Thursday, April 14, 2011

Is there any topic I don't touch on?

It's strange that we have been so busy, but I don't feel like I have anything to write. This morning I am trying to get some things done inside, because we have been gone so much that I am again getting behind. I am having a hard time convincing Marek that he does not need to be outside every second of the day, particularly because mom sometimes has things like laundry or dishes that need to be taken care of. Although, despite all my green efforts and lack of paper plate use over the past two years, I am seriously considering some heavy paper plate use this summer. It would be so much easier to keep up on dishes if summer meals were on disposable plates!

Today is the second day that we have our new friend Asher over to play. It has been going well, he is a sweet little guy. Marek doesn't really do well with Asher being the small one, but whenever Marek even looks at Asher or tries to talk to him or play with him, Asher starts crying... so that's probably not helping much. LOL. But they are excited to see each other in the morning, and so that is a good start.

I am going to start trying out a new iPhone app, called Home Routines. I am hoping it isn't like the other apps that seemed like a good idea but I could never keep up with, like Grocery IQ, Groupon, Mealboard, etc. The Idea by home routines is much like Flylady, or Motivated Mom's Planner. Another mom brought the Motivated Moms Planner to MOPS last month, but I missed the meeting, so I didn't know about it until I saw Facebook talk. I googled it and looked into it. It seemed very promising, except that it didn't have the ability to customize, and if you want it customized, you might as well make your own planner. On the Motivated Mom's Planner website, I was looking at the cost ($8) and saw that they had an iPhone app. the app is a little more flexible and also costs about the same. But then I saw that there were other similar apps that were higher rated, specifically Home Routines, which allows you to fully customize your tasks if you choose to, and edit them, and also allows you to add your own tasks, your own zones (which can also be edited) and has options as to when your chores reset, which zones happen which weeks, etc etc. It was also less than half the price, and had more and higher ratings by users. I decided to go ahead and give it a try. It's great because I have morning chores, afternoon chores, evening chores, and weekly chores, and I can even add other things if I want to. The zones are so nicely customizeable, not just WHAT your zones are (I put the bathroom in the same zone as the playroom and kids' bedrooms, because we always tend to work on those three together) and I appreciate the fact that I can add a front porch, back porch, and pantry to the pre-programmed list of zones. I can cluster rooms together (like dining room and living room, because ours are sort of one in the same) and that I can edit exactly what I want to do in each room, like have the kids pick up their crocs and put them in their baskets, or replace the hand towels in the bathroom, or take the recycling to the van on a specific day so that it makes it's way to Princeton when we are already heading that way for preschool. I can even create a morning chore that reminds me on that day to take the recycle OUT of the van and to the recycle center.

Now the thing is, I can still ignore tasks if I want to. So it all boils down to WILL I DO IT and WILL I KEEP DOING IT. I hope they come out with a motivation app sometime soon.

I am currently working on my Farmgirl Badges. This week I am hoping to get to Hobby Lobby to get some transfer paper so I can print out the badges I have earned so far.. and start embroidering them. I have Crochet beginner and Crochet Intermediate, Shopping Green beginner and Intermediate, Gaining Ground Beginner, Backyard Farmer Beginner, First Aid Beginner, and Aprons Beginner. I have several more that are partially completed. Once I get them all embroidered, I have no idea where I am going to attach them. Some put them on a denim jacket (which I don't want to do) and some on a tote bag (eh. I dunno)

We went out to the farm yesterday to work on the coop. the weather was beautiful and there was plenty to be done, but dad was working on seeing the hay ground, so I could only do the things that I could accomplish without any help. I took the roof off the chicken coop and pulled all the nails. Then I drew out the nest box measurements on the plywood. Last night I brought the plywood home, hoping that I would be able to cut it in the garage after the kids went to bed, but that didn't work because I couldn't find the circular saw. Someone must have taken it out of the garage. I found a the battery powered one, but it just couldn't cut it, which was SO frustrating. I ended up starting and having to leave it uncut. Grrr. Today Evan looked for the saw and said it is missing from the garage. Boo. SO now I am trying to determine if I want to feed everyone lunch and then load up all three kids AND the plywood and try to go to the farm and get it cut, or just wait till sometime later. Problem is, chicks are growing fast and weather is about to turn cool and rainy again, and I would love to be moving forward. Before we can side and roof, we need the nest box assembled and attached, and the holes cut in the back wall of the house for the hens to enter the next boxes. I need the side access door cut in the wall of the house, and a front and side door built and attached. The legs need to be put on.... and then I can work on siding. There are so many things that I feel like I can do if someone would just show me how to get started, but it's hard because dad has lots to get done too when the weather is nice. I know I should just be patient, but patience means full sized birds crammed in my basement.

This morning I got a call from the Gastroenterology Office about arranging payment for my bill. I had just opened it last week and thought it was awfully high, but what else is new. I hadn't gotten a chance to look up all the EOB's yet. I decided to go ahead and call the insurance company. Come to find out, all 4 claims were processed as out of network and nothing was paid.... because the Doctor's Office is not including the last two digits, the suffix, of the Tax ID number, in the physician's OR the group's billing information. This resulted in the insurance company's system NOT finding the physician or the group he practices with, and therefore made all the claims be denied for me. So the insurance company has corrected all of his tax ID numbers in their system and resubmitted them all through their system in order to have them reviewed and hopefully paid accordingly. So I tried to call the physician's office back, and they are at lunch. Of course. With no voicemail. I have such limited time to make a phone call without being interrupted by an ornery, screaming, hungry, persistent, or tired child... I hate when I can't at least leave a message so that they can call back later if they need more information. It sometimes takes me weeks to get a phone call completed.

For example, when I was on the phone with the insurance company, Marek decided he needed a banana. He had already had breakfast, AND a snack, and I was in the process of making lunch. The last thing I wanted him to have was more food because then he wouldn't eat lunch. Then 20 minutes later Ardyn starts asking me who I am talking to, and question after question, and then tells me that she needs to talk to that insurance lady about doctor bills because her ankle hurts and she wants to go see the doctor. Oy. This is why I get so cranky when my husband says "can't you just call" as though I am the person with all the free time on my hands. What he doesn't understand is that I have no QUIET on his hands. I am hoping that the new app will help me remember to make phone calls during quiet intervals.

So anyway, I call back after lunch, and I wait on hold for a little bit, no big deal. I get to the person who called me earlier and I told her that I had printed out all my EOB's and that I had them all in front of me, and had called the insurance company. I verified all the dates of service with her, and then I explained that the insurance company did not receive the last two digits of either the physician OR the group tax ID number. I told her that they were resubmitting each claim into their system with the corrected information and that it would take 30-45 days for the claims to be reprocessed and paid. This is when she started to get a little defensive. I told her that the claims had been paid as out of network providers. I told her there was one other issue that I wanted to share with her, and that the insurance company told me that the very first date of service, which was the time that I was an inpatient at the hospital and the surgery department called the gastroenterologist in for a consult, that the visit had been billed to the insurance company with an incorrect code for outpatient consultation, when it should have been inpatient consultation as I was an inpatient in the hospital. Then she got angry with me and started saying that this isn't possible, and she's looking right at the code and the location and I stayed calm and said "that's fine, I am just relaying what the insurance company is telling me, and they pay differently for outpatient consultations than for inpatient, and they may require you to resubmit the claim with the correct code." And then she said "But I am saying that is NOT possible and I don't know why they are telling you that" and I said "Listen, I understand what you are saying. I have done my part and called the insurance company and looked up all my EOB's and I am just telling you what the insurance company is doing and how they are now handling it. If you have a problem you are more than welcome to call the insurance company directly and discuss it with them." - Kind of like putting the conversation to an end.

What frustrates me is that most insurance companies and physician offices expect that every person that crosses their path has no idea about their rights, their insurance claims, and the potential (the very HIGH potential) for mistakes and incorrectly filed claims. I am not saying that the doctor's office made a mistake, I am saying that somewhere there is an ongoing miscommunication, every date of service from August 2010 until March 2011, and that this problem is not going to be fixed by continuing to do what they are doing. Obviously.

I am fortunate (I think) to have worked in healthcare, and learned a bit (and just a bit) about insurance and coding and health billing. I was also fortunate to work in the office of a REALLY particular and stingy insurance salesman (no, not related to me at all :) Who went over every single EOB and medical bill with a fine toothed comb, comparing each thing and even taking a calculator to each one to be sure there were not mistakes. And I can tell you, he found a mistake on at least 3 in 5 EOB's. This taught me that there is a very high chance you are being incorrectly charged, billed, OR reimbursed. So, hopefully this gets all straightened out with the insurance and the physician, because I have another appointment with the gastroenterologist and probably also another upper and lower scope coming up in the next month or two.

My ankle has been killing me today. I think it's because yesterday afternoon I was just sitting around here with the brace off because my leg was sweating and itching under it, and then when I left home initially I forgot it. Walking on it without the aircast felt fine, but I ended up having to come home and get it because it started hurting. Then when I was on my way home after MOPS Tacos, my ankle started to itch again, so I took it off, and forgot it in the van. Well, I have been walking on it this morning without the aircast and it hurts pretty dang bad. I am going to have to take myself outside and get it pretty soon. When Paige gets Asher I need to have Ardyn all dressed for dance class and ready to go soon after, so I keep hoping that if I just sit here with my foot up I can just go out and put the aircast on when we leave. But man is it hurting! stupid weak ankles.

Well, Marek wants to cuddle and rock, he's a tired guy today. Later :)

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