Monday, February 2, 2009

Damn Deductibles and running in circles

With January behind us, I completed the month end close for my Patient and Insurance accounts at work this morning. Before doing so, I had to enter any remaining insurance payments on accounts for the month. January is hell month in the Medical billing world thanks to just one little word......Deductible.

I would say that 80% of my patients had a deductible to satisfy for this months claims. So, I haven't had many payments from Insurance companies this month! Now I have to pursue collecting from patients that simply may not have the money this year to pay out of pocket for deductibles. I honestly feel for these people. DME supplies are not cheap. Most of my patient accounts have reoccurring supplies they need, much like we all know is the case with our Insulin pumps. Most of these patients are elderly. It saddens me every year when January rolls around because I know many of my patients are financially burdened by having to meet their deductibles each new year. I imagine even more so this year. So what does this mean for my next few months at work? It means that I am the bad guy. I am the one sending them their bill for medical expenses. I cringe knowing I will recieve phone call after phone call from angry Patients that don't understand their benefits. I will be cursed at, hung up on, called names, treated like I don't know what I am doing. Treated like their insurance is all my fault. I hate being the bad guy. What I really hate is deductibles. And insurance companies!

Receiving insurance payments today was scary. For 2009 reimbursement has decreased on most of our CPAP supplies. Of course, we all know that premiums have increased ALOT in most cases. Very interesting. Confusing. Sickening. Scary. I just don't know what to think about health care in this nation anymore. I hope Obama really does have the solution, and quickly.

The basal adjustment I made for Maddison TWO weeks ago hasn't improved for certain. One night is fine. One night is low. Then the next is reflective of totally crazy craziness that is just out of the blue CRAZY! Then her numbers are fine for three days. Two weeks later and I'm just not sure. I'm tired. I'm tired of trying to find where she drops those 60 points. As always, it goes something like this......One night was a weird dinner. One day she was high all day. On a Saturday she was low all day. Alot of exercise two nights and not the next. Weekends that are crazy. Sleeping in, staying up late. Hiking, trampolines, walking the dogs for miles. I'm running in circles trying to decide if I should leave the basal adjustment or change it again. I guess this is just called life. My crazy life anyway. Always running in circles :)

My morning workout routine is going GREAT! No more highs after starting my run! ((knocking on wood!))I can jump on my treadmill right out of bed at around 110 and hoover within 20 points the entire hour. Thank you Double Shot Espresso Light! (just 6c!!) I bolus just a tiny .1 (2c for me) so I guess a little insulin goes a long way! Not too high, not too low. Lets just hope it stays that way. I still haven't had to adjust any of my basal rates which is really weird. I do however knock off about 15c from my morning protein shake to avoid a drop and it seems to work pretty well. I hoover around in the 70's mid-morning so a handful of almonds and some cheese seems to do the trick for holding me over until lunch. Sometimes I will have to eat some raisins or tea with sugar to avoid a low, but amazingly no craziness. No lows with an hour workout every day? Isn't that unheard of? Oh well, I feel stronger and healthier already. I am still totally tired all day which is weird, it must be the extra running in circles with Maddison's numbers all night! Something tells me that will never change.....

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