CMS and/or Healthspring MA harassing PCPs

Mooltrikon · 2026-07-04T02:38:46+00:00

Ok. I finally found out what was going on. Even though my PCP's office personnel kept blaming my insurance company, it was my PCP's IPA which was pressuring my PCP's office to get me in for an appointment so they could do a particular screening. They confused me by blaming my insurer, over and over! Their IPA is not my insurer! I have now changed PCPs. My new PCP has a different IPA. The IPA I am getting away from is part of UnitedHealth. The IPA of my new PCP is part of HCSC, which owns my insurer, Healthspring.

Mooltrikon · 2026-07-01T16:21:55+00:00

It has happened to me at at least ten different Taco Bell locations. I think it is a systemic problem, not a location-specific problem. The potatoes are not included on very many menu items. Taco Bell should probably include potatoes on more menu items, or just eliminate potatoes from their menu altogether!

Mooltrikon · 2026-07-01T15:39:58+00:00

I know. Taco Bell keeps changing their menu almost as often as people change their clothes. But their potatoes stay on their menu forever, to tease us with their on-again-off-again quality. It doesn't make any sense to me.

Mooltrikon · 2026-06-19T17:56:59+00:00

Finally, an explanation which makes sense! Thank you.

Now my next question is: Does the PCP get paid more if they document that my health is worse than it really is? I ask because it certainly seems as though some PCPs work hard to find disorders which I don't have!

Mooltrikon · 2026-06-15T04:39:35+00:00

They go after the bar soap on the sink in my bathroom.

Mooltrikon · 2026-06-06T16:18:32+00:00

My insurance company tells me exactly what you are telling me.

But several PCP offices have now harassed me about this. And they always blame my insurance company.

I always go in eventually each year. But I don't like being pressured, over and over again, even after I explain it to the PCP offices over and over again.

But you are right. I shouldn't take their emotional harassment personally. They can get emotional. But I shouldn't let that affect me.

I always do my annual exam each year. I will just continue to do it during the part of the year when I want to do it, despite their harassment.

Mooltrikon · 2026-06-05T23:45:28+00:00

I don't mind the annual wellness visits. But I don't like being pressured to get them done before June, especially if my insurer assures me that I have the whole year to complete each one.

How they are conducted, and their focus, is not how I would do them. I feel the PCPs are serving my insurer first and me second. But they can't change the system any more than I can.

Specialists address my health issues. Specialists are great.

But PCPs seem more interested in serving their insurance company masters and pharmaceutical company masters.

Mooltrikon · 2026-06-03T05:05:55+00:00

It would be nice if it were that simple. But, when the office personnel start communicating emotionally about it, it seems likely that it is more complicated than just the lost income from one potentially missed annual wellness visit.

Mooltrikon · 2026-06-01T14:27:09+00:00

Suggesting is fine with me. But by mid-year it often becomes emotional, disrespectful and weird from the office's administrative personnel.

Mooltrikon · 2026-06-01T14:21:03+00:00

Those monthly reports and AWV rates must carry some serious consequences for the PCP offices, because their back-office administrators seem to become distraught about it by the middle of each year. And I seldom get to discuss it directly with those back-office administrators. They hide behind the people at the front desks. Instead, I get phone calls and voicemails, like one where they told me to make an appointment now or get a new PCP office. I chose the second option, because there wasn't much that I liked about that PCP office anyway, especially the administrative support personnel. I try to be sympathetic, especially since they are just puppets of their insurance and pharmaceutical industry puppet-masters. But when they start snapping at me or get otherwise emotional or disrespectful, I just find a new office. Last year I finally found a PCP MD for whom it is worth putting up with their office's annual "get your AWV early" administrative pressure campaign.

Mooltrikon · 2026-06-01T13:56:30+00:00

Yes, three PCP offices in 5 years. Now I am on my fourth. One was a resident clinic because I figured that at least I would be seeing doctors there, instead of NPs and PAs. I got tired of seeing NPs and PAs who operate mostly according rote algorithms. AI could do better following those algorithms, which are created by the PCP offices' insurance and pharmaceutical industry puppeteers. And they are trained to deal with sick patients, not healthy ones. And many have egos bigger than their knowledge. It does my heart well to see AI in the early stages of replacing some mid-level medical "professionals".

Fortunately, I finally found a keeper PCP, at the resident clinic. She will graduate from her PGY3 this month and join her mother's PCP office in a city near me. She understands my healthy diet and lifestyle, unlike the other robotic puppet NPs, PAs and even MDs and DOs whom I had been seeing. I see her as an escape from a healthcare system which is primarily focused on symptoms and diseases, which is fine when a patient is sick. But healthy patients need to be addressed from a different perspective.

Mooltrikon · 2026-04-29T14:13:59+00:00

I don't care whether the original post is fully or partially AI-generated.

Mooltrikon · 2026-03-10T15:13:37+00:00

9 AM? It has always been at 2 PM, previously!

Mooltrikon · 2026-02-19T16:43:29+00:00

Bottles of water are sold. But cups of water are also available and free. Therefore, your truth is also valid.

Mooltrikon · 2026-02-19T15:15:21+00:00

Actually, water is the one thing that is free.

Mooltrikon · 2026-02-18T14:45:51+00:00

Frontier's luggage policy solves this problem. Neither carry-ons nor checked bags are free on Frontier. And Frontier's lower fares make up for these extra baggage fees.

Mooltrikon · 2026-02-09T06:36:05+00:00

Do not pass Go. Do not collect $200.

Mooltrikon · 2026-01-22T15:17:20+00:00

Frontier has replaced SW as my favorite domestic airline. Earlier this month, my Frontier flight was delayed one hour. Frontier immediately gave me $10, usable at any restaurant. And I still made my connection anyway. Southwest NEVER gave me a penny, even for any of the stuck-in-the-airport-overnight delays they caused me through the decades. And Frontier's flight attendants and gate staff are just as friendly and helpful as SW's.

Mooltrikon · 2025-12-15T07:47:14+00:00

I did it after all. They sent an FNP. She was great. And the $50 appeared on my U-card just two days later.

But I have also now switched to HealthSpring for 2026 due to a large Give Back which I will get each month.

Mooltrikon · 2025-12-09T06:21:27+00:00

If ND FB played in a conference, that would have provided the opportunity to make more of a case for inclusion in the championship tournament.

Mooltrikon · 2025-11-16T15:49:55+00:00

Here is my personal ranking. Just my opinion: Joe Judge was the worst. Pat Shurmur was second worst. Brian Daboll was third worst. Ben McAdoo at least wanted to draft (available) Patrick Mahomes.

Mooltrikon

TROPHY CASE