Can we have a forum for "older" people with bc?
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Hi Di2012 I'm on medicare for a couple of years now and my 2nd is Cigna from work, I've had some problems (not big) along the way but I figured out it's how the Drs. worded something that usually caused a problem--I sould say how the people in the office fill out the forms so my DD! would call after and make sure the form was filled out accordingly to be covered And I know this is terrible but when I'd get a bill less than 30. I didn't pay it cuz I saw how much they charged and how much they got paid--well I'd pay the Dr.cuz I had to see them.
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Di2012- just a word or two on Medicare which happens to be my only insurance these days and the bills are starting to roll in. This is my 2nd go around. Radiation this time around. So far my Medicare HMO covering pretty well except I have to travel so far for treatment. My work insurance only covered saline implant back in 2006 no silicone and I had to get it done w/in a certain timespan. I am now quite a bit larger than when it was first done so am quite lopsided. Least of my issues right now though but this is not how I had planned my retirement years. Back then I got a wig which my insurance denied coverage ( it was not even real hair) Don't get me going on that subject. At least I still got my hair this time around- cross fingers.
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The greatest gift we give ourselves or anyone else is the quality of our attention. ~ Richard Moss
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Hot, muggy and sort of not so nice a day.....can't do much out of doors or you are wringing wet in no time. This time of year it is nothing for me to be in the shower from 3 to 6 times......depends on how often I have to go out and for how long and how much expended effort. I'm not bothering today outside much so will likely be a three shower day.
Hope you all have a fabulous Tuesday.....thinking about each and every one here.
Peace and love
Jackie
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Hi all, Just catching up. Have been busy trying to get things back together since our last trip to Pensacola and the camping trip before that. Helping DH at the broom shop as much as he needs me.
Going to try and get the yard back in shape as soon as it cools down some. We will probably go from heat to snow. HA HA
Have been doing pretty good, still have some days that I feel like someone ran over me with a truck. Sleeping pretty good.
Carole, take care in that heat. Iowa is having a bad heat wave, they are closing schools early every day.
Hugs
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Thanks ladies for responding RE: Medicare.....It seems my life since cancer had been my daily "journey" online to Medicare and hope that something pending has been paid, leaving 20% for my secondary insurance to pick up their portion (through my retired husband's union) and the problem being if medicare does not pay, either does the secondary.
4 surgeries in 6.5 months....trying to climb out of my TIRED state of mind
Di
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Di No wonder, u'r body and mind must be exhausted and then to worry about all this stuff--but I have noticed sometime it takes a long time for them to get to all these bills--u have insurance don't worry so much--just try to heal u'rself.
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Di- We have not had any issues with Medicare (knock on wood). Instead of checking online so much, you could just wait to see if you get a bill from the provider. So many times providers will resubmit under a new code and what was initially denied gets approved. Once we get a bill, I call and ask the provider about it. Often they tell me, it was resubmitted or that Medicare paid after the bill was sent out and that the balance is in fact zero. Try to forget about it, and just deal with it if you get a bill. You have 90 days after a denial to appeal so you have time.
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Hi Ladies,
Glad to see that everyone seems to be doing OK these days. Lots of travellers out there! The aide for the weekend was actually really good. She made mom some new kinds of food. Her appetite continues to increase! They had some initial trouble walking together (to the point of it not bein safe) but eventually the aide stopped hiking up mom's pants and it worked out. My boyfriend and I had an exhausting weekend of tennis-- 6 hrs. on Saturday after not playing for 14 months. We got roped into a pro-am "tournament." The tops of my legs were so sore I could hardly squat down to dress mom when I got back.
I haven't even unpacked yet but am already preparing for the next thing. I am getting ready for a BBQ Saturday for my birthday. Mom normally did all the beforehand cooking for it, so now its up to me.
Tuesday I am leaving again to go to the US Open in NYC, then I will go to CT for a few days. The same aide will take care of mom. She just took a job with an agency. We aren't ready to offer someone a full time position but I hate to lose her. My brother and I wanted to talk to a lawyer and accountant again. There is no money tree in the backyard!
Plus I just don't know the schedule I would want. I don't prefer living with an aide. I like my private time with Mom but I am aware now that taking care of her does literally absorb the entire day and sometimes I don't get to enjoy as much time because I am doing laundry, making food, etc. It makes it so complicated that my boyfriend and our stuff is 4 hrs. away in CT and that he travels every other week. I thought maybe having aide for 10 days on, 5 days off or something might work. But, not unpacking my suitcase yet and thinking of repacking it again after the weekend, are making me remember my days of work travel and the feeling of not quite ever being settled. Oh, how I wish I had participated in house hunting here when my boyfriend was willing to move. I just couldn't focus on it then. Sure, would make things a little easier now.
Sharon
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In daily life we must see that it is not happiness that makes us grateful, but gratefulness that makes us happy.
~David Steindl-Rast
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Di....i think Cammie gave you excellent advice. I do recall when I took care of my Mom that you get BILLS all the time it seems, but do need to WAIT until all resubmissions have been done and see what may be left then. I think if anything were paid it might be likely forgotten for a bit ---- in other words, if you pay quickly........there may be payments yet pending.......and Medicare would be waiting till THE END to assess if they needed to refund you.
If there is any question at all......you are likely far better off to wait and call and clarify where things are. Some "billings" are automatic and any payments coming in even one day after are not going to be reflected. It will all work out and hopefully in the end will be to your good as well as for your good.
Sharon.....though you have some decisions to make it indeed sounds like things are moving in a more positive direction. I am soooo glad your Mom seems to be showing more improvement than not. Don't mind saying a time or two I was on the edge of my seat.
As for keeping ( if you could ) this aide full time, that would be fantastic ( sometimes good matches are few and far between ) but your Mom will get stronger now and hopefully will not require perhaps as much "help" in some ways as she does now. Just meaning that you might find someone almost as good. I think in part......it is not a good person to care for your Mom but one you can work with fruitfully as well.
You may be able to find someone who only really requires a 3 day a week job, but who would be happy to fill in from time to time a bit more perhaps. I don't require weekly work anymore.....in fact, it would be too much for me though I can do it for short periods. If you can find someone who can work with you and be flexible with her and your time schedules....that would be excellent. I'm hoping it works out with you since some of the other "heavy-duty" stresses seem to be lifting.
Mommarch.....nice to get back to routine, huh!!!! Though you could do a bit more catching up ( do we ever really ) on sleep, it does sound like you are having some better results and getting a handle on things again. That old' new normal can be elusive sometimes but I do feel like there is nothing like GOOD sleep to help get us going in the right direction. In the class I just took they were talking about how difficult to control your body's' responses to food ( meaning usually over-eating of wrong fattening foods ) when you don't get the good refreshing sleep that is necessary to a well functioning body and person. All the great things that we have heard ( sometimes to the point of wanting to just yell-- stop already ) about drinking plenty of water and sleeping a certain number of hours.....is pretty much right on. I actually didn't know that your desire to eat foods not too good for you had anything at all to do with how much sleep you get per night.
Another adage comes to mind. Your never too old to learn...well, something. So glad it is all going better for you.
I'm off now to feed the feral cats and Chevy....if your reading here....get ready for an email coming your way.
Hope you all have a gorgeous day and stay out of the heat....if your having it like we are today.....
Peace and love
Jackie
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Reg, enjoy the US Open! DH and I are watching the matches on tv. Glad you don't seem to be dealing with constant stress like you were.
DH and I drove to Moorehead/Fargo yesterday and had a really nice day with our friends from Eden, SD, who met us there. It was about a 2 hr. drive for them and for us. We had lunch at a nice restaurant on the Red River which separates the two cities. It's kind of weird. You cross a bridge and you're in Fargo. Drive back across the bridge and you're in Moorehead. The bridges aren't very long because the Red River this time of year is just a muddy small river that we might call a creek in LA.
After lunch we visited the Hjemkomst Center. Try pronouncing that! It's a Norwegian word meaning Homecoming. The center houses a replica of a Viking ship that a MN man built in the 1980's. His dream was to sail the boat to Norway after it was finished. He died of leukemia before he could make the trip himself but four of his kids and some additional crew acted out his dream.
The center also had a full-scale replica of a stave church which is really a wonderful building. It's located outside on the property of the center. These stave churches were built by the Vikings after they settled down in Norway and had been converted to Christianity.
Another interesting exhibit was about the Saint John's Bible, of which I was unaware. It's a modern day hand-made production written in calligraphy with beautiful illuminated illustrations. The pages are very large.
Today DH and I went to town where I dropped him off at a barbershop and went to my favorite of the two farmers' markets, where I bought home-made bread and cookies and some really nice fresh veggies. Then DH and I had breakfast at a restaurant and afterwards went to Walmarts to pick up a prescription and buy a few items.
Back here at the camper I did some cleaning and am now comfortable on the couch writing this post!
Hope you all are having a good day.
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Carole u soud so happy--this is a wonderful time u'r having and it' great for u.
Reg u sound so much better and u'r situation sounds like it's improving to, S glad u'r mom is doing better and now u can find someone to help u out and u can stretch u'r legs so to speak.
Jackie when u said u have to feed the feral cats and Chevy--all in the same sentence, I guess she reminds u of that type of cat too.
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"You are not separate from the whole. You are one with the sun, the earth, the air. You don't have a life. You are life." ~~~~Eckart Tolle
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Morning on this very toasty day. Wouldn't mind but the humidity seems up a bit too and that has always been the part I don't like. Many times in California we ventured out to desert areas and enjoyed the day outings so much. With care and plenty of water. Heat is so easy to take most of the time if the dreaded humidity will just not rear up.
Carole....wish I were along. The things you do always sound so interesting and wonderful to experience. In my imagination ( and I'm sure I'm right ) you remind me of the people who always see the unusual things that so many ( I'm at the top of the list ) of us miss. Not sure why. I think I have learned to see more in something -- almost anything now that I'm older, but I still miss more than I like a lot of times.
Cammie...you see a lot too. I did not know I talked about feeding feral cats and Chevy all in the same sentence. Ok, I did as I went back and read it.......well, I guess I was afraid it would be missed and was trying to make sure it got LOTS of attention. I accomplished my mission.
Hope you all have a marvelous day and whatever you do.....don't get overheated.
Peace and love
Jackie
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Camille, you are so funny! I laughed out loud as I read your insult to Chevy as I sit here in the laundromat.
Bet nobody envied me doing laundry in a laundromat. This is our last laundry in Park Rapids in 2013.
We awoke to gloom and rain this morning, so loaded up the dirty clothes and brought along a BIG bag of quarters. Now the sun's out.
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Carole Laundry is not one of the 7 deadly sins--the envy of it is tho. It is a sin for having to do it. But as the sun comes out u'll be done and find something fun to do even if it relaxing u make it sound fun.
Well Jackie u know I had to bring attention to it--for Chevy. LOL
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Hi Carole! Me and Cammi.... Cammi and I! We are just 2 peas in a pod, and we have so much fun trying to drive each other crazy...Ha!
I guess I should mention, that Cammi just LOVES Chickens and Wasps... See, I have to bring these things up, or she feels left out!
And Cammi, you little squirt! Jackie DOES feed the feral cats, and me.... Hah! Well, maybe not FEED me, but she DOES send me email.... so THERE!
Cammi, I went to visit my neighbor yesterday.... I gave her 3 ears of corn for the chickens.... MAN! Their coop was a MESS! Flies everywhere! I said is it THAT dirty to cause all the flies? She said, yes, we have to keep the straw dry, or their messes cause the flies. YIKES! I mean! I don't want those flies anywhere NEAR me! So the "new" has worn off.... They had better clean their coop before they go on any more trips! And want ME to feed them! Cammi, will you come with me? I can push you through their gate, and I'll grab the gate and lock it fast, so they won't get out! THEN you can pick them up and cuddle the "girls" and I'll feed and water them! Oh yeah, THAT'LL work!
THIS is exactly how the chicken coop looks.... For all you gals that just can't wait to see a picture of it....
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That's not theirs--There is no poop in the coop Chevy--looks clean to me, but then u should see my room. Anyway u can feed those chickens all the corn u want then go and take their eggs at night- that's what u do I bet--no wonder u'r always saying oh I have fresh eggs, don't u candle them first at least??? It's barbaric. But I'm not here to judge u even tho u put that gavel on me.
And Jackie did say that so
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No CAMMI! I candle my ears.... NOT the eggs...Silly!
I KNOW that is not their coop... but that is the same design that they used to build it! You wouldn't WANT me to take a picture of their coop, until it was cleaned.... eeeeks!
I just changed our bedroom around. Moved the bed and the Dresser.... Now there is sort of more room.... kind of. I just like changes.
I don't get fresh eggs, unless they leave town....
I think they get 4 a day! But they have 2 little girls.... don't know what they do with all the eggs, but I can BUY eggs....Ha! 0 -
"WONDERFUL" news today
I received in the mail:Medicare has denied my entire hospital bill .....stating: "You were admitted for a planned removal of both breast. The limited records we received did not support the need for an inpatient stay."
Nice, I guess I was to go to the Mc Donald's drive thru or the "In and Out burgers" drive thru for my BMX!
This was the 2nd denial.
This is not good for my heart (had a silent heart attack at some time before my BMX)
After a denial in writing, I have 120 days to appeal....here I go again.....I think I am falling apart.
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OK Someone who knows about this will come on Di so don't panic these women are in the know. And I think words were left out someway on the forms for medicare cuz it's supposed to be (I think a 24 hr stay--which is stupid, but if there are reasons u stayed in longer that has to be put on the report. Oh Di just wait till someone who really knows about this--u'll get help.
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Di2012,this happened to us a couple of years ago. We did nothing. The hospital apparently supplied medicare with the info they needed and between medicsre and our HMO the entire bill was paid. But it sure gave us a scare as it was a very hefty bill. There really is no way they csn ultimately refuse payment, I feel quite sure. But who needs that kind of stress--it's really cruel. Makes one wonder how often this happens. I hope others who have had this happen will comment. Key words "limited records" is why doctors documentation is so important--your doc should be weighing in on this--he/she will be just as eager as you to have medicare pay the bill, as they should. Best of luck. I hope it is resolved soon. You don't need that kind of stress.
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Just get someone to write that you needed to be inpatient for monitoring due to previous heart attack. It's all in the wording. That's why experienced people make good money.
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Di see I told u don't give it a second thought--they will work it all out.
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A smile costs nothing but gives much. It enriches those who receive
without making poorer those who give. It takes but a moment, but the memory of it sometimes lasts forever. None is so rich or mighty that he cannot get along without it and none is so poor that he cannot be made
rich by it. Yet a smile cannot be bought, begged, borrowed, or stolen,
for it is something that is of no value to anyone until it is given away.
Some people are too tired to give you a smile. Give them one of yours,
as none needs a smile so much as he who has no more to give.
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Di...you don't really need any cheerful rah, rah, rah words from me...but I think these ladies are right. The 'agencies' involved can fight it out with special note to be careful of wording, and in the end it will get handled.
I also have to save -- and please don't take this wrong -- no one else but you is sweating buckets of the red stuff or feeling apprehension..even panic. Take many deep breaths and try and picture ANYTHING that tends to give you as much of a calming feeling as you can get. A beach, moonlight on water, fields full of flowers.....whatever it takes you give you a sense of peace. It will work out and I know most people go through several months before medicare bills ultimately get paid. It seems a slow process to me....at least it was when I was handling my mom's estate.................so slow deep refreshing breaths. It will work out.
Peace and love
Jackie
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Okay Di.... I got Sass from the STFU thread working on this with you... I had sent her a PM, and asked her to check in on this.... she answered me with this....
"Chevy is it Chrissy's thread? I pm'd di. Checked a couple web sites. Usuaully it's the providers that screw up with the diagnosis codes and don't get the authorizations needed.
I've asked her to call so I can get the denial codes and see which plan she has.
Encorage her to make sure she gets her appeal paper work in. AS long as the apeal is made in the proper time frame, at least there's time to track and understand the problem
If it's improper auth codes. Know one can usually turn around and charge the patient. They may try. But it's not legal
Medicare does have a 200.00$ a day charge. But it doesn't sound like that's what she saying.
"The limited records we received did not justify an inpatient stay" For inpatient stay she needs to have co-morbid conditions i.e uncontrolled diabetes, uncontrolled kidney failure----something in bad shape. A previous silent heart attack wouldn't fit the bill. BUT most silent heart attacks occur in the diabetic population.
So, I'll wait for her call
Will both stick close to her to make sure she follows through
"So Di, maybe we can help you! It's so tough to get lost in between the cracks! She helps all of us with everything! Hope this will help!
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I stayed in the hospital overnight after my bmx w/reconstruction and went home the next day. Somehow my breast surgeon and plastic surgeon got the overnight stay approved but some women have the surgery as an out patient. Hard to believe but true.
Our weather has improved greatly. DH and I went outside this morning to drink our coffee and I had to put on a long-sleeved shirt! The a/c has been turned off and the windows and door are open. I went for a 3-mile walk. This afternoon at 3:30 we have a tee time to play golf.
Chevy, I guess there must not be any kind of ordinance in your neighborhood against having farm animals. A chicken coop could definitely be stinky. I buy farm eggs from a woman at the farmers' market for $2 a dozen. That's cheap for fresh farm eggs. Usually they're $3 or $3.50 a dozen. Maybe it's my imagination but they do taste really good. Fresh eggs are hard to peel when hard-boiled, though.
Happy Friday to all.
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Carole, I really can't tell a difference in taste....Ha! I get to watch the 6 "girls" this week-end.....! Well not "watch" them, but go feed and water them. I will go early before any flies are around...
My neighbor said there will be a lot of eggs, for the 3 days! I HOPE so! I just know they DO taste good.... and hold together better than "store bought" eggs. 0
