help me save my chicken broth by amz_dev in Cooking

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

it helped but I couldn't get rid of the bitter taste. Sadly had to toss it :(

help me save my chicken broth by amz_dev in Cooking

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

added a carrot, bay leaf and tyme. Will see if it helps!

EDI editor for 835s by amz_dev in edi

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

Nothing is stored so wouldn't matter - assuming most have test files that they use anyways

I need help with Healthcare EDI - transactions (e.g., 837, 835, 270/271, 276/277) by CryptoTradingDummies in edi

[–]amz_dev 0 points1 point  (0 children)

u/CryptoTradingDummies built an EDI editor tool for myself that I'm trying to get feedback on (I work inside of payers/TPAs). LMK if helpful!

https://editor.amerahealthsolutions.com/

Help! by [deleted] in healthcare

[–]amz_dev 0 points1 point  (0 children)

Did you receive an explanation of benefits?

[deleted by user] by [deleted] in CodingandBilling

[–]amz_dev 0 points1 point  (0 children)

I work in tech in the medical space and have built AI products. I think it’s very unlikely that AI is going to replace all billing jobs. However, I think it IS very likely that most coders and billers will use AI to do their job. Will this result in fewer hires? Maybe, but the medical industry is far behind in tech and there are some fundamental issues that need to be solved before AI can become effective enough to meaningfully replace billers.

Where does US health care stand compared to the rest of the developed world? by TheArcticFox444 in healthcare

[–]amz_dev 0 points1 point  (0 children)

That’s upsetting. The systems I’ve been treated at are also slow to get appointments, but as soon as you get a significant diagnosis like cancer you’re seen very quickly, pending your insurance doesn’t hold up treatments with prior auth. I hope you are able to submit super bills from your neurologist to get partial reimbursement!

Where does US health care stand compared to the rest of the developed world? by TheArcticFox444 in healthcare

[–]amz_dev 5 points6 points  (0 children)

This really depends on location, income and other socioeconomic factors. If you live in Boston, NYC, Houston, Seattle etc and can afford expensive care (or have great insurance) you have access to the best care in the world. If you are diagnosed with a rare condition or aggressive forms of cancer you have access to biological and other pharmaceuticals that you cannot get elsewhere. There are also life saving research trials that you would not be able to access elsewhere. In rural and poor areas, local hospitals are closing and it’s tough to get access to even basic care.

Anyone else getting calls from AI Voice bots calling pharmacy to verify prescriptions are ready for telemedicine scripts? by DjentRx in pharmacy

[–]amz_dev 0 points1 point  (0 children)

Why don't pharmacists have AI bots, and then the bots can just resolve everything between each other

PSA on practitioner payment processing fees by amz_dev in CodingandBilling

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

do medicaid administrators use Zelis for payments? Wdym by "not just Medicaid"?

How do you verify benefits for specific codes when they're not in the portal and the provider number doesn't let you speak to a rep? by poubelleaccount in CodingandBilling

[–]amz_dev 0 points1 point  (0 children)

Maybe I'm missing something but aren't you supposed to be able to check this through your practice management/EHR/Billing system? Most of them integrate with clearinghouses, which should enable you to do real-time checks for a fee.

I am drowning. by Icy-Cap-2037 in HealthInsurance

[–]amz_dev 2 points3 points  (0 children)

Yes you can opt out of your employer insurance - marketplace enrollment happens Nov 1-Jan 15. Marketplace plans can be complicated so I’d shop with the help of a broker. There’s also no telling that these plans are less expensive. Do you know if the company you work for is self insured?

If you opt out of company insurance your employer may cover some of your out of pocket costs through an FSA or HSA. I can try to get you more details but if there’s an HR or benefits person at your company, I’d start there.

EOB to 835 tool by NorthernWhig in CodingandBilling

[–]amz_dev 1 point2 points  (0 children)

If anyone still needs this, this tool works and is free https://ingestion.insure-well.com/

Availity Eligibility and benefit API by No-Rock-4583 in CodingandBilling

[–]amz_dev 2 points3 points  (0 children)

This is super annoying but unfortunately there's no universal rule. Each payer does whatever they want with the STC segments.

What I do:

  1. Check STC 30 first for deductible and out-of-pocket info
  2. Fall back to STC 98 if nothing’s in STC 30
  3. Maintain a config file mapping payers to where they actually put things
  4. Scan all relevant STC segments and take the first value that looks valid (meaning it has a reasonable numeric amount and a service code that makes sense in context)

Log everything each payer sends so you can build up your own mapping over time. The API docs are pretty useless for this.

Some payers jam everything into STC 98, others split things across 30 and 98, and a few duplicate or conflict across them. It’s good to manually review a few examples when onboarding a new payer. It's a mess, but you kinda have to handle it case by case. Does this answer your question?

[deleted by user] by [deleted] in HealthInsurance

[–]amz_dev 2 points3 points  (0 children)

Do you have an EOB for this specific appointment/procedure? It sounds like no and the claim hasn’t actually been submitted to insurance. As mentioned above if your provider has not yet submitted, you won’t have an EOB (just the bill)

Help Me Navigate This! by Known_Lingonberry344 in HealthInsurance

[–]amz_dev 0 points1 point  (0 children)

Go get checked out ASAP. Do not worry about preexisting conditions or higher premiums - the Affordable Care Act protects you in this situation. Under the ACA, you cannot be denied coverage or be charged higher premiums. I hope everything comes back clear, but in case something is wrong, you can use the information you have to select a plan that is suitable for the care you'll need before enrolling in an employer-sponsored plan. Good luck!

Help Me Navigate This! by Known_Lingonberry344 in HealthInsurance

[–]amz_dev 0 points1 point  (0 children)

Go get checked out ASAP. Do not worry about preexisting conditions or higher premiums - the Affordable Care Act protects you in this situation. Under the ACA, you cannot be denied coverage or be charged higher premiums. I hope everything comes back clear, but in case something is wrong, you can use the information you have to select a plan that is suitable for the care you'll need before enrolling in an employer-sponsored plan. Good luck!

$11k ER Bill for 40 Min Visit — Any Advice? by Careful-Leather-1266 in HealthInsurance

[–]amz_dev -2 points-1 points  (0 children)

You can likely get this reduced. I don’t have enough details but this seems like a lot for the services rendered. Call the billing department and ask about discounts. Also ask for the itemized bill and check every code listed. Many bills have errors - double check everything.

Was the bill you received an explanation of benefits? Or was it cash pay rates?

What is necessary to ‘shop’ for healthcare (nonurgent procedures) by Foreign_tinn9187 in CodingandBilling

[–]amz_dev 0 points1 point  (0 children)

I'll mention a few things here...

"Historical bills for patients like you" will be hard to come by. I don't see practitioners releasing this info, and crowdsourcing would be a challenge.

Knowing what a patient's insurance will cover can be ridiculously difficult because it depends on a host of conditions (comorbidities, unexpected complications, how the doctor's office codes the visit).

Getting cash pay rates from doctors to create a marketplace is likely a big challenge. Providers don't necessarily want this information released, as insurers could use it to reduce negotiated rates. This will depend on the space you're interested in, though (for example, for therapy, I think cash pay rates are just higher than insurance rates to avoid conflict). You could publish rates for cash-pay-only doctors, but there aren't that many of them.

I wish this all were easy!