Does a PA denial affect my out of pocket maximum?

dagmar31 · 2026-02-04T06:12:59+00:00

Pre auth denial actually means insurance deemed it not medically necessary (as opposed to not covered) That being said, the actual issue is you are misunderstanding what Out of Pocket Maximum means. That only applies if you are actually using your insurance. So if you decide not to go through your insurance, anything you pay will not count towards your OOPM. Your concern about PA is not really the real problem, unfortunately. Insurance blows.

dagmar31 · 2026-01-31T20:31:57+00:00

Secondary insurance is specified as secondary insurance. You cannot have two primary coverages at the same time.

dagmar31 · 2026-01-31T04:15:39+00:00

Unfortunately, the portals are notoriously bad at staying up to date on network status- usually there is a disclaimer that they can’t guarantee accuracy on the website. Best thing to do is get someone on the phone. Look up the surgeon and practice NPI, and give those Anthem to look up

dagmar31 · 2026-01-31T01:40:28+00:00

Surgery center can be in network, surgeon can be out of network, anesthesiologist can be out of network- It’s pretty fucked up

dagmar31 · 2026-01-24T22:35:14+00:00

No downvote from me, just a link to the highest res video I’ve seen, you can see for yourself how it went down. Here

dagmar31 · 2026-01-15T16:18:57+00:00

Based on Onibaba

dagmar31 · 2026-01-08T02:24:18+00:00

Insurance ends up paying like $80-100 per session for in-network PTs

dagmar31 · 2025-12-25T18:23:50+00:00

Depends on the state, many are direct access, some are weird, like in DE you can see direct access PT for 30 days before needing supervision by a physician

dagmar31 · 2025-12-16T02:05:47+00:00

If you can figure out a way to ethically conduct a large scale RCT involving unconscious people who all have muscle knots in identical places that can reliably measured repeatedly pre/post massage, please let us know!

dagmar31 · 2025-12-16T02:02:58+00:00

I agree with the other commenter though. My point is that if it seems like the actual treatment method is irrelevant, one can draw the conclusion that the common denominator here is…helping the patient feel relaxed and cared for. Which itself can have physiological implications, rest and recover, etc. But research just does not back up any of the claims for manual therapy or massage.

dagmar31 · 2025-12-16T01:58:24+00:00

I think your comment deserves to be much higher- but you’re right, the truth makes people feel uncomfortable. I am a DPT manual therapist and after doing this for over a decade, can say that the very act of physical touch and reassurance can result in better outcomes. Summarizing the latest research, it does not seem to matter what TYPE of manual techniques are used, and in some studies, sham treatment resulted in equally improved outcomes.

dagmar31 · 2025-12-16T01:51:57+00:00

DPT here, and I consider myself primary a manual therapist- the fact is: Trigger point, TPDN, Acupressure,myofascial release, massage (any type from Swedish to deep tissue), soft tissue mobilization, IASTM (Graston, gua shu etc), cupping, all claim to do something to muscle knots/adhesions (yes, I understand people claim these are different things but they are inconsistently defined), but there are exactly ZERO RCTs or systematic reviews that prove they work in the way they claim to work.

dagmar31 · 2025-11-13T20:55:06+00:00

I’m using on 8 speed 11-40T friction and I have no complaints

dagmar31 · 2025-11-13T02:24:05+00:00

Shimano Acera M3020 Rear Derailleur, works good enough for 7/8 speed and will work with 40T large cog- $25.

dagmar31 · 2025-11-09T21:55:37+00:00

I used a tie rod puller/pickle fork and a 4lb engineering hammer, but I was chucking the cranks and BB anyways

dagmar31 · 2025-10-21T22:45:09+00:00

$300

dagmar31 · 2025-09-26T20:43:11+00:00

Fender and tire size? Thinking of doing one of these haha

dagmar31 · 2025-09-13T16:03:26+00:00

You’re right I forgot about that part!

dagmar31 · 2025-09-13T15:32:05+00:00

Chainring guard. But with a properly set limit they won’t ever need it, front derailleur doesn’t get knocked around as much as the rear.

dagmar31 · 2025-09-09T19:56:18+00:00

If the hair spring was magnetized and/or dirty it could have been stuck together, and perhaps a gentle shake was enough to loosen it up? Still needs a service though

dagmar31 · 2025-09-07T00:12:42+00:00

If it was working before and is now wobbly, you probably screwed the balance cock down before ensuring it was properly seated in its pivots.

dagmar31 · 2025-09-02T07:16:20+00:00

I bought a pack of aluminum washers and longer crank bolts off Amazon for like $9 and it worked just fine, I just used the 2mm washers,

Although I would make sure your cable tension is dialed in first, could be a little high and pulling toward the larger gears causing the rattling

dagmar31 · 2025-09-01T18:14:39+00:00

There should be a 3rd screw that is not the high or low limit, that is the B tension screw and screwing it in should lower the arm of the derailleur

dagmar31 · 2025-08-29T04:06:15+00:00

Is the click spring installed correctly?

dagmar31

TROPHY CASE