myiW Current Conditions and Forecasts Community Forums Buy and Sell Services
 
Hi guest · myAccount · Log in
 SearchSearch   ProfileProfile   Log in to check your private messagesLog in to check your private messages   RegisterRegister 
Pipe dream? Obamacare
Goto page Previous  1, 2, 3 ... 142, 143, 144 ... 199, 200, 201  Next
 
Post new topic   Reply to topic    iWindsurf Community Forum Index -> Politics, Off-Topic, Opinions
View previous topic :: View next topic  
Author Message
coyotewindsurf



Joined: 03 Apr 2006
Posts: 1276
Location: SF Bay

PostPosted: Fri Nov 29, 2013 7:08 pm    Post subject: Reply with quote

isobars wrote:
Thanks, Mo, but, yes ... I went through all that with the insurance beancounters at the big local hospitals, the docs, and the PT/rehab insurance people. That approach is reserved for specific providers at specific locations.

Medicare coverage is quite comprehensive. Most reputable PT/rehab providers deal with Medicare regularly. The specifics of who can provide are listed on Medicare's website. It's certainly not as limited as you suggest.

From Medicare's website:
Quote:
Who can give me outpatient therapy services?
You can get outpatient therapy from any of these health care professionals:
• Physical therapists

 • Speech-language pathologists

• Occupational therapists
Doctors and other health care professionals (like nurse practitioners,
clinical nurse specialists, and physician assistants) may also offer PT, SLP, and OT services.

Where can I get outpatient therapy services?
• Offices of privately practicing therapists
• Many medical offices
• Outpatient hospital departments, including those of critical access hospitals
• Rehabilitation agencies (sometimes called outpatient rehabilitation facilities)
• Comprehensive outpatient rehabilitation facilities (CORFs)
• Skilled nursing facilities (SNFs) for outpatients or residents who aren’t in Medicare-certified parts of the facility
• At home, from certain therapy providers, like privately practicing therapists and certain home health agencies (if you aren’t under a home health plan of care)

_________________
mo
Back to top
View user's profile Send private message
isobars



Joined: 12 Dec 1999
Posts: 14624

PostPosted: Fri Nov 29, 2013 7:45 pm    Post subject: Reply with quote

coyotewindsurf wrote:
The specifics of who can provide are listed on Medicare's website. It's certainly not as limited as you suggest.

Please tell that to the many frustrated patient advocates, insurance coverage professionals, and providers I've consulted. They've devoted years to this issue with no improvements.

Perhaps you misunderstand my extremely brief reference to the problem. The key seems to be the distance, in driving miles, from the parent hospital to the satellite facility providing the service. If the PT I'm using worked at the parent hospital ... the actual building ... from which his paycheck is mailed, Medicare would at least double my cap as you describe. But since his physical facility is attached to a gym X miles away so he can use the gym's equipment for rehab, his services are capped at the initial $1,900 per calendar year.

Why use him? Because he and his equally qualified partner at the same facility are THE physical therapists the whole city's school and pro teams and coaches and physicians insist upon for getting their amateur and professional athletes back in the game. The other 8-10 PTs I've used over the decades lack their highly advanced training, rare board certifications, and exclusive and extensive experience in completely rehabilitating sports injuries. The evidence from everything from PubMed to buds with knee scars overwhelmingly convinces me their superior expertise is critical to success. Even my previously preferred sports medicine orthopedic surgeon demonstrated a lack of understanding of the rehab mandatory, by all accounts, for normal mobility, let alone windsurfing.

I'm going to choose my providers as best as I can, as long as I can, before rolling over and subjugating my health and quality of life to whatever treatment and whomever hack in a white coat some freaking politician or his TSA/DMV-rejected beancounter decrees. THAT, not ideology or mac's cries of racism, is why this president's and his sycophants' misguided attempts to screw up our health care even more piss me off to high heaven.
Back to top
View user's profile Send private message
pueno



Joined: 03 Mar 2007
Posts: 2766

PostPosted: Fri Nov 29, 2013 8:02 pm    Post subject: Reply with quote

Mr. Two-faced wrote:
pueno wrote:
Mr. Fick-shun wrote:
...the untold billions spent on failed websites...

Snip


Your deliberate omission of my whole list -- including a very specific and admitted $740B -- illustrates that of all the people here, you are the most dishonest. Is that because you're an outsider who doesn't share the tie that binds us windsurfers?

Gosh, I thought I was on your magic killfile and that you couldn't read my posts.

You hate that I caught you in blatant plagiarism.

And you're pissed that I'm right about your vitriol, angst, bile, acid, and unbridled O-hate.

Lie much, Mikey? Laughing Laughing Laughing
.
Back to top
View user's profile Send private message
isobars



Joined: 12 Dec 1999
Posts: 14624

PostPosted: Sat Nov 30, 2013 8:48 am    Post subject: Reply with quote

As I've said multiple times lately, pueno, I've opened my shields occasionally to see how well iW's new moderation policies (in conjunction with each individual's conscience) are affecting the worst offenders, in case I can shorten my $#!+ list.

Both you and they flunk the test, I hope I've learned my lesson in your case, I find Mo's comments infinitely more useful and topical* than yours, and I have no idea what your plagiarism comment refers to.

* In fact, I'm filing hers in case I find a weakness in Medicare's brick wall.
Back to top
View user's profile Send private message
pueno



Joined: 03 Mar 2007
Posts: 2766

PostPosted: Sat Nov 30, 2013 9:09 am    Post subject: Reply with quote

Mr. Fick-shun wrote:
...and I have no idea what your plagiarism comment refers to...

Of course, I expect you to totally ignore this response because of your imaginary "killfile." But in case you don't...

...look HERE, Honest Abe. Laughing Laughing Laughing

You won't admit to reading this, Mikey, but others will... and they'll recognize that you both lie and steal.
.
Back to top
View user's profile Send private message
isobars



Joined: 12 Dec 1999
Posts: 14624

PostPosted: Sat Nov 30, 2013 9:29 am    Post subject: Reply with quote

coyotewindsurf wrote:
if your therapist provides documentation that your services were medically reasonable and necessary, you won’t have to pay for costs above the $1,900 therapy cap limits. Your therapist must give you a written notice, called an “Advance Beneficiary Notice of Noncoverage” (ABN), before providing services that aren’t medically reasonable and necessary. Medicare doesn’t pay for therapy services that aren’t medically reasonable and necessary. The ABN lets you choose whether or not you want the therapy services. If you choose to get the services, you agree to pay for them if Medicare doesn’t pay. If you get therapy services that aren’t medically reasonable and necessary and Medicare doesn’t pay for them, you won’t have to pay for the services unless an ABN was given to you beforehand.

I instructed my PT up front to do everything necessary to maximize my knee recovery, and let me juggle the costs among my four insurance sources and, if necessary, cash. Fortunately, I'm getting FEWER therapy appointments -- MUCH fewer than many or even most ACL patients -- because my PT is very impressed how diligently I work at it on my own and is aware that Medicare caps me at $1,900 regardless of statements of necessity from both PT and surgeon, unless I want to accept a much lower level of care. He and my surgeon say I'm progressing a bit ahead of the norm, even compared to their high school and college athletes, few of whom have the time or will power I devote to it. I'll be damned if I'm going to risk the rest of my life's windsurfing to a PT who hasn't rehabbed scores or hundreds of ACLs by the proper highly demanding protocols.

I feel sorry for people on socialized medicine, as they can't get anywhere near the care I've gotten over the decades for a blown-out knee, torn rotator cuff, broken back, multiple cancers, crumbling cervical vertebra, violent vertigo drop attacks leading to ambulance runs and a tentative imminent death diagnosis, emergency EGD and mechanical esophageal dilation, or any of the dozens of other medical challenges I've faced. The UK, Canadian, and other foreign nationals I correspond with marvel at the cancer care we take for granted in the U.S., for example. I hope to God that this president and every successor fails in the implementation of anything resembling his stated goal of a taxpayer-funded government-run health care system, because it will end the great features of U.S. health care in an ill-advised and incompetent attempt to fix its individually repairable flaws.
Back to top
View user's profile Send private message
isobars



Joined: 12 Dec 1999
Posts: 14624

PostPosted: Sat Nov 30, 2013 9:44 am    Post subject: Reply with quote

And you're a desperate and deceitful laughing stock, pueno. Plagiarism involves deceit, whereas I made or implied no claim of originality. I just clipped and pasted some support for my comments about Holdren's background.

And that's all the time you're worth this year.
Back to top
View user's profile Send private message
pueno



Joined: 03 Mar 2007
Posts: 2766

PostPosted: Sat Nov 30, 2013 11:51 am    Post subject: Reply with quote

Mr. Plagiarist wrote:
Plagiarism involves deceit, whereas I made or implied no claim of originality. I just clipped and pasted some support for my comments about Holdren's background.

You really are pitiful, Mikey. You know very well that you took another's original writing and presented it as your own.

Original writing does not require that the author say, "I swear that this is mine."

Plagiarism is precisely what you said you did: "...clipped and pasted some support..." In other words, you took another's words and presented them as your own.

You get an F- on your thesis, Mikey. Hang your head, you failed the course.

You are a liar, a thief, and a shameful, unethical plagiarist.

Oh, yeah........ and a hypocrite.
.
Back to top
View user's profile Send private message
swchandler



Joined: 08 Nov 1993
Posts: 6031

PostPosted: Sat Nov 30, 2013 2:48 pm    Post subject: Reply with quote

"I'm going to choose my providers as best as I can, as long as I can, before rolling over and subjugating my health and quality of life to whatever treatment and whomever hack in a white coat some freaking politician or his TSA/DMV-rejected beancounter decrees. THAT, not ideology or mac's cries of racism, is why this president's and his sycophants' misguided attempts to screw up our health care even more piss me off to high heaven."


Why does isobars say stuff like this? When he offers unqualified rants like this, I find it hard to believe that he's being honest and candid about the situation with his PT options. Everything is so twisted in his world. He talks up a storm about how superior medical care is in the US, and how it's so terrible elsewhere in the world, but I guess he doesn't think that we're listening when he negatively goes on to slight his surgeon and virtually all the other PT options available to him. Nobody but his selected PT is even close to being competent or qualified to manage his rehab. On top of that, we all know that he's never been treated for any medical condition elsewhere in the world.

What can you take away from what isobars says? In my view, very little, if anything, can be taken as the truth, particularly if it has anything to do with the ACA or Medicare. Why would I say that? Frankly, it really comes down to is the fact that isobars isn't even close to being fair and unbiased in his comments. One only needs to look at the last few pages of what he's posted to this thread. Moreover, most of it his commentary concerning health care and healthcare reform is founded in hateful diatribes culled from gutter sources that lack credibility.

What do I know about health care and health insurance? Well, I'm not going to bore everyone here with my personal stories about the medical care that I received this year, but I will say that it was substantial, and that it represents well over $100K in claims. On the 19th, I had shoulder surgery, and I'm now recovering over the remaining weeks of the year. Starting the new year, I too will be involved in a rehab program to get back into shape. Once I finish with that, it's on to my other shoulder for the same procedure later in the year. Will I be ranting and carrying on about President Obama, the ACA, my insurance company and government run healthcare like isobars does here? No, not really. That's not to say that I won't have some interesting experiences and opinions, but I'm not dedicated to offering boatloads of negative theater and predictions of the sky falling.
Back to top
View user's profile Send private message
mac



Joined: 07 Mar 1999
Posts: 5575

PostPosted: Sat Nov 30, 2013 2:58 pm    Post subject: Reply with quote

Can you imagine living in Richland Washington and having some know it all nut case come in for physical therapy for an injury? Can you imagine that he would have half read a series of articles about his injury, will be convinced that he knows exactly how to treat it--and will not listen to a word you say?

No wonder the VA and Medicare won't treat Mike Fick!
Back to top
View user's profile Send private message
Display posts from previous:   
Post new topic   Reply to topic    iWindsurf Community Forum Index -> Politics, Off-Topic, Opinions All times are GMT - 5 Hours
Goto page Previous  1, 2, 3 ... 142, 143, 144 ... 199, 200, 201  Next
Page 143 of 201

 
Jump to:  
You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot vote in polls in this forum
You cannot attach files in this forum
You cannot download files in this forum

myiW | Weather | Community | Membership | Support | Log in
like us on facebook
© Copyright 1999-2007 WeatherFlow, Inc Contact Us Ad Marketplace

Powered by phpBB © 2001, 2005 phpBB Group