Thanks MissB. I've been away from this thread for a while although it was my baby and labor of love at first when I started it.
But now I have another thing to add. the newest insurance scam:
Hospitals "admit" the patient but in the medical records, they are admitted "for observation" rather than "inpatient". There is no apparent difference to the patient, they are in a hospital room and a hospital bed, getting hospital meals and IVs. But when the insurance bill comes there is a major difference: instead of a fixed payment of $250 per day co-pay, the out of pocket is now 15% - the full outpatient rate. I had never heard of this until this week when I rushed my wife to the hospital emergency room on Tuesday before Noon for abdominal pain. She ended up having her appendix taken out at Midnight. [she's home now and doing fine- I'm the caregiver now}
I noticed the "observation" entry in her medical record and raised holy hell. Two days later, 7 increasingly legalistic emails, 4 Vice Presidents and One CEO confrontations later: the hospital decided to bill her as inpatient.
It's these damn Milliman guidelines that all the hospitals and insurance companies and now even CMS (Medicare) use.
So don't you just hate it when they find one more way to charge you more for health TX?
Charm