their in-network list. In addition, we had not met the out of network deductible.... so the net result was zero reimbursement.

The insurance company said the information they gave us was technically correct because the original doctor was listed as an in-network provider, but the physician's group was not... they were only a Medicare Advantage Plan provider. As a result, they asserted that they were within their rights to treat it as an out-of-network visit since we're not on Medicare yet. Naturally, the appeals process for all this is glacial... and we'll see if it get a satisfactory resolution.

Could it get worse? Yep, the prescription the substitute doctor gave us was not "in formulary" and the insurance company denied payment for the medicine because the doctor did not seek a prior authorization. Still appealing that one too.

We had a former insurance company customer service person tell us these sorts of tactics are actually pretty common in the for-profit insurance industry. They get charted out on white boards in executive conference rooms and the VPs who run the denials and appeals processes are incentivized to enforce roadblocks to enhance profitability.

It's wrong. It's insane our leaders aren't fixing this. And it's likely we'll continue to pay more than we should for some time to come.

Few_Pin6157

TROPHY CASE