MONKEY MUSINGS DAILY OPEN DISCUSSION #47 7/21/09 - 7/29/09

[mytime]

 5-Legged Pup Rescued From Coney Island Freak Show  Kind Southerner pays $4K to save puppy from "Freaks of Nature" show 

http://www.nbcnewyork.com/news/local/5-Legged-Pup-Rescued-From-Coney-Sideshow.html

Awe!  Some people are so cruel and others are so good!  Thank God for the kind Southerner!! 

I want Micahel Vick to pay for Lilly to have a good home (not with him, of course) and pay for the surgery.  He owes it to all animals to make up for his cruelty to them. 

I hope the NFL does not take him back but you know they will.   

[mytime]

Mission complete!!  5 dogs - 2 crates - $800.00 lighter!!   

They were all so good except for one dog.  Guess who cried non stop?? 

Now off to get mine and daughters hair done.  Highlights and cut for her.  Color and cut for me.  Going away is a lot of work and over rated.  IMO 

 

Oh, I am using that!! 

[mytime]

I think I need some cool shades too!   

Ok gotta go.   

[klaasend]

I think I need some cool shades too!   

Ok gotta go.   

I'll work on the shades 

[crazybabyborg]

I want to have enough money and security to never work again. Any ideas??? 

Hi Monkeys!

I swear, maybe there's something to the phenomena of finding an old loaded geezer that you can smile at every once in a while and he'll support you in a comfortable lifestyle!   

Work Sucks!

I'm on a rant here!

I just saw on TV that they estimate 23 billion a year is paid fraudulantly on behalf of Medicare and Medicaid recipients. Even the OIG admits it's primarily to providers who haven't navigated the rules and regulations properly around providing those services to Governmentally insured individuals. GEE! YA THINK? It might have something to do with the THOUSANDS of pages of regulations that change monthly! So, included in the Health Care proposal is 100 million to catch those providers who are just providing Health Care and have either miscoded something, allowed a patient in the waiting room while a provider takes lunch (yeah, that's a rule), has a sign in sheet with anyone elses name on it, is a day late on the required monthly treatment plan, or has a transcription service who gets the transcripts back in 48 hours rather than 24!

I'm serious here: I could provide services for 1/3 the cost if I could simply employ a Board Certified Physician to provide health care to patients, submit the claim, complete with notes if they'd like, and expect payment. I have no problem at all being reviewed for quality of services provided. But, I have compliancy consultants to help me navigate the requirements, accountants to help me structure fee and compensation schedules to meet the rules, employees hired to oversee Physician notes, and staff to keep up with the paperwork. Providers are scared to prescribe pain medications when they are genuinely needed because it's a short path to red flags and it automatically requires random drug screenings and pill counts and that just adds another logistical layer to keep up with. Licensed Psychiatric Professionals must be brought in for counselling if chronic pain is the problem and any kind of long term pain medication is required.

I don't know what else I can do to try to do this right, yet I live in fear for everything I've worked for all my life. Recently, a cardiac group in Nashville was "descended" upon by an outsourced Medicare company to "spot inspect" and they were cited for over a million dollars in payback. All Medicare payments stopped while the group filed an appeal. The issue? Labs were done without a specific written order. All payments for each patient were marked for repayment. The cardiologists were sending the patients to the lab for work and the charts included the presenting problem, complete with references to proposed course of actions based on lab results, the lab results themselves and follow up care based on the lab results, but there wasn't a seperate written order for the labs. The group SPENT over a million dollars on the appeal and won a year later. They had the deep pockets to weather it. I wouldn't. I don't have the money to withstand that kind of assault, and all my personal assets would be subject to seizure for payback. The outsourced companies doing the inspections work on commission, and they have every incentive to find something, anything, that will pay their salaries.

It's wrong. It's just wrong.

OK, thanks for your patience. Rant over.

[klaasend]

[crazybabyborg]

WOO HOO, Klaas!!! 

[AZSunny]

I have a question.  I do not understand why the Harvard professor was arrested after he said "ya, I'll speak to your momma outside!"  what does that mean, and why was it considered hostile and  racial??  I see the charges were dropped, but I don't get what this means??

Police wrote in their report that when the sergeant on the scene tried to calm Gates, he shouted "You don't know who your [sic] messing with!", and when it was suggested they talk about the matter outside, he retorted, "Ya, I'll speak with your mama outside."

[AZSunny]

WOO HOO, Klaas!!! 

That is great!!  She never looked better.

[klaasend]

I have a question.  I do not understand why the Harvard professor was arrested after he said "ya, I'll speak to your momma outside!"  what does that mean, and why was it considered hostile and  racial??  I see the charges were dropped, but I don't get what this means??

Police wrote in their report that when the sergeant on the scene tried to calm Gates, he shouted "You don't know who your [sic] messing with!", and when it was suggested they talk about the matter outside, he retorted, "Ya, I'll speak with your mama outside."

AZsunny - I really don't know.  I think people are way too sensitive.

[AZSunny]

I have a question.  I do not understand why the Harvard professor was arrested after he said "ya, I'll speak to your momma outside!"  what does that mean, and why was it considered hostile and  racial??  I see the charges were dropped, but I don't get what this means??

Police wrote in their report that when the sergeant on the scene tried to calm Gates, he shouted "You don't know who your [sic] messing with!", and when it was suggested they talk about the matter outside, he retorted, "Ya, I'll speak with your mama outside."

AZsunny - I really don't know.  I think people are way too sensitive.

Agreed, and certainly the police were in error with this arrest, but I couldn't figure out what made the officer so mad.  oh well, thanks. 

[marymary]

I want to have enough money and security to never work again. Any ideas??? 

Hi Monkeys!

I swear, maybe there's something to the phenomena of finding an old loaded geezer that you can smile at every once in a while and he'll support you in a comfortable lifestyle!   

Work Sucks!

I'm on a rant here!

I just saw on TV that they estimate 23 billion a year is paid fraudulantly on behalf of Medicare and Medicaid recipients. Even the OIG admits it's primarily to providers who haven't navigated the rules and regulations properly around providing those services to Governmentally insured individuals. GEE! YA THINK? It might have something to do with the THOUSANDS of pages of regulations that change monthly! So, included in the Health Care proposal is 100 million to catch those providers who are just providing Health Care and have either miscoded something, allowed a patient in the waiting room while a provider takes lunch (yeah, that's a rule), has a sign in sheet with anyone elses name on it, is a day late on the required monthly treatment plan, or has a transcription service who gets the transcripts back in 48 hours rather than 24!

I'm serious here: I could provide services for 1/3 the cost if I could simply employ a Board Certified Physician to provide health care to patients, submit the claim, complete with notes if they'd like, and expect payment. I have no problem at all being reviewed for quality of services provided. But, I have compliancy consultants to help me navigate the requirements, accountants to help me structure fee and compensation schedules to meet the rules, employees hired to oversee Physician notes, and staff to keep up with the paperwork. Providers are scared to prescribe pain medications when they are genuinely needed because it's a short path to red flags and it automatically requires random drug screenings and pill counts and that just adds another logistical layer to keep up with. Licensed Psychiatric Professionals must be brought in for counselling if chronic pain is the problem and any kind of long term pain medication is required.

I don't know what else I can do to try to do this right, yet I live in fear for everything I've worked for all my life. Recently, a cardiac group in Nashville was "descended" upon by an outsourced Medicare company to "spot inspect" and they were cited for over a million dollars in payback. All Medicare payments stopped while the group filed an appeal. The issue? Labs were done without a specific written order. All payments for each patient were marked for repayment. The cardiologists were sending the patients to the lab for work and the charts included the presenting problem, complete with references to proposed course of actions based on lab results, the lab results themselves and follow up care based on the lab results, but there wasn't a seperate written order for the labs. The group SPENT over a million dollars on the appeal and won a year later. They had the deep pockets to weather it. I wouldn't. I don't have the money to withstand that kind of assault, and all my personal assets would be subject to seizure for payback. The outsourced companies doing the inspections work on commission, and they have every incentive to find something, anything, that will pay their salaries.

It's wrong. It's just wrong.

OK, thanks for your patience. Rant over.

Afternoon Monkeys,

HI CBB,

  I read your rant and though I can see how very bright and informed you are, it was Greek to me.  I will however  be happy to agree with you as a fellow Monkey.   

[AZSunny]

I want to have enough money and security to never work again. Any ideas??? 

Hi Monkeys!

I swear, maybe there's something to the phenomena of finding an old loaded geezer that you can smile at every once in a while and he'll support you in a comfortable lifestyle!   

Work Sucks!

I'm on a rant here!

I just saw on TV that they estimate 23 billion a year is paid fraudulantly on behalf of Medicare and Medicaid recipients. Even the OIG admits it's primarily to providers who haven't navigated the rules and regulations properly around providing those services to Governmentally insured individuals. GEE! YA THINK? It might have something to do with the THOUSANDS of pages of regulations that change monthly! So, included in the Health Care proposal is 100 million to catch those providers who are just providing Health Care and have either miscoded something, allowed a patient in the waiting room while a provider takes lunch (yeah, that's a rule), has a sign in sheet with anyone elses name on it, is a day late on the required monthly treatment plan, or has a transcription service who gets the transcripts back in 48 hours rather than 24!

I'm serious here: I could provide services for 1/3 the cost if I could simply employ a Board Certified Physician to provide health care to patients, submit the claim, complete with notes if they'd like, and expect payment. I have no problem at all being reviewed for quality of services provided. But, I have compliancy consultants to help me navigate the requirements, accountants to help me structure fee and compensation schedules to meet the rules, employees hired to oversee Physician notes, and staff to keep up with the paperwork. Providers are scared to prescribe pain medications when they are genuinely needed because it's a short path to red flags and it automatically requires random drug screenings and pill counts and that just adds another logistical layer to keep up with. Licensed Psychiatric Professionals must be brought in for counselling if chronic pain is the problem and any kind of long term pain medication is required.

I don't know what else I can do to try to do this right, yet I live in fear for everything I've worked for all my life. Recently, a cardiac group in Nashville was "descended" upon by an outsourced Medicare company to "spot inspect" and they were cited for over a million dollars in payback. All Medicare payments stopped while the group filed an appeal. The issue? Labs were done without a specific written order. All payments for each patient were marked for repayment. The cardiologists were sending the patients to the lab for work and the charts included the presenting problem, complete with references to proposed course of actions based on lab results, the lab results themselves and follow up care based on the lab results, but there wasn't a seperate written order for the labs. The group SPENT over a million dollars on the appeal and won a year later. They had the deep pockets to weather it. I wouldn't. I don't have the money to withstand that kind of assault, and all my personal assets would be subject to seizure for payback. The outsourced companies doing the inspections work on commission, and they have every incentive to find something, anything, that will pay their salaries.

It's wrong. It's just wrong.

OK, thanks for your patience. Rant over.

I totally agree with you.  Can you imagine what may happen if the government then takes over our healthcare.  NO Thank you!  I prefer to responsible for paying my own healthcare.

[Northern Rose]

I have a question.  I do not understand why the Harvard professor was arrested after he said "ya, I'll speak to your momma outside!"  what does that mean, and why was it considered hostile and  racial??  I see the charges were dropped, but I don't get what this means??

Police wrote in their report that when the sergeant on the scene tried to calm Gates, he shouted "You don't know who your [sic] messing with!", and when it was suggested they talk about the matter outside, he retorted, "Ya, I'll speak with your mama outside."

AZsunny - I really don't know.  I think people are way too sensitive.

They need some excitement in their lives

[AZSunny]

I have a question.  I do not understand why the Harvard professor was arrested after he said "ya, I'll speak to your momma outside!"  what does that mean, and why was it considered hostile and  racial??  I see the charges were dropped, but I don't get what this means??

Police wrote in their report that when the sergeant on the scene tried to calm Gates, he shouted "You don't know who your [sic] messing with!", and when it was suggested they talk about the matter outside, he retorted, "Ya, I'll speak with your mama outside."

AZsunny - I really don't know.  I think people are way too sensitive.

They need some excitement in their lives

LOL....poor squirrel

[trimmonthelake]

Klaas,can you tell me what this means?   

7/21/2009     A     MOTION FOR TRANSCRIPTION & ORDER

I got it from the Orange County Clerk.

[trimmonthelake]

WOO HOO, Klaas!!! 

That is great!!  She never looked better.

OMG,how funny.   

[klaasend]

Klaas,can you tell me what this means?   

7/21/2009     A     MOTION FOR TRANSCRIPTION & ORDER

I got it from the Orange County Clerk.

Not sure, sounds like a motion is being filed for a transcript of a video or something.  Is this in the Anthony case?

[Anna]

I want to have enough money and security to never work again. Any ideas??? 

Hi Monkeys!

I swear, maybe there's something to the phenomena of finding an old loaded geezer that you can smile at every once in a while and he'll support you in a comfortable lifestyle!  

Work Sucks!

I'm on a rant here!

I just saw on TV that they estimate 23 billion a year is paid fraudulantly on behalf of Medicare and Medicaid recipients. Even the OIG admits it's primarily to providers who haven't navigated the rules and regulations properly around providing those services to Governmentally insured individuals. GEE! YA THINK? It might have something to do with the THOUSANDS of pages of regulations that change monthly! So, included in the Health Care proposal is 100 million to catch those providers who are just providing Health Care and have either miscoded something, allowed a patient in the waiting room while a provider takes lunch (yeah, that's a rule), has a sign in sheet with anyone elses name on it, is a day late on the required monthly treatment plan, or has a transcription service who gets the transcripts back in 48 hours rather than 24!

I'm serious here: I could provide services for 1/3 the cost if I could simply employ a Board Certified Physician to provide health care to patients, submit the claim, complete with notes if they'd like, and expect payment. I have no problem at all being reviewed for quality of services provided. But, I have compliancy consultants to help me navigate the requirements, accountants to help me structure fee and compensation schedules to meet the rules, employees hired to oversee Physician notes, and staff to keep up with the paperwork. Providers are scared to prescribe pain medications when they are genuinely needed because it's a short path to red flags and it automatically requires random drug screenings and pill counts and that just adds another logistical layer to keep up with. Licensed Psychiatric Professionals must be brought in for counselling if chronic pain is the problem and any kind of long term pain medication is required.

I don't know what else I can do to try to do this right, yet I live in fear for everything I've worked for all my life. Recently, a cardiac group in Nashville was "descended" upon by an outsourced Medicare company to "spot inspect" and they were cited for over a million dollars in payback. All Medicare payments stopped while the group filed an appeal. The issue? Labs were done without a specific written order. All payments for each patient were marked for repayment. The cardiologists were sending the patients to the lab for work and the charts included the presenting problem, complete with references to proposed course of actions based on lab results, the lab results themselves and follow up care based on the lab results, but there wasn't a seperate written order for the labs. The group SPENT over a million dollars on the appeal and won a year later. They had the deep pockets to weather it. I wouldn't. I don't have the money to withstand that kind of assault, and all my personal assets would be subject to seizure for payback. The outsourced companies doing the inspections work on commission, and they have every incentive to find something, anything, that will pay their salaries.

It's wrong. It's just wrong.

OK, thanks for your patience. Rant over.

CBB,
I know exactly what you are talking about and it is why some physicians will no longer take Medicare patients.  Same with State Medicaid patients.  Just not worth the hassle.

And I do cringe whenever I think of this red tape nightmare being applied to the entire system.  Who would want to be subjected to all this and told how to practice in the first place?  Health care workers will be leaving in droves as no one wants to deal with this and worse.  Universal health care has bankrupt every place that has tried it unless the care is rationed and they try to use the physicians, etc. to do the rationing so it will appear the doctors are the bad guys.

And yes, I firmly came to believe that once some figured out the billing procedure, they promptly changed it and kept doing so on an continuing basis in order to avoid paying a fair fee for service.  Like the post office, if the government is involved, expect chaos, waste and ineffecient use of funding.  They price fix like anything which is supposed to be illegal.

[Anna]

Mission complete!!  5 dogs - 2 crates - $800.00 lighter!!   

They were all so good except for one dog.  Guess who cried non stop?? 

Now off to get mine and daughters hair done.  Highlights and cut for her.  Color and cut for me.  Going away is a lot of work and over rated.  IMO 

 

Oh, I am using that!! 

KCJackie, LOOK!

A baby puppy crying his little eyes out, shoved in a crate!    Oh, but he loves it, etc?  Yeah, right!

 

 

Just messing wit ya, MT!  He will be fine and prolly only cried until you got out of site.  Pups know how to deliver guilt trips with the best of 'em.


You look mah-velous, Dahling!