Ask MetaFilter questions tagged with healthcare Questions tagged with 'healthcare' at Ask MetaFilter. Fri, 26 Dec 2014 08:35:02 -0800 Fri, 26 Dec 2014 08:35:02 -0800 en-us 60 Best state in the US for Health Insurance Chronically ill, fixed income US expat. Is it possible to get affordable health insurance in the US? This is pretty much a hypothetical question, but I figure I’d do some research anyway. Snowflakes after the fold: I am a US citizen that has lived internationally for about 2 decades. Around 5 years ago I developed a chronic illness that has taken me out of work and placed me on LTD payments through my last employer. The policy covers a significant proportion of my last salary through normal retirement age and continues to contribute to Super. I’m moderately financially stable, but unlikely to ever be able to return to meaningful work in my previous professions. <br> <br> I receive treatment (~monthly IV infusions) for my condition through the public system in combo with private health insurance, hit the PBS safety net annually (for prescription drugs), am required to have monthly blood tests, see a GP and specialist monthly, require additional diagnostic and monitoring imaging periodically, regular physio, etc.<br> <br> My brother and his family would very much like me to join their household. I’d like that too. They currently live in a single-payor country and have been expats for a couple of decades as well. The twist is they are strongly considering returning to the US sometime in the next year.<br> <br> There are any number of significant reasons to me why I wouldn’t want to return to the US. One of them used to be the inability to get health insurance with my, very expensive, pre-existing condition. But with the advent of the ACA, it seems that that isn’t the absolute limitation it once was.<br> <br> Speaking to family this week they said if I joined them, I could choose any state / city in the country I wanted. Aside from the practicality of them finding appropriate employment, housing, schools for the kids, etc, what states have the best health insurance options for someone in my situation and how could I go about figuring out the potential costs?,2014:site.273521 Fri, 26 Dec 2014 08:35:02 -0800 Anonymous Strep throat in the wrong country I am almost positive I have strep throat. I'm in the US for the holidays but I live in Canada and all my health insurance is based there. What are the easiest, cheapest options now? <br> There is a slight chance this is just the worst sore throat I've ever had, but it's been hurting for four days now and it feels very similar to the last time I had strep (slightly less painful, or I'd already have asked this.) No cough, not really a runny/stuffy nose, just throat pain. All I want is a prescription for antibiotics.<br> <br> I think that my Canadian healthcare will refund me whatever it costs? (I have travel coverage, I believe). Is this true? Will they cover all of it?<br> <br> How much will it cost me upfront? Is it cheaper to go to a regular doctor or an urgent care clinic?,2014:site.273316 Sat, 20 Dec 2014 22:03:30 -0800 raeka HIPAA/Medical Release for Emergency Situations? In the event of an emergency, what can be done to ensure that doctors/hospital can share information with another unrelated adult? My partner and I live several hours away from anyone we're legally related to. There's a surgery in the cards in the next year or so for him, which got us thinking. We're in the process of getting all the necessary HIPAA forms in place with our regular doctors so that my doctor can share my medical info with him, and his with me. I believe that will cover us for his surgery as well, since we'll make sure to sign a HIPAA release in place as part of the pre-admittance process. But now we're wondering about emergencies - if I'm in a car accident and rushed to the ER, for example, is there anything we can put in place, or that we can carry in our wallets, that says "yes, please tell this person what's going on"? <br> <br> I don't think we need healthcare power of attorney here, since we're less worried about making major decisions and more about not being uninformed in the event that they'll only talk to a legal relative. Beyond basic "person I love is hurt" anxieties, there are specific health issues at play that make an open line of communication between doctor, partner, and patient super-important for both of us.<br> <br> Possibly relevant details: we are unmarried, though we do live together. USA, New York state. <br> <br> tl;dr: with basic HIPAA releases in place, what can I do to make sure that care providers can (legally) talk to my partner if I'm under <strong>emergency</strong> care, and vice versa?,2014:site.273025 Mon, 15 Dec 2014 07:35:26 -0800 okayokayigive Is This A Phone Scam? My Health Insurance Company Calls Me... What can a phone scammer do with your home address and kid's date of birth? I've heard that phone scams are getting "better" in terms of sounding very professional and being able to spoof caller ID, so I'm paranoid that I just told some scammer too much. So I've been getting calls from a call center with the opening pitch saying that "this is [my health insurance provider] calling to inform you about important services for your child's wellness." They then say they need to verify my identification -- and ask for my home address and kid's date of birth (no SSNs or anything). They also ask if my kid has had any of a decently long list of medical conditions and then asked for the name of my kid's doctor. <br> <br> Asking for the name of my kid's pediatrician struck me as odd.. because shouldn't my insurance provider already know that? I asked, and the call center person explained that "we don't have a complete record of your family's healthcare providers because we're a different department..." or something like that.<br> <br> The thing that really struck me as strange is that after answering these questions, they just say "we'd like to inform you that we've activated your child's wellness services, and if you have any health questions you can call the phone number on the back of your insurance card to access a 24-hr nurse hotline." They didn't actually tell me the phone number to call... so I asked what the number was... and the person said, "hmm. I'll get that number for you..." and then there was about a minute of silence until the person came back with an 800 number that I later verified was actually a 24-hr nurse hotline provided by my healthcare insurance company.<br> <br> Now.. am I being paranoid or does this call sound sketchy to anyone else? I didn't reveal any SSNs, but I did just tell some random person my home address and my kid's dob.... and the only information I got in return is that I can call a number that I already have? If this *is* a real call from my health insurance company, it's not very informative for me and sounds a bit unprofessional. If it isn't a real call from them... what is the scam angle? Am I just going to get on a mailing list for medical spam? Anything worse than that...?,2014:site.272824 Wed, 10 Dec 2014 11:54:05 -0800 mhh5 How to find a doctor for prescriptions outside your healthcare plan? My PCM says she wants to prescribe me a drug that is in common usage, but she is not allowed to do so. She says that I should find a doctor outside my health plan that can prescribe it. Is this a good idea, and if so, how do I do this? I don't want to waste time or money, or do something idiotic. The drug in question is phentermine for weight loss- she says that I have such a high likelihood of diabetes that it would really help improve my overall health/life chances if I can get my weight down swiftly before my prediabetes gets fullblown. However, the VA and military, from whom I get my medical care, are emphatically against any sort of weight-control drugs. (I'm not sure why, I suspect it's something on a moral scale about feeling like it's cheating) She said that it wasn't even in the system for her to prescribe, and suggested I find an outside provider.<br> <br> Concerns I have are:<br> <br> 1) If I get a prescription outside the system, it will not be tracked by any of my VA providers, which opens me up for negative drug interactions.<br> <br> 2) How do you find a doctor just to prescribe you something your doctor can't, with a minimum of visits? I have a sense that patients who are thought of as "drug-seeking" are usually blown off or redirected by providers.<br> <br> Any help or advice in finding me a successful outcome would be appreciated.,2014:site.272693 Mon, 08 Dec 2014 11:51:37 -0800 corb What are the most lucrative healthcare jobs? I am thinking of changing careers completely from finance to healthcare. I’m trying to get an understanding of where the jobs are, and which ones pay well. My requirements are:<br> <br> - good pay (+$100K per year)<br> - in demand <br> - education can be completed in 3 years or less <br> - ideally would not require direct patient care, or if it did, would not involve blood<br> <br> Due to my last two requirements, med school and nursing are right out. I’m thinking about jobs like imaging, medical lab technician etc. (I can handle blood in a clinical setting, just can’t handle drawing it/watching it being drawn). <br> <br> I’m sure there are many more “hidden” jobs in this field of which I’m unaware – please help me round out my knowledge.<br> <br> My background in finance might also lend itself to admin-type jobs; I’m open to hearing about those as well.<br> <br> I’m in Toronto, Canada.,2014:site.272678 Mon, 08 Dec 2014 08:55:30 -0800 yawper Ten-day course of Cipro for UTI? I was recently diagnosed with a UTI at an urgent care clinic. The PA (I did not see an MD or NP) prescribed a ten-day course of cipro to treat it (500mg, twice a day, for 10 days). That seems excessive to me (though I will take the full course of antibiotics as prescribed). Is such a long course of antibiotics commonly prescribed for UTIs? The symptoms had been occurring on and off for a week and a half, and I was in a fair amount of pain when I went into the clinic. (Yes, I know I left it too long.) The nurse told me there was both blood and white blood cells in the urine sample I gave that day. This is the first UTI I've had in about three years, and that last UTI was the last time I was prescribed antibiotics for anything.<br> <br> I do not have insurance or a primary care doctor, and the clinic told me that any follow-up would require my paying full cost out of pocket (again) for an appointment -- they don't do phone calls -- so following up with a doctor or the clinic is not going to happen. <br> <br> As I said, I will take the antibiotics as prescribed regardless, but I'm just interested to know if a 10-day course is commonly prescribed in general, likely prescribed because I waited so long to see a healthcare professional, or very rarely prescribed and maybe I shouldn't go back to that clinic for care in the future.,2014:site.272200 Fri, 28 Nov 2014 15:43:34 -0800 Anonymous NY Health Exchange Looking for information on some of the NY Exchange Plans (NYC) Last year, when I bought my plan from the Health Exchange, only one company (United Healthcare) had contracted with the hospital in NYC where most of my doctors are located and where I have my tests/labs/imaging done. This year, lots of plans include those same doctors, and all of the plans are less money than UHC. The ones my doctors will take in 2015 are Affinity, Oscar, and Empire. So,<br> <br> Empire is pretty well known, but can anyone tell me anything about the other two that might influence my choice?<br> <br> I know that some plans save money by having you go to inconvenient labs/imaging centers or get your prescriptions from a particular place, and I'll be calling both those companies to find out if that is the case. Can you think of other questions I can ask now to save myself aggravation later on? <br> <br> TIA,2014:site.271838 Thu, 20 Nov 2014 12:06:42 -0800 AMyNameIs County Mental Health Center Woes I suffer from severe anxiety and PTSD, and I have been on benzos for 10 years now (first Xanax and then clonazepam). My insurance limits me to going to the county mental health center, and my psychiatrist there sent down a mandate that I have to stop the clonazepam. I'm frustrated, especially since I was not offered anything different for anxiety. I am mostly upset about poor communication and it’s not so much that I am questioning her judgment from a medical perspective. I am not seeking advice about managing anxiety; I want advice about self-advocacy. There was a fire in my apartment a few weeks ago, and I went to the ER for smoke inhalation. While there, my bloodwork still showed alcohol from the previous night. I don’t know what my BAC was. Alcohol was not a factor in the fire.<br><br><br> My psychiatrist tends to be more conservative when it comes to benzos, especially when patients drink at all. The ER called the mental health center, which is the only place I can go to see a psychiatrist at all. I don’t have private insurance, only state medical assistance and SSDI. There are 2 psychiatrists in town who accept state healthcare, and both of them are really bad. So I see a psychiatrist at the mental health center instead, even though that means having to make an appointment three months in advance. I also get my meds from their pharmacy, so the ER contacted them to get me replacement meds for the ones left behind in the fire.<br><br><br> I am not sure exactly what the ER folks told my psychiatrist’s office. A week or so after the fire, I stopped by the mental health center to let a nurse know about some of the trauma symptoms I was experiencing. That’s when the nurse told me that my psychiatrist had stopped the clonazepam because of the alcohol in my system. (The nurse said my case manager had been trying to reach me, but I hadn’t received or missed any phone calls from them.) The nurse gave me instructions on how I was to taper off. <br><br><br> I was pretty upset about this, and I was very frustrated as well by the manner in which I found out about it. I am appreciative that the mental health center is way underfunded and beyond strapped, but it still upset me that there was no way to actually have a conversation with my doctor about this. I was even more upset when I went to pick up the smaller supply the next week so I could properly taper and I discovered that the nurse hadn’t given me the right instructions and now I wouldn’t get to taper at all. <br> <br><br> Between the benzo withdrawal and the trauma of the fire and all its complications, my anxiety was reaching impressive new heights. I had no circadian rhythm. My blood sugar was always crashing suddenly. I had nightmares every time I slept. My thoughts raced and I trembled constantly. I kept calling the crisis people at the mental health center for any kind of intervention at all, but I didn’t get a call back until days later, and they just asked me a couple questions but didn’t do anything. <br><br><br> Last weekend I reached my breaking point because there was just no way I could get relief and the nightmares meant I never felt rested. I went to urgent care at my primary care clinic and told all of this to the doctor I saw there. She said that she didn’t want to do anything against my psychiatrist’s advice but that she thought I needed relief, especially since benzo withdrawal was likely a huge contributing factor in my symptoms. She proposed that she give me five days’ worth of a low dose of clonazepam and that her office would call my psychiatrist and try to work out a mutually agreeable plan.<br><br><br> I didn’t hear anything from either doctor’s office and I finished the five-day supply a few days ago. I called the primary care clinic to see if they had been able to work anything out, and they told me that they had been leaving 3-4 messages a day for my psychiatrist all week. I called the mental health center myself and left another message, this one asking them to talk to the other doctor.<br><br><br> A nurse from the mental health center called me back later and said that my psychiatrist was unwilling to prescribe any more clonazepam. I said that that was fine and I knew that but that the primary care clinic had wanted to discuss options with her. I don’t know if she misunderstood or what, but the gist is that that conversation would not take place. She told me to go exercise when my anxiety spiked. <br><br><br> Now as I’m preparing for the withdrawal to start all over again, I don’t know what to do. Aside from Zoloft, I am not on anything else for anxiety. I’ve tried many other things in the past without luck, and I’m concerned about what’s to come for a lot of reasons. I am also very angry and disappointed that they’ve been so difficult to work with, especially since I can’t just go elsewhere with a more accessible psychiatrist or better communication system. My therapist doesn’t have any ideas, and she’s expressed similar dissatisfaction with the mental health center before. <br><br>I don’t know if going back on the clonazepam is the best option or not, but I know I would like to be heard in my own healthcare. Can you think of ways that I could either get a better experience at the mental health center or get care elsewhere?,2014:site.271606 Sun, 16 Nov 2014 11:23:02 -0800 mermaidcafe Continuing education requirements for PTA in Virginia A family member is a physical therapist assistant in Virginia. They just completed a one or two-year massage therapy course at a local college (I forget the details). They want to know if the course meets their continuing education requirements. (<a href=" Education:">Requirements here</a>.)<br> <br> They wrote the board and asked, and the board simply said it counted if it met the standards. In other words, they aren't going to interpret anything for them and give a clear yes or no answer.<br> <br> They're pretty busy, and I am too, but I'd like to help out by getting them an answer. Is this the kind of thing that an attorney or some other rules-knower might be able to just interpret for them for a small fee? From afar, it would be a simple way for me to help and would save them a bunch of stress and time looking into it themselves.,2014:site.270778 Thu, 30 Oct 2014 10:08:43 -0800 jsturgill Best health insurance plan for shuttling green card holder? If someone is a 65+ recent green card holder with only 3 years work experience in the US and who hasn't lived continuously in the US for 5 years (but has visited every year for several months for a decade), they don't qualify for free or even paid Medicare. What is the best health insurance plan for them if they spend 5-7 months in the US, and the rest in their home country in Asia? Are they best off with an Obamacare plan, or some kind of special immigrant health insurance, or what? Thanks.,2014:site.270718 Wed, 29 Oct 2014 09:00:41 -0800 shivohum a health insurance gap. a cobra loophole. I am going to have a health insurance gap between October 31 and December 23rd. That is a time period less than 60 days, and I hear there is a COBRA loophole, and I would like advice about it. I am starting a new job the week after next, and thus leaving my current one next week. I have health insurance from my current job through the end of the month. Unfortunately, there is a 57-day waiting period for health insurance at my new job, which would give me health insurance on December 23rd.<br> <br> I currently work at a small company that is apparently not great at negotiating with insurance providers, because I found out that my COBRA payment, should I go that route, would be <em>astronomical.</em> Almost $700 a month for not-so-great health insurance for one person astronomical. While I technically could pay this, I would very very very much prefer not to--it's a lot of money for me, and I'm a fairly healthy person who is up-to-date on all medical appointments. The main thing I use my insurance for is my birth control prescription.<br> <br> I'm told that COBRA has a 60-day election window, and that what I should do is take the paperwork, keep it, and if something happens to me while I don't have insurance, file the paperwork, which would be retroactive and provide me allegedly uninterrupted coverage, so I could go to the doctor. I like the idea of this plan, but I worry: what if I get hit by a car or need my appendix out or have a piano drop on my head. Would retroactive coverage mean that, after I'm in the hospital for one of these emergency ailments, I could mail the paperwork in within that same 60 day window and thus be covered, even if I mail it <em>after</em> I receive care?<br> <br> Basically, please explain to me how the COBRA 60-day window works. And feel free to offer other alternatives if there are any (I live in NY; apparently "temporary" health insurance is not a thing in my state). I also already looked into the state marketplace, and all of the plans had a deductible higher than my COBRA payments would be (my current insurance has no deductible).,2014:site.270130 Fri, 17 Oct 2014 08:15:29 -0800 millipede My assault casts a long shadow over my medical record... My history of sexual assault is in my medical record. My <em>electronic</em> medical record. This is driving me nuts and becoming a mental roadblock for me when I seek further healthcare. I want to be seen for various health concerns-- for example, I am concerned about my longstanding complete and utter lack of libido. But because my mental health records make note of my history of sexual assault, I feel like the general response will be, "Oh, of course you're not interested in sex given your history of assault; here's a referral to a psychiatrist." <br> <br> Even if this were indeed the thought process my healthcare provider followed (and I'm not saying that it will be), I know that it would be easy for me to insist on a blood test to get my hormones checked. Furthermore, I could very well be unnecessarily wary that she'd make those sorts of assumptions-- after all, a good clinician wouldn't, right? <br> <br> But the fact that this part of my medical history is visible to my healthcare providers is driving me crazy. Not only is the fact that I was assaulted in my medical record, but snippets of my personal life and response to the assault are in there because I was in therapy for a while. I am in healthcare myself and I know that once it gets buried deep enough in my record, people won't read that part of my record if I'm being treated for, say, something in nephrology or cardiology. But still! It's there and I feel like there's such stigma and I don't know why it bothers me so much, but it does. It's keeping me from scheduling medical appointments I should have no issues scheduling. <br> <br> I am frustrated with how inarticulate I'm being in writing this question, and maybe it's not clear what I'm asking here,... but I just feel like many of my medical concerns are not legitimate anymore because everything can be chalked up to my history of assault. This might be all in my head, but it has also been compounded by the fact that my PCP is frequently unavailable to see me (month-long waits...), by having a bad experience or two within the same healthcare system I'm currently seen in, and by generally disliking the homogenous, super-conservative environment I am currently living in. <br> <br> What is it exactly that I am experiencing here? Am I making this all up? How can I get over this mental block? How can I talk to my healthcare providers comfortably? Any other tips? Thank you!,2014:site.269952 Mon, 13 Oct 2014 21:40:49 -0800 gemutlichkeit Help me help - U.S. healthcare woes My dear friend is resigning from her job in the near future. She will move to another state in 2-3 months and plans to go without health insurance until she can find a job there. Is this as bad an idea as I think? How can I help? She is under 30 and in good health. She says she can’t afford interim coverage. I can afford, and would happily pay, the catastrophic insurance rates I’m seeing on (if that’s an option). I just don’t want her to risk getting trapped under a mountain of debt. How can I tactfully offer to help her out? Should I?,2014:site.269745 Thu, 09 Oct 2014 14:58:27 -0800 ista I have health insurance. Now what? Asking for a friend: Please help a complete (and mostly healthy) newbie figure out how to navigate the US healthcare system in CA. Explaining like you would to a five-year-old would be great. So for the first time in my life, I have comprehensive health insurance (thank you Obamacare!) The thing is, coming from a country where health insurance isn't a thing, I have no idea how it works. <br> <br> Snowflake details:<br> <br> - I have coverage through my school-specific plan (Anthem Blue Cross in CA)<br> - I am 26, more or less healthy, no major problems.<br> - Based on a couple of observations, and conversations with friends, I may have type 2 diabetes. <br> <br> My question is: how do I even start? I'm not exaggerating when I say I have no idea where to begin; do I just call a doctor that takes my insurance and set up an appointment? As for getting tested for diabetes, do I go to a primary care doctor first, so they can order tests for me, or do I find a lab and ask for tests? Help!,2014:site.269670 Wed, 08 Oct 2014 08:44:13 -0800 Tamanna Same Day Orthopedic Care in Philly Area? Help me find someone to figure out what's wrong with my knee in Phila, PA area. NOW. Background: I'm 45, active, father of 3. Last week, started feeling pain in the back of my knee, chalked it up to age/arthritis as it wasn't particularly worrisome or tied to any particular trauma. This week, pain has migrated and become more severe. Seems to be mostly in the medial part of the knee, accompanied with pops and a feeling of fullness or internal swelling. Yesterday afternoon and overnight the joint locked up twice, once as I turned over in my sleep (!), accompanied with severe pain. <br> <br> So - I can't walk very far without the pain coming on, and am afraid I may collapse. The options I know of are:<br> -Call my primary care doc. This doesn't appeal as she would just refer me and I really need to get this treated ASAP.<br> -Go to ER. God no. Please. <br> -Go to urgent care center. Hmm. Mainline Health has one nearby, they offer imaging services on site. Leaning this way. <br> -Go to orthopedic urgent care center- here is one in Malvern: <br> I know nothing of this organization, and online research has been equivocal.<br> <br> So, your advice, both general (e.g. go to urgent care) and specific (see Dr. XXXYY, she'll squeeze you in same day) is welcome! <br> <br> Thanks.,2014:site.269367 Thu, 02 Oct 2014 04:54:27 -0800 Mister_A recs for vets accessible by public transport? So I am about to adopt my first cat (specifically <a href="">this one</a>, yay Mefi!). I'm looking for a vet for regular wellness checks in my area (Emeryville, CA, near Ashby Bart) - the catch is that I'm reliant on public transport, and I don't have a ton of money. Suggestions? The one that would normally be the most convenient to me is the <a href="">Berkeley Human Society</a>, since it's on the same bus line as I am (72), but it's currently not taking in any new appointments. The <a href="">VCA is not too far and offers free pet first-exams</a> but they have really polarized reviews on Yelp. The <a href="">East Bay SPCA</a> is a little further out, but may be doable.<br> <br> The cat will be fixed and have a basic check before s/he comes to me, but I'm not sure what to do from here on out. Do I claim one of the free pet exams and do another check? How do I find a vet that works with my transport situation? I understand that medical care for animals doesn't come cheap; I'm more concerned about having to travel hours to get to a vet when necessary.<br> <br> (Also any tips for a first-time cat butler would be super helpful!!),2014:site.269241 Tue, 30 Sep 2014 00:09:16 -0800 divabat Never thought being over-insured would be a bad thing. Looking for any experiences, counsel, legal referrals to deal with health insurance clawback/SNAFU that's has my blood boiling. Rather than being under-insured, apparently our problem is being *over-insured*<br> <br> Recently received notice from health care providers that we "owe" a significant amount of money for healthcare delivered in 2012 and paid at the time by our insurance, which has since clawed back the payment. <br> <br> The situation as I understand it: <br> &gt; Both myself and my spouse have insurance through our employers and have paid for coverage for each other as well. We though this was "smart" to pay for "extra insurance"<br> &gt; My spouse incurred substantial medical expenses in 2012 and these were paid for my my insurance company A. Big healthcare costs were a new thing for us as was/is navigating healthcare insurance, but we'd thought we'd been very conservative in paying for two sets of policies<br> &gt; Company A just informed healthcare providers that since spouse was also covered by Company B back in 2012, they are retroactively denying claims, years later. <br> &gt; Company B says they have no obligation to pay since too much time has past to make a claim for 2012.<br> &gt; This appears to leave us on the hook for many thousands of dollars of healthcare that had been previously paid.<br> <br> I'm shocked, livid, and angry.<br> <br> Has anyone been in a similar situation or does anyone have any advice on how to best navigate with the obvious goal of not paying for services we believed we were doubly insured against?<br> <br> Does anyone have a referral for a lawyer in the Seattle area that could assist here?,2014:site.267155 Thu, 21 Aug 2014 09:48:36 -0800 donovan Advice on getting a Benefit Exception from our healthcare insurer? Husband needs open heart surgery. Our preferred surgeon is not on our healthcare plan. We're going to request a benefit exception. We are in Washington state. We are on an individual plan, not with an employer. I called the insurer and requested a case worker. Any suggestions on my approach? Feeling overwhelmed already. We are going to ask the cardiologist to write to the insurer and request a benefit exception to pay for our preferred surgeon, Dr Q. We want to use Dr Q for the surgery because 1. Cardiologist believes patient is at high risk for a catastrophic event. 2. Dr Q performed the patient's first open heart surgery, several years ago (paid by a different healthcare insurer). 3. His familiarity with the patient makes him the best choice for a successful surgery and avoidance of expensive complications. <br> <br> And we still have to find out if Dr Q's hospital is covered. He works two hospitals, but he will only do this procedure at Hospital A. And we need to get a plan-approved anesthesiologist. <br> <br> Yes, we will look into using a plan-approved surgeon, but I want to request the benefit exception and see what happens. <br> <br> My throw-away email is,2014:site.267083 Wed, 20 Aug 2014 05:02:20 -0800 Anonymous What is the NIH job application process and timeline like? I'm a nurse practitioner in the U.S. Public Health Service Commissioned Corps (4 years experience), and I'm applying for jobs at the National Institutes of Health. I've had one prompt and enthusiastic response, but I've heard nothing from the rest, so I have a few questions about NIH's hiring process and timeline. So far, I have applied for seven NIH jobs, starting at the end of May. I "best qualified" for the first job that I applied for and interviewed there in a pretty quick timeline (two weeks after the job closed I was notified that my application was referred, and then I received an interview offer one week after that). They seemed interested in moving forward with hiring me, but I didn't feel it was the right fit, so I took my name out of consideration and have been waiting to hear back about the other jobs.<br> <br> The closing dates for these other jobs range from June 3rd-June 24th. I can see in USAJOBS that I "best qualified" for three of the jobs. The other three say that my application was received but do not indicate if I qualified, or if my application was forwarded to the hiring official. So either I wasn't selected at all for those three jobs, or the HR departments are moving much more slowly in reviewing applications.<br> <br> My questions are: <br> 1. How long does the process take to be interviewed/hired for a job at NIH and how much does that vary by institute? <br> 2. Can I reasonably expect that I am still under consideration for these other jobs? At what point should I assume that I am not? <br> 3. Can the other institutes see that I didn't move ahead with the first job, and would that reflect negatively on me? <br> 4. Will the status in USAJOBS change if my application was received but not referred to the hiring official? <br> <br> If anyone has any prior experience with the USAJOBS/NIH process, hearing about that would be extremely helpful. Throwaway email at,2014:site.265681 Thu, 24 Jul 2014 15:14:37 -0800 Anonymous How do I find an acute care nurse practitioner to shadow? I'm applying to a graduate entry nurse practitioner program this summer (application due Oct 12). I know that this is what I want to do. I know the program I want, but I'd really like to see an ACNP in action. The trouble: I just moved to Columbus, OH and I don't really know anyone.,2014:site.265410 Sat, 19 Jul 2014 18:31:24 -0800 shesdeadimalive Stop me from committing health care fraud. (tongue-in-cheek) Yeah, I have no intention of committing health care fraud, but I am a bit uncertain on whether I should do this or not (request reimbursement from two insurance companies). More under the fold. So, to make a complicated situation short and easy to understand, I moved from the west coast to the east coast. I was under the respective west coast state's MedicAid program; now, I'm under the east coast state's MedicAid program. <br> <br> The west coast state's MedicAid program was a bit vague on whether or not they would reimburse out-of-state costs, but was clear they would reimburse for emergencies. My two medical cases were edge emergencies/urgent/serious, so I submitted the reimbursement forms and the needed proof. The west coast's MedicAid program responded via mail and asked for more proof/more details, such as medical justification, so I gathered the needed information.<br> <br> While I did that, I did a bit of research on the east coast's state and its' reimbursement policies. As time is running out for the deadline to apply a reimbursement form, along with the needed evidence, I also filled that form out. I've gathered everything I need for the two programs, for reimbursement, but took pause before mailing the two thick envelopes out.<br> <br> I'm afraid that if I submit reimbursement requests for both MedicAid programs at the same time, this will be considered fraud. The issue is that the east coast MedicAid program has a faster timeline, vs. the west coast state, but I'd like to make sure I have a backup due to the time constraints. Would it be a good idea to submit both simultaneously? What happens if both reimburses me (as in, I get two checks)?<br> <br> Thanks!,2014:site.265243 Wed, 16 Jul 2014 14:58:58 -0800 dubious_dude How best to track medical expenses and medical records? Can you give some advice on how to document/archive medical expenses and medical records? My wife and I are particularly meticulous filers, but I don't think we've found our best practices for the medical stuff. Details inside. We've got good systems for things like account statements and taxes, etc., but the medical stuff is throwing me a loop. We need both a system to track both records and open billing items.<br> <br> Generally, everything is scanned and filed on the computer. We don't keep paper long term, other than documentation we'd need originals for.<br> <br> We have your usual medical and dental plans, though our medical plan is a high deductible plan with an HSA (we also have an FSA). We are trying to leave the money in the HSA so that it can grow, so we need a system that allows us to keep track of our past medical expenses for reimbursement in future years (5, 10, 25 years later, whatever); the FSA, which just covers vision and dental, we draw from as soon as we spend the money.<br> <br> Meanwhile, the insurance company will send us EOBs that relate to claims for services that we need to keep track of (and often, double check). E.g., an EOB will arrive with an unfamiliar service provider, and we have to confirm it was the nurse who saw me for a clinic visit, or the EOB will say the provider can bill us $211.41, but we received a bill only for $123.21 (or no bill at all) and we want to stay on top of what we could be charged. We use a shared Googledoc for this now, but it's hard to keep current.<br> <br> As for medical records, rather than billing records, we have your typical lab results, prescriptions, etc.<br> <br> Do you have recommendations about how best to organize these materials? For instance, I can't tell if it makes more sense to file all of the billing records by year, or by which of us was the patient. For medical records, do I file by year or by complaint? Or broken down by complaint by year? <br> <br> Not having a great system in place has meant that these records are scattered in a few places, and the Googledoc is out of date, and I'd like to fix that.,2014:site.264082 Tue, 24 Jun 2014 08:18:04 -0800 Admiral Haddock Twitter feeds from academic departments/programs. I'm looking for examples of high-quality (official) Twitter feeds from academic departments/programs that are particularly informative (either to students or non-students, ideally both). I'm especially interested in departments or programs in healthcare/medical science-related fields, but all suggestions are welcome.,2014:site.264043 Mon, 23 Jun 2014 12:28:24 -0800 Ufez Jones Would you pay an extra $1K/yr to be able to choose your own doctors? How much is it worth to you to have (relative) freedom of choice? Enrolling in health insurance and I'm debating between an HMO and a PPO (both under Blue Shield of CA). The difference in cost is roughly $1,000. I'm a 26 year old female but I'm not exactly "healthy". I have mysterious, debilitating, chronic joint pain all over (undiagnosed as of yet), a couple car accident-related injuries that flare up every now and then, and I need to get a pap smear every 3 months due to a recent scare. So acupuncturists, chiropractors, internists, rheumatologists, and gynecologists must all be within easy reach for me. - <strong>How much would you pay to have the choice of seeing a doctor or specialist directly</strong> (granted s/he is within network) instead of being restricted to managed care partners? <br> <br> -<strong> Do you have experience with Blue Shield in Los Angeles?</strong> Have you found differences in quality of care between their HMOs vs PPOs?<br> <br> - Lastly, do you have Blue Shield HMO/PPO in Los Angeles and love your primary care physician, rheumatologist, internist, acupuncturist, chiropractor, gynecologist, etc.? Please do share! <br> <br> I'm currently on a HealthNet HMO and recently, the pain of going back to my Primary Care Provider (PCP) to get a referral for a specialist every time and hopping from laboratory to imaging center and back for diagnostics has been agonizing -- but it might've been agitated by a long commute and the fact that multiple issues compounded at once. <br> <br> I'm electing healthcare on my own for the first time as a young professional (just aged out of my parents' plan -- big ups to Obama for a good, extended run) and confronting the paradox of choice. I'd appreciate ANY advice. Thanks so much!,2014:site.263894 Thu, 19 Jun 2014 20:33:22 -0800 doctordrey