Recent content by lkc15507

What is the name of your state (only U.S. law)? Texas / Missouri My elderly mother recently received a proposed oil, gas, and mineral lease on some property in which she apparently has interest located in Dimmit County Texas. We (and most of those involved) are located in Missouri. I never knew...

What is the name of your state (only U.S. law)? Missouri. I hope to keep this a concise as possible, but its very nature is going to make that difficult at best. This question regards a contractual issue between a self-funded health plan and a provider on behalf of one plan participant (and...

First of all, I don’t expect anyone to agree with my viewpoints. I did and still do agree that drz is and will be ultimately responsible for this bill. What I am suggesting is that an appeal to the payer is not the only avenue that could possibly be pursued. I do not interpret drz’s original...

Please, please do as ellencee suggests and allow an attorney that you can physically see and talk to review your mother's case. Pulmonary embolus is a known risk of any surgical procedure, but any mental status change requires investigation by a health care provider. The abdominal pain may or...

While I agree that the daycare should have consulted a parent prior to taking the word of a 7 year old, I would think that you should be appreciative that there was medication on hand for your son. You have said that he received an "additional" dose, yet the remainder of the post indicates it...

I realize I have just made one big assumption. I have been assuming that drz spent an overnight observation in a facility, however, the post doesn't actually say that. Since this could have been an outpatient procedure, it would of course eliminate much facility / UMD (ethical) responsibility...

Sugarpuddin Although there is not enough information in your post to determine the situation, I can say this. I have never run across a situation in which dental implants are considered medical. Every plan I have ever reviewed would only cover repair of natural teeth resulting from an injury...

drz Well, my answer is the same—you owe the bill—unless you get really, really lucky. I have to say that I agree with you in large part. Most facilities these days have Utilization Management Departments and knowing what your insurance will and won’t cover is precisely one function of the...

Oh my gosh. I am so very sorry for you. While I will completly defer to others for legal answers, I will make a couple observations. The rashes you described are often clinical indicators for healthcare providers of sexual abuse. Health care providers are obligated to report any such...

The poster does not mention what symptoms were present when originally presenting to the physician. Much of the treatment plan for such problems comes from clinical presentation, not just MRI's and / or other diagnostics. In fact, clinical presentation is the first line in diagnosis...

stmas: Since medical collection absolutely can damage your credit, do as ellencee suggests and contact your attorney. But, I just want to add a couple of observations and then see if anyone has additional input. If I understand correctly, your health care insurer paid the claims originally...

Absolutley, yes, this is a HIPAA violation. The only way out of that is if the individual were directly involved in your care and had your consent to relate that information. Or, directly involved in your care and you were incapacitated / incapable of giving consent. In addition to the advice...

By January 2005 your COBRA should have long since been exhausted. The fact that it had not been is obviously an error that even you seem to acknowledge. Your ex-employer actually seems to me to be very generous to have suggested continuing COBRA in 2005 because of that error. What is not in...

Your post makes no sense to me. No one has advocated anything other than a prudent review of this person's situation. "Numerous"? I don't even find the word in these posts. If there are previous posts, she was probably intimidated or put off by unfriendly folks. Who the heck advocated...

Pure supposition, but from your post, I assume that you have a fully insured employer group health insurance plan. If that is the case, your employer has no right to your personal health information (a definition of PHI can be had by searching the Dept of Labor website and the Code of Federal...