Friday, June 17, 2011

Crazy, I say.

I've never really had any complaints about the insurance provided by my employer. It's rather cheap at $12.75 per week and the co-pays are reasonable. I have no idea how this may change since the ownership structure at the Palms is changing/has changed. I've been told that the Caesar's Entertainment insurance package isn't very good, but that is just second and third hand information at the moment.
What I can say is that the whole world of medical coding and billing doesn't make any sense to me. Back in April I made an appointment for a "yearly" physical. I show up, pay my $14 co-pay and visit with the Dr. I mention a knot under my jaw--a blocked salivary gland as it turns out, and ask him what he thinks about Chantix. He writes me a script for Chantix and sends me for blood work. End of story, right?
Not quite. As I have come to find out, a well visit/physical ceases to be a well visit once you mention ANY concerns. The billing department coded their claim to the insurance in such a way that "tobacco use disorder" became the primary reason for the visit. The insurance doesn't pay for "tobacco use disorder" so the doctor's office bills me for $104.
First of all, I don't have a disorder, I smoke. Who the hell determined that to be a disorder? Secondly, why would the billing office code that as the primary reason for the visit knowing that no insurance company is going to pay for the visit? The nice lady in billing said they will recode and resubmit and that should take care of it......
BTW, I have decided that continuing to smoke poses less of a risk that taking Chantix. I talked to pharmacists and nurses who all said that they would NOT take Chantix. Other options such as the "patch" may be a consideration in the future.
I had an interesting night at work last night.
Except for the time when I dealt a bad-beat, I received my personal best tip for dealing a hand of cards. The way it happened baffled me, so here is the rest of the story:
A player that I recognized but hadn't seen in perhaps a year comes in to play.
I ask him where he has been and remark that it has been a LONG time since he played in the room. He goes on a nice run while I am in the box and he tokes nicely. On my next down at that table, we repeat the run and the nice tokes. The next time I am at that table he loses a monster pot which puts a HUGE dent in his stack. After that hand he gets up to leave......and..... pushes me the remainder of his chips.
The single largest tip I have ever received (ignoring one bad-beat hand) came from the player who LOST the hand!
'Splain that one Lucy.
Brad, Simon, Stephen we miss you at the Palms! WSOP time isn't the same without you.


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