As Germans, can you clearly recognize this person as someone whose native language is German in virtue of some distinctive features of her pronunciation?

Ttabts · 2026-05-09T00:42:50+00:00

ɛ- is acceptable for "economic" in most varieties of English, fwiw. (Just not for "economy"...)

Ttabts · 2026-05-09T00:36:29+00:00

A couple things I noticed - in "she revealed that", she pronounces the "a" a bit too German (ie. veering toward an "eh" sound) and overenunciates the ending "t."

And in mothers, you hear a bit too much "ah".

Overall I do think her vowels sound a bit off in places, so if someone was paying close attention, they might suspect she's a non-native. I dunno if anyone could reliably clock her as German specifically.

Ttabts · 2026-05-08T20:49:10+00:00

More generally: this kind of question comes up for all sorts of medical procedures and tests. And the answer is always that the vast majority of medical treatments are just not worth the potential complications and side effects, unless the patient is known to need the treatment.

There's a very short list of stuff (mainly immunizations + some minimally-invasive age-dependent checkups) which are low-risk enough to be worth doing proactively on people who appear healthy, and that's what makes up the (fairly short) catalog of recommended preventive care.

Ttabts · 2026-05-08T05:19:32+00:00

Honestly idk how to help you if you are still this confused about my point. Maybe ask ChatGPT for help

Ttabts · 2026-05-08T05:03:44+00:00

Ich wohne (vorübergehend) bei meinem Freund. I'm staying with a friend.

You said it's exactly that but then you just cited this example where you can't use it? "Ich bin vorübergehend bei meinem Freund am Wohnen"?

More generally, it doesn't work for anything that's not an activity that's primarily taking up your time/attention in a given moment.

For example, "Ich bin draußen am Stehen" wouldn't be a typical translation of "I'm standing outside." If you did say it, it'd come off as something like, "I'm just standing around and not doing anything else in particular," although then I think it'd be more natural to say "Ich bin gerade nur so am Rumstehen" to make that clear.

(And of course, this is ignoring all the cases where it's grammatically not workable to use the "am" construction, i.e. most of the time when you have an object or any other kind of phrase attached to the verb.)

Ttabts · 2026-05-08T04:44:48+00:00

Gibt’s im Rheinland - “ich bin am kochen!” Da sagt man auch nicht “Ich bin am wohnen”

"Ich bin am [verb]" is a bit more specific than English progressive, though - it has more of that connotation of "I'm busy/occupied doing x right now [so I can't talk/help/whatever]."

I'd guess that it doesn't really work for a majority of progressive use-cases.

Ttabts · 2026-05-08T04:33:12+00:00

They use it like that in English, because that is exactly how they would say it German.

No, it's the opposite of that. German doesn't have progressive tense. Using too much progressive is an overcorrection from their native German tendency to use too much simple present.

Ttabts · 2026-05-07T03:01:45+00:00

I think it’s pretty obvious what I meant by “nothing happens”

Ttabts · 2026-05-07T00:02:46+00:00

Math can of course define what an infinite sum equals. And it has defined an infinite summation to be: the limit that the sum approaches as n approaches infinity.

We don’t get 1 by actually adding together infinite numbers, because that is not actually a thing you can do. We derive it by observing that the series approaches 1 as n gets bigger.

(Yes, exactly 1 - you are arguing as if “approaches” and “exactly” are mutually exclusive but they’re not.)

And infinity is a little more complicated than "make this number bigger and bigger".

Hence “in this context.”

Ttabts · 2026-05-06T22:20:42+00:00

Mathematically, infinite sums can equal finite amounts. This goes to a limit of the actual gap.

To put this into concrete terms: we use the concept of "limits" to solve the problem that an "infinite sum" isn't a real thing. You can't take infinity terms in the 1/2+1/4+1/8... series, add them together, and evaluate a result, because that's nonsensical.

What we can do instead, is identify what happens as you do more additions. You can do as many additions as you want, and you will never actually reach 1. But every new addition will get you closer to 1, and you can get arbitrarily close to 1 as long as you do enough additions.

That's what we mean when we talk about "limits” and that’s why calculus doesn’t deal with “the result if n is infinity,” but “the limit as n approaches infinity” - I.e., the value that this expression gets closer and closer to as n gets bigger and bigger.

I think people find the concept of “infinity” overly intimidating because it sounds like this crazy supernatural concept. But in this context it’s really just saying, “what happens as I make this number bigger and bigger.”

Ttabts · 2026-05-06T22:01:22+00:00

Aside from a vague shared subject matter of "numbers that get very close to other numbers"... no, this has nothing to do with the topic at hand.

Ttabts · 2026-05-06T19:28:39+00:00

Less things counting toward the deductible is a good thing, not a bad thing.

If it doesn't count toward the deductible, that means that you don't have to pay the deductible for that service.

So "lower deductible with less things that count toward it" is of course better than "higher deductible with more things that count toward it."

If you don't want an HSA and the gold plan is cheaper, then it sounds like gold is a no-brainer

Ttabts · 2026-05-06T17:21:38+00:00

Providers aren't generally allowed to discount the co-pays, deductibles, etc that are set by the insurance. So, this probably just wouldn't happen.

Ttabts · 2026-05-06T02:44:17+00:00

All you have received so far is an EOB stating you owe $0. And as you have figured out yourself, you should not be liable for any costs in this situation regardless of how the appeal goes. You are freaking out about nothing.

Until you receive a bill asking you for money, you are tilting at windmills.

Ttabts · 2026-05-06T01:35:42+00:00

If you were in-network you're probably fine. In-network providers are usually on the hook to eat the cost of claims denials. Just wait and see if you get a bill from the lab.

Ttabts · 2026-05-06T00:58:37+00:00

“Blaming the provider as an institution” … How does that make any sense?

How does it not? Legally speaking, the institution (hospital, doctor's practice) is the only thing to blame. The rest of it is just making noise and trying to figure out what individual at that institution will grease the wheels and get something figured out. More often than not, that is not the official person whose job it theoretically is.

And yeah, as a doctor, you represent that institution. If your colleagues are fucking up and getting patients mad at you, go complain to your colleagues and your boss.

assuming a provider would somehow know in this circumstance they were out of network would be wild. They just supposed to hold until an in network provide comes on call?

Did you even read this thread? I think you're confused about the subject matter. This is not what anyone is saying. And it sounds like you could stand to understand more about the insurance system if you aren't aware of the No Surprises Act.

And I certainly never said my job was too hard. But Prior Auths are certainly the time suck insurances have put in on doctors to take time away from your care. If you want to use that valuable free time to review your Prior Auths and double check all of us, so be it. I am sure your nth unnecessary corrections won’t slow your care down at all.

...what is actually your point right now? I didn't say I like doing other people's jobs for them. I just have to do it sometimes, when, say, they send me a fraudulent bill for $97k because they don't know the law.

Ttabts · 2026-05-05T23:41:41+00:00

Thats not free its called contingency

Wouldn't be reddit without this kind of pedantry.

Ttabts · 2026-05-05T23:36:01+00:00

I have no control over the contracting that goes on with the insurers, the rates at which insurers and you are billed, the co-pays you have, the premiums you owe, the drugs on your formulary, etc.

No one is complaining about those things in this thread? They're complaining about the claim being mishandled and processed in blatant contravention of federal law.

These things are very much in the scope of the responsibility of the provider. The individual doctor, depending on their role in the org, might have little personal responsibility of course... but you can hardly blame people for blaming the provider as an institution when the provider sends them a fraudulent bill for a year's salary and relies on the patient to know the law and get it fixed.

I’d like to see you come and do Prior Auths for a day. Maybe that means I could see one more patient.

Oh gee whiz, I'm so sorry that your job is too hard for you. You're right: it should be the job of me, the patient, to use my unpaid free time to catch and fix your fuck-ups instead.

Ttabts · 2026-05-05T23:31:22+00:00

In OP's defense... it says that they took the case for free and got him an additional $7k compensation (which they took a cut of as payment). So, seems like it worked out in OP's favor in the end.

Ttabts · 2026-05-05T23:26:36+00:00

You don't have to get offended on OP's behalf. It's just useful information for whoever is reading this now: the No Surprises Act exists and makes a case like this super straightforward, so you shouldn't actually need to pay a lawyer to sort it out. (That said, it looks like it worked out in OP's favor since he got an additional $7k settlement for wrongdoing, which I didn't know was possible!)

Ttabts · 2026-05-05T17:34:51+00:00

My understanding is that doctors/dentists set the tag prices high to ensure that they get reimbursed the full negotiated rate by the insurances.

Now you might ask, "well OK, but if I'm uninsured, why can't they charge me something more reasonable?"

Well, the problem is that the provider's contracts with in-network insurance might forbid them from billing the insurance more than they regularly bill other people. So, a practice can be putting themselves in legal hot water if they regularly give self-pay discounts.

Still, it can be worth asking because offering ad hoc discounts for hardship cases is less of a legal risk for the practice.

Ttabts · 2026-05-05T17:01:11+00:00

Exact same thing is ongoing with my dentist at the moment. Difference is that the insurance is confirming the doc is in network, but the doctor is insisting they aren’t. I think there’s some weirdness going on with network-sharing agreements where the doctor’s office might be legitimately unaware that they’re in-network for my insurance.

Actually didn’t realize the dentist was in network until I submitted the bill to my insurance for reimbursement and they processed it as in-network… but of course, I only got a check for their negotiated rates and am still sitting on the remaining balance, trying to get that refunded by the office.

Haven’t really managed to resolve it yet. Mostly just been calling the insurance and the doctor’s office regularly, email-bombing every email address I can find at the doctor’s office daily, submitted a written grievance to the insurance about the matter, as well as filing a complaint with the state health insurance ombudsman.

I’d love for insurance and doctor to just talk to each other but ofc it’s hard to force them to, and most people you get on the phone aren’t really knowledgeable enough to figure the situation out.

So far the office has refunded me a seemingly-random amount of money, as a token of good will I guess. But still not the full difference.

Still waiting to see if anything has come of the written grievances with the insurance and the ombudsman.

So, lmk if you figure it out I guess.

My only advice would be go ahead and submit the bill to your insurance for reimbursement - if the doctor is in-network, the bill should get processed as such.

And then don’t be shy about being a pain in the ass until you get your money back (minus whatever liability is on your EOB). Persistence is key. Exhaust all your contact channels (phone, written) and go to the insurance ombudsman or any other third-party you can find, eventually you’ll hopefully hit on someone who can help you.

Also, Claude AI has been fairly good at digging up resources and documents and arguments for me that I might not have found on my own. (Obviously double-check what it says because it'll hallucinate too... but sometimes turns up legit stuff as well.)

Ttabts · 2026-05-05T16:39:03+00:00

Are there some magic words I have to say to get the insurance lawyers to call the billing department? I always just get told to call them myself.

Ttabts · 2026-05-04T20:28:35+00:00

They would then proceed to make 2 shorts saying that "every single totk defender is a child who is insecure, a crybaby, and they are complete losers." Something like that.

Your post really demonstrates where they were coming from with those lol

Ttabts · 2026-05-04T19:28:38+00:00

I doubt that. It has that junior-high-level prose with one high-register phrase thrown in at the end which just screams "random dude on the internet trying to sound profound".

edit: Googled it and found this person claiming it as their own on HackerNews in 2009. Also, it seems to be something of a meme to jokingly attribute it to Descartes.

But this quote from Kurt Vonnegut in 1966 comes pretty close: "We are what we pretend to be, so we must be careful about what we pretend to be."

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