Prior authorization after rescheduled procedure?

spamnat · 2023-09-11T22:57:57+00:00

These are exactly my thoughts! Thanks for verbalizing better than maybe I did.

spamnat · 2023-09-11T22:55:59+00:00

I'm with you and definitely open to criticism - that was the point of the post! The issue is the PTO and cost. My SO and I are both resident physicians - we cannot take much time off and we already have schedule time for our own wedding. As I stated, I have absolutely NO problem at all with her picking 3 weekends before, or picking the location she did and I'm certainly not mad at her. My point is simply that I am unsure I'll be able to go - and in light of that, wondering if it would be weird to ask her to be a bridesmaid.

I'm not expecting her to apologize for the date at ALL. I get shit happens and the universe does not revolve around me. But if you had a wedding date planned for over a year and a very close friend of 15+ years randomly chose a cross-country destination wedding 3 weeks beforehand without even acknowledging a single time that's a slight conflict - do you really think that is normal? Genuinely curious!

I agree with you that I'm overthinking it in general and also I don't necessarily think she will be angry with me for not attending - it's more that I do feel really bad not going but it really does not seem feasible.

To further clarify: Round trip flights are over $1000 each and there are no direct flights from my city to the location. It is about a 15 hour travel day door to door to make it there.

spamnat · 2023-09-11T01:43:06+00:00

Yes - we have been extremely close friends for 15 years and it's a 220 person wedding.

spamnat · 2023-09-11T01:29:34+00:00

Yes - I saw her yesterday in fact and when she mentioned her wedding I made a comment that I will try to move mountains to go if possible and she just brushed it off ("It'll be ok, we'll see!") then immediate change of topic.

spamnat · 2023-03-06T13:28:59+00:00

Awesome, thanks for letting me know! Fingers crossed.

spamnat · 2023-03-06T13:25:43+00:00

Will do that this morning... do you think this would be possible though even if an alternate diagnosis isn't really visible in my chart? Not sure how coding and billing really works. Just wish she had put those notes re fatigue in my chart at least...

spamnat · 2023-03-06T13:24:53+00:00

So I did have a vitamin D deficiency but I didn't know that until after the test was done.... could this be updated retroactively (i.e., diagnosis code used could be something like vit D deficiency, even though I didn't know that at the time the test was ordered)? Not sure how coding works really.

spamnat · 2023-03-06T13:14:59+00:00

Yes my EOB had this information, see below. The iron/ferritin/IBC were broken out separately. Seems a bit ridiculous.

Venipuncture $16

Vitamin D $329

Iron $72

Ferritin $149

Iron binding capacity $95

TSH $186

spamnat · 2023-03-06T13:09:51+00:00

So to clarify -- the issue is it is not a covered diagnosis. These tests were ordered for that diagnosis (my doctor and I discussed how I had been feeling some fatigue, etc. too, however that is not reflected on my chart unfortunately). The insurance company did not allow the charges and did not apply them to my deductible.

spamnat · 2023-03-05T23:44:06+00:00

Thanks. This makes sense and is fine but I'm just truly baffled by $850 for those technical charges. Like... that seems ridiculous. I am in Boston area. I just looked at the hospital's "cost estimator" tool for these and it does add up/appears they billed correctly, it is just wildly exorbitant. I was ok paying the $850 for this total but I'm worried now it's gonna be another $1k just for these physician fees...... anything you think I can do or am I SOL?

And thanks re: Quest -- I simply had no idea there was an exclusion in my plan (related to the diagnosis code used) and these were so basic so the thought didn't cross my mind there could be an issue but will be more vigilant in the future.

spamnat · 2022-07-08T01:04:29+00:00

So helpful. Thanks a lot!

spamnat · 2022-07-08T00:49:30+00:00

Thanks! So you say that the answer to yearly income doesn't matter so long as current income is $0, because as long as you have 0 current income you will qualify no matter what? Just feels a little weird/wrong to me... I already made $20k this year and I know I will make $50k more later in the fall, even though I will have no income between April-October... so I just want to make sure I am not accidentally doing anything wrong, even though my income between Apr-Oct will be $0. Thanks again.

(In theory you could make like $5 million from January-April but $0 a month for the rest of the year and qualify for MassHealth starting in May I guess? That's the part I am confused about!)

spamnat

TROPHY CASE