So far, I haven’t been able to move my little herd of blogs off my friend Jesse’s server over to WordPress.com or, as another friend suggested, to WestHost.
When I started FaM as a little hobby on the now defunct iLife, I was pretty techie for my times. But now I’ve fallen way behind the curve and worse, have exactly ZERO desire to learn still more piles and piles and piles of arcana, most of which will be out of date within a couple of years. I am just flat learning-curved out!
So, unless I can hire someone to help with this project or find a live person at WP.com (good luck with that!), I don’t know when or if Funny will find its new home. Or when or if Plain & Simple Press, Fire-rider, 30 Pounds in 4 months, or any of those will ever get transferred.
Meanwhile, I’m BUSY, dammit, and don’t have time to fiddle with that stuff. Have to break off what I’m doing here and run down to a grocery store to extract some money for Luz, who’s probably on her way over here as we scribble.
Then check in with the stoonts…OMG! Only ONE MORE SET OF PAPERS and I’ll be free of teaching freshman comp for the REST OF MY LIFE!
I’m almost done with the second salacious book. Ooo la la! What a hoot! This stuff could get addictive — it’s pretty fun to write. Let’s hope it’s as much fun to read. 😉
And I still have to write the Boob Book proposal, notes for which have been sitting on the desk since before I went into the hospital.
And some laboratory sent a threatening letter saying I owe $952 for some test, the nature of which is not mentioned. They say “your insurer” rejected the claim. They don’t say what the test was for or why it was rejected.
In the same raft of mail, along comes a notice from Medicare informing me that they rejected whatever this was because it was for genetic testing for a DNA defect.
To my knowledge, I never had any such test. Had I been asked, I would have said “no.” If any such test was given, I never was told the results.
They want NINE HUNDRED AND FIFTY-TWO DOLLARS for this phantom test.
When you call the 800 number for the lab, you get a sales pitch. I’m sitting interminably on the yakkity hold button for the Mayo’s accounting department. I haven’t tried to contact Medicare yet, because I know what a horror show that’s going to be and I at least need to know what on earth I’m talking about. If I can find out at all.
Medicare says the appeal was rejected because it was filed after the deadline.
So now I get to diddle away an hour or more screwing with this. I think I’ll cut it short by sending a letter to both of them — Medicare and this lab outfit — stating t hat I never had any such test, that I was never told of any need for an appeal or of the appeal itself, and that I believe the whole thing is fraudulent. That at least will delay my having to pay for it, for awhile.
God, God, GOD how I hate dealing with bureaucracies!!!!!!!!!
Good Luck with the medical billing and getting to the bottom of it…It must be the season…I’m STILL battling a lab, my Doc and my Insurer over “routine lab work” performed during my “wellness visit” which is to be covered 100% (I read the book). The lab says I owe $8 and some change…but can’t tell me with certainty what tests weren’t covered and why I wasn’t told additional testing was needed and for what reason. Crazy….In addition, DW had some bumps on her that resembled chicken pocks…Went to her GP Doc 3 times in 10 days who finally sent her to a dermatologist who diagnosed it at first glance as eczema and prescribed a $4 topical cream which worked great….dermatologist bill…$59. Later get a bill from the GP Doc just shy of $500…for no effective care…Sooo I challenge the bill with the Doc’s office….no response…..Aaaand just last week the accounting department of the hospital that OWNS the GP Practice calls and wants to know why I haven’t paid the DW’s bill. I explain everything and this was “all news” to the hospital who is now doing some research. BUT the CSR did find it a bit “excessive” for a case of eczema…Good Luck in your battle….
Well. I finally DID get through to a human being at the Mayo. And he agreed with me: they NEVER DID ANY SUCH TEST ON ME.
I said (furious), “It sounds like a fraudulent charge.”
He said (sounding cool and level-headed), “That’s exactly how it sounds.”
“Holy mackerel!” I said. “Well, what should I do about it?”
He suggested I write, by snail-mail, to Medicare and explain that no such test was done, sending them the demand from the lab, and then send the same package to the lab. And send the Mayo a copy, too, for their records.
Holy she-ut.
I’d like to give this lab the benefit of the doubt and say someone’s finger missed a key and entered an incorrect code. BUT… They entered the claim TWICE, under two separate code numbers! Evidently, they’re deliberately trying to charge Medicare $952 for a test that never took place.
I think it’s pretty routine to run genetic testing in suspected breast cancer cases; on the pathology specimens if nothing else. Maybe that was the root of this? Did they ever give you CPT or LOINC codes for the tests supposedly performed? I could look those up for you (since I write medical software …)
That said, there are so many places for mistakes or outright fraud to occur in the whole billing/reimbursement process; extremely frustrating!
Could be. I think they would have told me. True, the Mayo assumes that anyone who walks in the door is rich as Croesus (they have valets to park your Jaguar for you). But I can’t imagine Dr. P wouldn’t at least have mentioned that the test showed nothing awry. Remember, there never was ANY sign of invasive cancer. It was all DCIS, which no longer is regarded (in enlightened circles) as cancer. Throughout the whole adventure, Dr. P was very concerned to reassure me that I did not have an invasive cancer and to keep me in the loop for all decisions. She did so repeatedly, at every step along the way. If she’d had a result of a genetic test, she would have told me what it was.
Also, had I been asked, I would have declined, first because I happen to know insurance and Medicare won’t cover it and that it’s ridiculously expensive, and second because I believe that if I had a genetic mutation predisposing me to reproductive cancers, it would have manifested itself long before the age of 70.
The codes are 88271 (Dna testing for genetic defects) and 88274 (genetic testing).
In addition, Medicare is refusing to cover it because the lab, which never mentioned anything about it to me before this, did not submit its appeal until after the deadline — and so I think even if the test was ordered (the Mayo says it was not), the cost redounds to the lab because it dropped the ball in appealing and it didn’t tell me about this in time for me to deal with it.
Those codes are commonly used by pathologists doing in situ hybridization – my guess would be that this was a test done, or supposedly done, by the pathology department, which often has a different billing system than the rest of a hospital. I seem to remember you have your pathology reports – do you remember if they mention anything about HER2? (Yes, I know you’re not on the hook for this, but sometimes satisfying to get to the bottom of a mystery)
From http://www.breastcancer.org/symptoms/testing/types/fish:
“Fluorescence in situ hybridization (FISH) is a test that “maps” the genetic material in a person’s cells. This test can be used to visualize specific genes or portions of genes. FISH testing is done on breast cancer tissue removed during biopsy to see if the cells have extra copies of the HER2 gene. The more copies of the HER2 gene that are present, the more HER2 receptors the cells have. These HER2 receptors receive signals that stimulate the growth of breast cancer cells.
The FISH test results will tell you that the cancer is either “positive” or “negative” (a result sometimes reported as “zero”) for HER2.”
Pathology can do other kinds of genetic tests on the specimens as well, but this is the only one I’m familiar with.
BTW, that site I just referenced again shows how complex and confusing this whole area of breast cancer diagnosis and treatment is. There was an NPR story mentioning mammograms and DCIS and [the whole mess you went through] just this week. Uggggh.
Hm. We already knew it was HER2-positive from the St. Joe’s biopsy, which was done months before.
I’m sure the various path reports are in there, but…you simply can’t IMAGINE what a mountain of paper is stashed in that file drawer. It flowed in through the mailbox like a tsunami. I’d have to paw through page after page after page after file folder after file folder to find it.
And frankly, I’ve got to get on with my life now. I can’t keep on wasting my time with this shit. It’s consuming my life! If bringing an end to it means I have to pony up $952 that I think I don’t owe, then dammit, that’s what I’ll have to do.