JawsBlog

9/13/2009

On Insurance Denials

Filed under: Health/Medicine — Jaws @ 9:16 pm

From Fark:

“Hospital hiring “Medical Denials Specialist” to assist with insurance billing issues. Good benefits, room for growth”

As part of my current job, I handle the vast majority of insurance claim rejections at the practice I work in–so seeing a position like this doesn’t strike me as a big deal.

A lot of claims that are rejected by insurers, are rejected for simple reasons. Most of these rejections are simply reversed upon appeal.

Some of the more common reasons for rejection:

–Wrong date of birth on file for the patient (this is a common one)
–Patient reports a hyphenated last name; insurance co only has a non hyphenated name on file.
–People who go by their middle names, rather than their first names…
–Patients who haven’t updated their information with their insurers (in terms of coordination of benefits)
–Ins. company overlooking a prior-approval/referral

A lot of these are merely clerical things–that once corrected, enable the claims to be reprocessed–and paid to the provider.

There are times when claims are rejected due to cancellation of coverage, etc. but the aforementioned are more common. It just takes some time to iron things out–and then more time to sit on hold waiting for a CSR at the insurance company to work with to fix things.

Another season begins

Filed under: Cleveland/NEO,Sports — Jaws @ 5:53 pm

And the Browns lose….

At least they got an offensive touchdown!
(The game wasn’t broadcast here).

Anyone else catch the end of the Bengals-Broncos game? What an ending!

Including the kitchen sink

Filed under: Wierd Side — Jaws @ 11:56 am

Airports’ arsenal of snagged swag

Travelers have at tempted to board planes armed with 10-point deer antlers, car parts, peace pipes, a kitchen sink, a grill, and even unwashed adult toys, according to the TSA.

It’s beyond me why one would travel with a kitchen sink…

9/12/2009

That one hurt

Filed under: Sports — Jaws @ 11:44 pm

The Buckeyes looked to play a great game–save for that last drive.

The OSU offense though–Pryor didn’t look very sharp. The Buckeye’s O-Line looked a lot better this week (compared to last). The Buckeyes couldn’t sustain a drive much of the game, either….

The defense on the other hand, has rebounded from last week’s near debacle against Navy. Save for the last drive, the D looked strong and ferocious. (That triple option was a pita).

Oh well, time for sleep.

Gloomy day

Filed under: General — Jaws @ 3:48 pm

It’s cold outside not to mention gray, cloudy and gloomy.

At least it’s not pouring today (like yesterday).

Even worse, the sister is hogging tv, passed out on the couch, so no football for me! (Boo!)

9/11/2009

In Memory

Filed under: General — Jaws @ 8:27 pm

9-11-01

Never forget!

9/10/2009

Produce FTW!

Filed under: Health/Medicine — Jaws @ 10:19 pm

High Fruit And Vegetable Intake Linked To Antioxidant Status And Cognitive Performance In Healthy Subjects

Lamest attempted hit piece ever

Filed under: Politics — Jaws @ 10:00 pm

A politician who took No-Doz.

A legal, OTC caffeine pill….

This is newsworthy because…..?

Kickoff!

Filed under: Sports — Jaws @ 9:57 pm

It’s football season again!

Pittsburgh just scored the first points of the season.

Question though: Why must the season “Kick-off” on a Thursday?

Pro football isn’t played on Thursday (save for Thanksgiving Day–but that’s different)–it’s a SUNDAY game!

/Just Saying
//The Titans just tied the score with 48 seconds to go in the half.

Widowmaker

Filed under: Fitness,Personal — Jaws @ 9:54 pm

Today was a leg day in the gym…and I pushed myself to a new extreme.

Worked up to a heavy triple off the box. Then I dropped the weight a bit and went for a widowmaker on free squats.

For those of you who aren’t gymrats, a widowmaker is a set of 20 squats, using your 1o repetition max.

It was painful and my legs were pumped the rest of the day–but I accomplished it–and that’s what counts in my book

My body’s response is well…forthcoming….

9/9/2009

No speech for me

Filed under: Politics — Jaws @ 9:11 pm

Didn’t watch the President’s speech. Didn’t have any interest to.

Personally, I’ve bit a bit frustrated with the government as of late–with regards to a Medicare change of address I’ve been toiling with All we want to do is update an address–and the Medicare people keep making us run in circles and jump through hoops. (Besides giving incorrect instructions) Then there are the technicalities that they use to reject an applicaiton (flaws in their own computer software no less)

All this to change an address!

9/8/2009

Street (cart) Wars!

Filed under: New York City,Wierd Side — Jaws @ 9:45 pm

There seems to be a battle brewing amongst street cart vendors.

A “Halal food card ‘mafia’”? That just sounds so silly…

Soda Taxes

Filed under: Health/Medicine,Politics — Jaws @ 9:12 pm

Obama is apparently “open” to the idea of a ‘soda tax’

Doubtful that such a tax would actually go into effect (I can see the beverage industry lobbying hard against it).

On the same note, how about a tax break for green tea drinkers?

9/7/2009

Delusional?

Filed under: Cleveland/NEO,Wierd Side — Jaws @ 1:50 pm

PD: 1,200 supporters turn out to welcome former Rep. James Traficant home from federal prison

Wait…what? Why?

Clothes Shopping

Filed under: Personal — Jaws @ 1:37 pm

I’ve said it before, and I’ll say it again…I hate clothes shopping!

Needed some new pants–so I hit the department stores and tried on different things. Found something that works (hoorah!) and will now go online and order another pair or two at a better price.

Still, I find it quite hard to go clothes shopping alone…

9/6/2009

Crackberry

Filed under: Personal,Science/Technology — Jaws @ 3:28 pm

Yes, I’ve taken the plunge and gotten a blackberry.

It was time for a new phone anyway…so may as well make the leap up.

Time to go read the manual…

9/5/2009

Excellent Column on today’s game

Filed under: Sports — Jaws @ 9:12 pm

Bill Livingston (PD Sports writer) nails it on the head: Ohio State’s close call a credit to Navy

OSU-Navy Halftime Thoughts

Filed under: Sports — Jaws @ 1:35 pm

–Terrell Pryor is a beast. 6’6″ 230lb!

–The triple option can be quite a pain to defend against (see Navy’s first possession). Though the good guys seem to be getting used to it.

–The triple option, being a predominantly run-based offense, can chew up a lot of clock.

–Is it now officially sweater vest season?

9/4/2009

No more sleeping during the sermon

Filed under: Jewish Stuff/Judaism,Wierd Side — Jaws @ 9:51 pm

Especially if the rabbi is packing heat for the Holidays.

An interesting security idea–but wouldn’t a gun be considered mukseh?

9/3/2009

Fashion No-No!

Filed under: Wierd Side — Jaws @ 9:51 pm

The trendy potbelly was bad enough but now, male hipsters are bringing back short-shorts for men?

Um…why? For what reason?

And why wear short shorts if you don’t have any wheels to show off?

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