Don't usually watch CFB but Arkansas just got hosed by the refs.

4 hours ago, EaglePhan1986 said:

@LeanMeanGM

Eagles 24-20

Smith 50+ yard TD 

 

 

Steelers get Watt back for tomorrow against Saints but lose Fitzpatrick.

5 hours ago, EaglePhan1986 said:

You should probably complain about it to them 

Not worth it. 

13 minutes ago, LeanMeanGM said:

Steelers get Watt back for tomorrow against Saints but lose Fitzpatrick.

Saints look locked in to be a 7-10 team to me.  That’s assuming a win over the Steelers this weekend.  I’ve learned how emotionally unrewarding it is to count on a bad team to win a game for you 

2 hours ago, Sack that QB said:

Haha... so I got the letter back from my insurance company about my denied MRI. They listed the reason. They said "Reason listed for MRI order: dizziness. We have concluded that reason alone is not sufficient for an MRI. If your dizziness has room spinning symptoms or some hearing loss, etc" and listed a bunch of things that would make it sufficient. Which is hogwash, my doctor documented like 10+ symptoms I've been dealing with, all listed in this letter. So basically my insurance company didn't read crap. Or they did, but lied and hoped I wouldn't appeal so they don't have to pay.

I've noticed that this has been going around too. I have a relative who got kicked off disability last year. They have a very serious chronic illness and they were booted off because "we reviewed your medical history and decided you are no longer ill" and they were incredulous. Turns out they for some reason either ignored all their hospital and doctor's visits over or just disingenuously focused on one doctor's visit where it was a routine checkup and wasn't with their specialist. They got back on after appealing, but still, annoying.

Man, everyone's looking to F you over at every turn. I gotta start documenting everything now just in case.

Shouldn't be too hard to get this overturned. I have an appt next week, coincidentally on the last day of my peer to peer window. Hopefully they do it then that day.

Suspect the ICD10 code used by the doctor wasn’t the one that would trigger acceptance.  If, for example, the doctor is using R42 (general dizziness), that probably gets an MRI denied.  You say he wants a brain MRI, that probably requires a diagnostic code that ties to the brain.  

Search tool. https://icd10cmtool.cdc.gov/?fy=FY2023&query=Brain

If your doctor reports, bills or online charts include codes, consider using the tool to review.  The first step health insurers usually take is reviewing the diagnostic codes. HE is a great resource as likely are several other posters in here that are involved in the reporting side of medicine. Computers rule engines are probably what are holding you back.  Good luck 

3 hours ago, Sack that QB said:

Haha... so I got the letter back from my insurance company about my denied MRI. They listed the reason. They said "Reason listed for MRI order: dizziness. We have concluded that reason alone is not sufficient for an MRI. If your dizziness has room spinning symptoms or some hearing loss, etc" and listed a bunch of things that would make it sufficient. Which is hogwash, my doctor documented like 10+ symptoms I've been dealing with, all listed in this letter. So basically my insurance company didn't read crap. Or they did, but lied and hoped I wouldn't appeal so they don't have to pay.

I've noticed that this has been going around too. I have a relative who got kicked off disability last year. They have a very serious chronic illness and they were booted off because "we reviewed your medical history and decided you are no longer ill" and they were incredulous. Turns out they for some reason either ignored all their hospital and doctor's visits over or just disingenuously focused on one doctor's visit where it was a routine checkup and wasn't with their specialist. They got back on after appealing, but still, annoying.

Man, everyone's looking to F you over at every turn. I gotta start documenting everything now just in case.

Shouldn't be too hard to get this overturned. I have an appt next week, coincidentally on the last day of my peer to peer window. Hopefully they do it then that day.

Unfortunately any notes do not accompany the claim.  Only the Diagnosis (last time I checked they were ICD-10) codes and procedure codes (probably HCPCS).  It sounds like the billing department of your provider did an inadequate job in submitting the claim.  If your doctor has identified and documented 10+ symptoms, each one of those symptoms will have a specific diagnosis code.  Some of the symptoms may map to the same diagnosis code, so 10+ symptoms identified by the doctor may result in less than 10 actual codes for the billing submission.  Further, the doctor needs to identify one of those codes as the "Primary Diagnosis."  All the others are "Secondary Diagnoses." 

Everything you have described does NOT point to an insurance company problem.  Rather it points to a billing department problem at you healthcare provider.  It is ESSENTIAL that your doctor/provider provides the insurance company with ALL the codes in the peer to peer review.  if they don't, I predict the appeal will be denied.

NOTE: I spent 25+ years in healthcare finance and administration, and was both a hospital Patient Accounting Manager and the CFO of a startup HMO and a product manager and regional sales manager for a hospital and physician billing software company that had over 1,000 hospital clients nationwide.

1 hour ago, BigEFly said:

Suspect the ICD10 code used by the doctor wasn’t the one that would trigger acceptance.  If, for example, the doctor is using R42 (general dizziness), that probably gets an MRI denied.  You say he wants a brain MRI, that probably requires a diagnostic code that ties to the brain.  

Search tool. https://icd10cmtool.cdc.gov/?fy=FY2023&query=Brain

If your doctor reports, bills or online charts include codes, consider using the tool to review.  The first step health insurers usually take is reviewing the diagnostic codes. HE is a great resource as likely are several other posters in here that are involved in the reporting side of medicine. Computers rule engines are probably what are holding you back.  Good luck 

Was going to say same thing. Its a code driven thing

tell them fell from it and code that

2 minutes ago, ToastJenkins said:

Was going to say same thing. Its a code driven thing

tell them fell from it and code that

Toast is spot on.  Any kind of fall is a huge red flag for an insurance company.  Falls can get very, very expensive.

Scott unspecified on injury report.  Probably the replacement for Maddox.  Both Maddox and Jobe are out. 

3 hours ago, KINGnabb said:

Love it.  Looks like a Family Photo.   Donovan would be the Dad, Vick the Uncle and Jalen the Son.  LOL.  They're all rockin the goatee too.  

So who is RGIII?  Annoying neighbor?

Incredible that in the year of our lord 2022 that Josh Andrews is on a 53-man roster. I’m so happy it’s the Saints’. 

14 minutes ago, bpac55 said:

So who is RGIII?  Annoying neighbor?

Is Russell Wilson the uncle you don’t trust to leave your children with?

@LeanMeanGM

Eagles 34

Commanders 14

Bonus: Goedert 2 TDs

I’m here matt

Rebels have a chance here to win 31-30 and hand Bama their 3rd loss. They'll screw it up somehow, I'm sure.

1 hour ago, BigEFly said:

Scott unspecified on injury report.  Probably the replacement for Maddox.  Both Maddox and Jobe are out. 

 

Oh God, that sound alike CJGJ at nickel and Wallace playing. 

I like Penix

40 minutes ago, olsilverhair said:

I’m here matt

No date night with hpenis? 

8:00

FSU- DE/OLB Verse

vs

Syracuse- RB- Sean Tucker

 

2 prospects of interest for us.

 

1 minute ago, RememberTheKoy said:

 

How much lube you go through watching this? 

2 minutes ago, HazletonEagle said:

8:00

FSU- DE/OLB Verse

vs

Syracuse- RB- Sean Tucker

 

2 prospects of interest for us.

Just realized that the top-5 OT prospects are underclassmen, that ain’t great.

Kstate (DE Felix Aludike) vs Baylor (NT Ika and OT Galvin)

Just now, Waiting4Someday said:

Just realized that the top-5 OT prospects are underclassmen, that ain’t great.

Kstate (DE Felix Aludike) vs Baylor (NT Ika and OT Galvin)

Just looked at Charlie's mock on walterfootball, and he has us taking Ika at the end of the 1st. 350lbs with some quickness. I like the idea of a massive DT combo with Davis and him.

1 minute ago, HazletonEagle said:

Just looked at Charlie's mock on walterfootball, and he has us taking Ika at the end of the 1st. 350lbs with some quickness. I like the idea of a massive DT combo with Davis and him.

Agreed. JD can play 4i-0T, so they can be the field together or split reps. Ika wouldn’t be trapped on the bench.

Lots of good/interesting prospects in the TCU-Texas game.  Robinson for Texas.  Johnston for TCU.  Newton and Daniels CBs for TCU. Duggan for TCU.