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Elextra

@ Elextra @literature.cafe

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Comments
179
Joined
2 yr. ago

  • United Healthcare denies claim of woman in coma

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  • I know in the 10 years ive worked in a hospital ive never had a patient denied care in ICU unless the reason listed above. I also know A LOT about insurance, much more than most healthcare professionals. I also connect my doctors to insurance when we do need to appeal decisions and ask for a peer to peer.

    Im not saying insurance never denies care. They do. Anecdotally though, never had incorrect denial with ICU. Its too easy to prove insurance definition of "medical necessity' there. I am still very doubtful of this specific example. Downvote all you want but the scanario I gave above is almost 100% probably what happened. I'm just explaining the process and likely what happened. Its okay if I'm not believed. I know what's true and how healthcare works. Its bittersweet that I have my job because I know how to navigate the healthcare system and get my patients what they need for their healthcare goals.

    Edit: Also, with the scanario above, almost 100% of ICU professionals would agree with insurance for the reasons listed above. We know how it feels to want to bring someone up from the ED but can't because we have beds already full... There are a very few select patients occasionally that want to live in the hospital. I'm aware we are encountering some people at their most vulnerable, traumatic times. It sucks. But they can't live there.

    The only other reason I can think for denial is if treatment is experimental. Otherwise, its really easy to appeal and get the care approved in ICU.

  • United Healthcare denies claim of woman in coma

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  • I agree with the insurance company too and most doctors would. I'm not sure who this doctor is but most people in healthcare industry that actually work ICU will agree. I also challenge commenters here to speak to your (hospital) healthcare friends about it too, especially if they work ICU.

    ICU beds are very limited and honestly not designed to house pts who are intubated or comatose indefinitely. They are designed to be short term with active treatment. Otherwise, if they need to live somewhere as a comatose pt, they need to go to a subacute facility, forever on a vent. That's the real reason why United Healthcare denied. "Not medically necessary" ('for hospitals' is what they left out).

    If hospitals kept every uninduced comatose pt, they wouldn't be able to treat anyone else (think stroke, cardiac, trauma, severe pulmonary, etc). Pts with TBI for example, 50% will never have consciousness returned and just have to live in this vegetative state. . Not only that but hospital staff isn't trained to provide long term care. They aren't educated or specialized in doing so. Some hospitals only have let's say 20 ICU beds. Larger ones maybe 40. But even without people living in them, they are near 100% capacity every day.

    Subacute facilities are also really difficult. They have trouble staying afloat because the care they provide is so expensive and most are reimbursed at a loss (Medi-Cal).

    Theres lots of things wrong with the healthcare system but like this poster said, its not a good example. There are honestly literally millions of other examples that are absolutely egregious.

  • Americans struggling with student debt expect ‘much worse’ under Trump

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  • Its... Income based... As much as I hate loans of all the loan options its the easiest for many people because you only have to pay such a small fraction of your income to repay it 5-10% most common... And if you're compliant, they forgive it anyways after 20 years.

    I didn't take that option but many of my friends did. Also, anyone taking out loans whether it be house, car, etc I believe should know what terms are and select what works best for their life.

  • What's the best psychology trick you know?

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  • Another fun trick I learned in sales is that if you're trying to get someone to purchase something, instead of having them focus on whether or not they should get something, change their question to something else.

    For example, I used to sell phones. Instead of having people try to figure out if they want the newest Samsung or not, I would take the phone in two different colors and ask if they liked it in blue or black instead. Putting it in their hands let's them imagine having the phone already and the question changes from should I purchase this phone to what color do I want?

    I'm quite sure this can translate to other questions and decisions people ask themselves

  • What's the best psychology trick you know?

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  • So similar thing I learned in sales. I avoid using the word "help" because if you ask something like "is there anything I can help you with"? The word "help" subconsciously makes them feel like you are implying they are weak, vulnerable, and need assistance. Where as if you ask them "is there anything I can do for you"? The word "do" has a more positive connotation and implies that you are offering a service or a gift, which more people are likely to agree to.

  • What's the worst present you've ever received?

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  • Maybe but none of us saw it, even my friend who eventually became her friend later on and into adulthood.... I met her mom at least twice and she was always nice and seemed very attentive, concerned about her daughter.

    We also grew up very affluent. They were too.

  • What's the worst present you've ever received?

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  • In middle school, there was this one super unpopular girl that gifted me acne medication for Christmas.... Unprompted. We weren't even friends and yes, I had acne problems like most teens did.

    I never bullied anyone in my life before and since, but I did that year.... This was why she was so unpopular. The year after, she called 1 of the 2 only black kids the N word, got her ass kicked and either removed or expelled from school.

    I have no idea why anyone would go around picking fights, especially with no friends to begin with. Before anyone asks, no, no mental health issues.

    Edit: I also wasnt "popular" and had very little friends too. I mean, it wasnt right either way to turn bully either but I was young

  • Trump taps MAGA loyalists who lost their own races for plum administration jobs

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  • Team of Losers.

  • My dog fell asleep too (well, like a year ago)

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  • I love heelers!!! So cute!!

  • Leaked video shows UnitedHealth CEO saying insurer will continue practices that combat 'unnecessary' care

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  • UHC is better than some other providers... Just keep that in mind. Blue Cross, Blue Shield for example notorious and even worse.

  • Raygun: the musical cancelled after viral Olympian's legal threat

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  • Per this article, there were no favors.

    But odd she won some prestigious competitions yet doesn't even seem qualified

  • A Hospital Helped a Beloved Doctor’s Practice Flourish Even as It Suspected He Was Hurting Patients

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  • Wow the story is insane. He literally ran his own cult in a hospital.

  • Anthem Blue Cross Blue Shield Won’t Pay for the Complete Duration of Anesthesia for Patients’ Surgical Procedures

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  • Which keyboard app do you use on your phones? Do you enable clipboard history in it?

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  • Removed

    What is most concerning to you about the next four years?

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  • This. I fear more for others than I do myself

  • About 20% of Americans regularly get their news from influencers on social media, report says

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  • I listen to Philip DeFranco occasionally on my way home. He does wonderful recaps first focusing on media news, then us politics, and foreign/world news. He also posts sources

  • Is it worth getting into video games?

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  • Agree with this. Stardew Valley and many games can be found on mobile and quite popular with the gaming community. I am not sure as a beginner player I would start off with Stardew Valley as there are a lot of mechanics? Would recommend more of the below as there are not as many things to figure out:

    High recommendations for Vampire Survivors. There is a demo with that link as well as direct app access.

    Additionally, Animal Crossing Pocket Camp for $20 come December is great intro. Super relaxing game.

    100% recommend Slay the Spire as well.

    For games without a mobile option, I feel like Portal 1 and Portal 2 are must plays for anyone. And are not too graphically intense for any computer. Its a puzzle game. You run and jump into portals to figure out the puzzles. I wish I could play them again for the first time. All the above are amazing games. Wishing you the best on your journey!

    P.S. if you have a friend to game with, It Takes Two is a pleasant experience.

  • Bluesky Might End Up Defeating Twitter Once and for All

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  • Major outlets did do some previously. Unfortunately, look at the active user count of Mastodon vs other social media outlets.

    These companies want to reach the most people as possible. Theres also an AskLemmy about barriers to adoption of the general public unfortunately that was answered quite well :/

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    The Enshitification of CVS

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  • Hmm you have a good point for me specifically....

    For some people, their insurance can also lock them into which pharmacy is contracted. But I don't have this issue.

    I have those two because its the most convenient for me locally. Local pharmacies matter because if a non maintenance Rx is needed, you need to have it sent there. An Rx delivery service like Optum or Express Scripts won't work well for non maintenance Rx (takes days for delivery). BTW, I find Walgreens the same as CVS in business practices, salaries/care to pharmacists, etc (source: pharm friends).

    There are pharmacies in like grocery stores and the like a bit further away from me but their selection is limited and if you need a medication it may take time for it to arrive at their location.

    The true local pharmacies are very few...and I live in the bay area. There are 4 that I know of. Imagine living outside of CA/San Fran area.

    So... Yes, I can change to one of those "true" local pharmacies but they are significantly out of the way. I don't want to utilize a target or Safeway pharmacy for reasons listed above. Something for me to think about though because I typically support businesses with my money.