skygypsie 2 #1 April 17, 2011 State employees aren't the only to bitch about entitlements! Evidently, after 25 years of federal non-civilian service with retirement benefits & years of paying Union dues, retirement costs & health/ dental deductions, throughout...the insurance policies are about as worthless as the paper they're printed on ! After a recent race to the car with our dog; & tangling me in her cable in doing so, to claim shotgun...she won I broke my jaw, when I landed on my chin... jamming my lower jaw on both sides, into the sockets. ER referred me to an Oral Surgeon, who states I need a jaw realignment procedure costing $ 3400, ASAP ! However, they demand payment up front prior to surgery, because Federal insurance reimbursement is either typically denied, then appealed, taking as long as a year to pay They did offer to file the claim & reimburse me, if/ when they get it Makes a person wonder...what's the point in working, filing & paying out the azz for over 1/2 their lifetime This poor working skydiver will just have to 'not grin & bear it'... no $3400 extra, laying around here I never knew sneezing, laughing or coughing through the nostrils would be so difficult Quote Share this post Link to post Share on other sites
Amazon 7 #2 April 17, 2011 Amazing what happens when you actually try use those health benefits... you thought you had and have paid for isn't it. Quote Share this post Link to post Share on other sites
dreamdancer 0 #3 April 17, 2011 would have had no problem using the national health service if that had happened over here in the uk...stay away from moving propellers - they bite blue skies from thai sky adventures good solid response-provoking keyboarding Quote Share this post Link to post Share on other sites
lawrocket 3 #4 April 17, 2011 Sure. As long as he waited for three or four months... My wife is hotter than your wife. Quote Share this post Link to post Share on other sites
Amazon 7 #5 April 17, 2011 QuoteSure. As long as he waited for three or four months... Yet a whole bunch of those "socialist" countires manage to keep their citizens alive longer than ours does with "the BEST" medical care in the world.. I think your hatred of those systems is allowing you and others to build a wonderful mythology to feed your own fears that perhaps we are ane not doing the best for ourselves than we could. Quote Share this post Link to post Share on other sites
dreamdancer 0 #6 April 17, 2011 he would have got treated straight away - and it wouldn't have cost him a penny...stay away from moving propellers - they bite blue skies from thai sky adventures good solid response-provoking keyboarding Quote Share this post Link to post Share on other sites
kallend 1,649 #7 April 17, 2011 QuoteSure. As long as he waited for three or four months... Ignorance does not become you, counselor.... The only sure way to survive a canopy collision is not to have one. Quote Share this post Link to post Share on other sites
rhaig 0 #8 April 17, 2011 QuoteQuoteSure. As long as he waited for three or four months... Ignorance does not become you, counselor. careful.... that "I" word is specifically forbidden. People have been banned for that.-- Rob Quote Share this post Link to post Share on other sites
kallend 1,649 #9 April 17, 2011 QuoteQuoteQuoteSure. As long as he waited for three or four months... Ignorance does not become you, counselor. careful.... that "I" word is specifically forbidden. People have been banned for that. Unlike stupidity, ignorance IS 100% curable. Fact is, there is no 3 - 4 month wait for emergency care in any western European country. That is RW propaganda that the RW espouses knowing full well that most of their base won't bother to check.... The only sure way to survive a canopy collision is not to have one. Quote Share this post Link to post Share on other sites
jgoose71 0 #10 April 17, 2011 And this here is why we shouldn't have a government run single payer program. The Medicare/ Medicaid programs and who knows who else have obviously burned there bridge with this doctor. I'm sorry to here it. Your only other choice, unless you can find $3500 laying around, is to take your referral to another oral surgeon. Since oral surgeons are specialists, the government won't pay without the proper paperwork trail, IE, a referral from the ER or your primary care provider. Yes, I have had the same run around a couple of times..... Good luck. I hope you can eat a steak again soon with out having to puree it first..... "There is an art, it says, or, rather, a knack to flying. The knack lies in learning how to throw yourself at the ground and miss." Life, the Universe, and Everything Quote Share this post Link to post Share on other sites
skygypsie 2 #11 April 18, 2011 Thanks me too I tried the re-referral route by the ER & also involved my primary care doc ! Since they are of the same medical facility ( system), their response: "... unfortunately we've referred you to who we normally refer these types of cases to..." I'll make some other attempts tomorrow ! Forced to be somewhat silent & in pain...is not my most flattering character trait...trust me ! I can be fairly overwhelming, driven & pursuasive Otherwise it looks like I'll be healing eau de naturale' It's been a bittersweet time for the hubby ! Though he's getting a slight reprieve from my ramblings... he says he'd rather put up w/ my jibber jabber, rather than... my lock jaw Just wondering what the Feds will pull when it comes time to pay out my FEGLI life insurance, when the time comes........... Quote Share this post Link to post Share on other sites
muff528 3 #12 April 18, 2011 Quote State employees aren't the only to bitch about entitlements! Evidently, after 25 years of federal non-civilian service with retirement benefits & years of paying Union dues, retirement costs & health/ dental deductions, throughout...the insurance policies are about as worthless as the paper they're printed on ! After a recent race to the car with our dog; & tangling me in her cable in doing so, to claim shotgun...she won I broke my jaw, when I landed on my chin... jamming my lower jaw on both sides, into the sockets. ER referred me to an Oral Surgeon, who states I need a jaw realignment procedure costing $ 3400, ASAP ! However, they demand payment up front prior to surgery, because Federal insurance reimbursement is either typically denied, then appealed, taking as long as a year to pay They did offer to file the claim & reimburse me, if/ when they get it Makes a person wonder...what's the point in working, filing & paying out the azz for over 1/2 their lifetime This poor working skydiver will just have to 'not grin & bear it'... no $3400 extra, laying around here I never knew sneezing, laughing or coughing through the nostrils would be so difficult I wonder why Federal insurance reimbursment is "typically denied"? Is your insurance not provided through a private insurance company or is it "something else"? Quote Share this post Link to post Share on other sites
skygypsie 2 #13 April 18, 2011 I have a major insurance carrier through the Federal gov't. I've had no other problems with provider billing or payments, since my retirement. I've been treated by major health providers in WI; as well as, at Mayo Clinic over the past few years with very reasonable co-pays. I've called the insurance carrier per The Office of Personnel Management & they indicate there should be no problem, as long as correct coding & no attempts at erroneous billing are provided in the claim ! I signed the claims waiver with the Oral Surgeon, so only they can file the claim... & only they will be paid ! The provider's office assures me, they will reimburse me... once/ if, they receive payment by the insurance company. They explain because they are dental surgeons & specialists; which is typically covered by dental coverage, my situation is of a medical nature with jaw structure repair needed. Evidently, it is a loop hole that has been road blocked in the past, based on the speciality provider medical -v- dental My dental insurance does not cover this, as my teeth are fine! The procedure consists of realigning my jaw with devices implanted under my teeth...top & bottom ! Quote Share this post Link to post Share on other sites
BIGUN 1,075 #14 April 18, 2011 Second and third opinion on both the jaw and the insurance?Nobody has time to listen; because they're desperately chasing the need of being heard. Quote Share this post Link to post Share on other sites
jimbrown 0 #15 April 18, 2011 QuoteThe procedure consists of realigning my jaw with devices implanted under my teeth...top & bottom ! Really? And you believe this procedure is neccesary? Suck it up and walk it off ,Dude!! Don't be an expensive puss! Peace, Jim B. Quote Share this post Link to post Share on other sites
skygypsie 2 #16 April 18, 2011 Perhaps so...fractured jaw in 3 places ! I viewed the xrays, as they were shown on a screen as I watched...the fractures were pointed out & left side of the jaw, jumped the socket ! In other words, it's not in the socket ! Been 'sucking' with it for over a week, so what's another 4-5 I chose to deal w/ it, rather than go into debt... if the insurance I've paid premiums for; by payroll deductions & out of pocket for over 25 years, doesn't pony up ! Btw: it's dudette...& puss in the feminine form But thanks for the advice Peace to you, as well Quote Share this post Link to post Share on other sites
DaVinci 0 #17 April 18, 2011 Quotehe would have got treated straight away - and it wouldn't have cost him a penny... You saying he doesn't have to pay taxes???? Just because you don't pay for the service directly, does not mean you do not pay for it at all. Quote Share this post Link to post Share on other sites
DaVinci 0 #18 April 18, 2011 QuoteAmazing what happens when you actually try use those health benefits... you thought you had and have paid for isn't it. You did notice: 1. Federal non-civilian service? 2. She is a UNION employee? Her union didn't really help her out. Quote Share this post Link to post Share on other sites
ryoder 1,400 #19 April 18, 2011 Generally, the longer you let a medical problem go w/o treatment, the worse it gets. I would put it on a credit card, get it fixed, and worry about paying later. Right now, I am recovering a ligament restoration surgery that would have been a lot less serious, had I sought treatment immediately after the injury."There are only three things of value: younger women, faster airplanes, and bigger crocodiles" - Arthur Jones. Quote Share this post Link to post Share on other sites
dreamdancer 0 #20 April 18, 2011 i'm saying she would have been immediately treated without being asked whether she was insured or not - sounds good doesn't it? you should try it.stay away from moving propellers - they bite blue skies from thai sky adventures good solid response-provoking keyboarding Quote Share this post Link to post Share on other sites
DaVinci 0 #21 April 18, 2011 Quotei'm saying she would have been immediately treated without being asked whether she was insured or not That is not what you said: "he would have got treated straight away - and it wouldn't have cost him a penny..." Quote Share this post Link to post Share on other sites
lawrocket 3 #22 April 18, 2011 You're right. It was a smart ass comment. And for dreamdancer - what makes you think it wouldn't have cost him a penny? He would pay for it, wouldn't he? My wife is hotter than your wife. Quote Share this post Link to post Share on other sites
freethefly 6 #23 April 18, 2011 QuoteQuotei'm saying she would have been immediately treated without being asked whether she was insured or not That is not what you said: "he would have got treated straight away - and it wouldn't have cost him a penny..." Seems to me what DD is saying is that SG would had been treated without a doctor saying pay me now. Being that their tax dollars is their insurance payments, they are good to go."...And once you're gone, you can't come back When you're out of the blue and into the black." Neil Young Quote Share this post Link to post Share on other sites
DaVinci 0 #24 April 18, 2011 QuoteSeems to me what DD is saying is that SG would had been treated without a doctor saying pay me now. That is not what he said... "he would have got treated straight away - and it wouldn't have cost him a penny..." Then he tried to say I should try it.... I did, Military and it sucked. Quote Share this post Link to post Share on other sites
DaVinci 0 #25 April 18, 2011 Quotesounds good doesn't it? you should try it. I have had US govt HC (Army).... It sucked, you should try it. Quote Share this post Link to post Share on other sites
