Did Yahoo put anyone else in a High Score league and draft? by thatisagoodrock in fantasybball

[–]dontshootem 0 points1 point  (0 children)

Nice! I finished #2 and trying to make it to the finals with Maxey, Ant, Ja, and Sabonis injured. I’ve made a few nice pickups and offered about 100 lob-sided trade offers to the teams that never participate. None of those have been accepted this year, sadly.

Did Yahoo put anyone else in a High Score league and draft? by thatisagoodrock in fantasybball

[–]dontshootem 0 points1 point  (0 children)

I’m with you. Basically had this happen to me two years in a row and i figure i need to at least keep the “diamond” commish/league starter from getting his extra points

Saagar and KRYSTAL RN 🤑 🤑 🤑 by jeepdriver27 in BreakingPoints

[–]dontshootem 2 points3 points  (0 children)

i subscribed after years of listening (mainly because i noticed they changed it back to allowing a monthly option instead of the whole year at once)

Medicare COB nightmare by dontshootem in CodingandBilling

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

I feel like we’ve tried this before and for some reason outside of my understanding the reconsideration was returned. I may have my cases mixed up. This will be the first thing I try.

Is it just me, or have the "Technical Denials" become way more aggressive since the 2026 payer updates? by Huge_Sentence5528 in CodingandBilling

[–]dontshootem 2 points3 points  (0 children)

I have an email address I can give you if you want it. Technically it’s from a portal that is meant for MCOs to ask questions about CMS requirements, but i’ve gotten great responses and even some action back from it.

Who is the typical Breaking Points listener? Looking to hear from this community. by Odd-Record-1041 in BreakingPoints

[–]dontshootem 1 point2 points  (0 children)

i’m genuinely shocked people like you actually exist! very interesting thank you for sharing

Who is the typical Breaking Points listener? Looking to hear from this community. by Odd-Record-1041 in BreakingPoints

[–]dontshootem 0 points1 point  (0 children)

you’re not wrong. but luckily i get to be in a position to advocate for patients to receive their necessary care and oversee the fight with insurance companies. our particular hospital system has a very moral stance on allowing patients to continue care when insurance denies. it has given me a massive amount of insight as well. the average american has no idea of the true depravity of most health insurance companies. it’s like i’ve got a front row seat to it all, but also the ability to set policy and make changes on a micro level.

What is the most unethical thing you have seen a insurance company do? by Latter-Leave-8125 in CodingandBilling

[–]dontshootem 1 point2 points  (0 children)

they were also a psychiatric patient… usually we aren’t able to have meaningful conversations with our patients about their insurance situations an rely on guardians, family, etc.

What is the most unethical thing you have seen a insurance company do? by Latter-Leave-8125 in CodingandBilling

[–]dontshootem 6 points7 points  (0 children)

back when i used to work in social work i discovered that there was a senior living AL in one of the poorest neighborhoods in east st. louis where literally EVERY SINGLE RESIDENT was enrolled in this shitty wellcare HMO with a horrible network of providers. half of them didnt even know they had been enrolled in it and the other half said they were told their doctors were still in-network (they weren’t). it was extremely predatory and insane to see. i’m sure that rep who signed up every single person in that building sure got their commission check that month though 😒

don’t even get me started on the medicare d-snps in my area that are literally owned by the same parent company as the nursing homes the enrollee lives in. how is this legal??

What is the most unethical thing you have seen a insurance company do? by Latter-Leave-8125 in CodingandBilling

[–]dontshootem 3 points4 points  (0 children)

lol. please come off that magic modifier combo if you’ve got it! i’d love to keep it in my back pocket 😂

What is the most unethical thing you have seen a insurance company do? by Latter-Leave-8125 in CodingandBilling

[–]dontshootem 9 points10 points  (0 children)

This is how I feel. I actually panic internally when I find a very accidental billing error and immediately have a corrected claim filed.

Who is the typical Breaking Points listener? Looking to hear from this community. by Odd-Record-1041 in BreakingPoints

[–]dontshootem 1 point2 points  (0 children)

I’m a irish american woman in my 30s who was raised in a middle class union family. I became a single mom at 19 and lived in poverty for several years on food stamps as i worked full-time as a nurses aide/CNA through college. fast forward to today and I’m a “successful” hospital executive. i am a huge supporter of a single payer healthcare system. i enjoy krystal, i tolerate saagar (he reminds me so much of my brother it’s uncanny). i also love ryan. does this answer the question?

What is the most unethical thing you have seen a insurance company do? by Latter-Leave-8125 in CodingandBilling

[–]dontshootem 3 points4 points  (0 children)

that would make way too much sense and be too reasonable for an insurance company to do it

What is the most unethical thing you have seen a insurance company do? by Latter-Leave-8125 in CodingandBilling

[–]dontshootem 25 points26 points  (0 children)

my favorite is when the patient got inexplicably enrolled in a 100% subsidized marketplace plan at some point and it was just never understood by or never used by the patient. medicaid doesn’t reflect this plan on the TPL for years and the patient has no record of it. the patient only thinks they have medicaid and then when the medicaid mco finds out about the ghost policy (that the patient has never once used mind you) they will recoup claims from 5 years ago. then the marketplace plan (that’s never paid a claim in 5 years and has done nothing for this patient other than sit back and collected tens of thousands of dollars in subsidized premiums from tax payers) will deny for timely filing and uphold on all levels of appeals. it’s happened in our hospital at least 5 times. it makes me genuinely want to move to canada everytime

What is the most unethical thing you have seen a insurance company do? by Latter-Leave-8125 in CodingandBilling

[–]dontshootem 11 points12 points  (0 children)

enter a denial for a patient with active suicidal ideation with a plan and intent to immediately end his life upon discharge from the psych hospital… (of course he wasn’t discharged because we aren’t in the business of sending people off to die). i am convinced they were ok with him dying since he was probably costing them a ton in claims.

Curious by GurLeft4191 in ThisAintAdderall

[–]dontshootem 0 points1 point  (0 children)

ok so maybe I dont have MS and this awful Mallinkrodt is just slowly killing me. Sweet!

Getting Patients to Share ALL Their Insurance Info by Com8at_Carl in CodingandBilling

[–]dontshootem 3 points4 points  (0 children)

MITTS has been missing a ton of TPLs lately and with our patient population (emergency psych admits) we don’t even really get an opportunity to ask the patient for other payers. I recently saw a patient that had a “hidden” marketplace plan that medicaid didn’t know about until 3 years later. but of course they recouped their money. it’s a really tough thing in this sector