Monday, May 28, 2012

INSURANCE CLAIM FORMS, aka the HCFA-1500
























You may someday need to file your own insurance claim form. Whether it be that your provider doesn't accept your insurance, so won't do the necessary billing, or you may have a provider that doesn't do "secondary" or "supplemental" claim billing.  Whatever the case may be, you need to file it on a
HCFA-1500 claim form.  You can download one from the internet @  http://www.dm.usda.gov/shmd/owcp-1500.pdf     In order to do this, you will need your own personal insurance information, a copy of your providers bill, which should include the charges, codes (diagnosis and billing), identification numbers, and name,address, phone number, etc.  If there are any blanks you do not know how to fill out, or don't understand, call your insurance company and ask for their assistance.  They will be able to help you with this, or direct you to the questions and answers you need to get from your provider of services.

Monday, May 21, 2012

Bay to Breakers 12K

Okay, I’m going to go off the beaten path today.  This blog has more to do with health, than billing.  So here goes……… 

I ran my first 12k yesterday.  For those of you who are not familiar with the metric system (like myself), it calculates to 7.45 miles.  It was a beautiful day for the running of the 101st Bay to Breakers in San Francisco, CA.  Myself, my sister Donna, youngest daughter Kirsten and niece-in-law Juliette all dressed alike in pink tutu’s, pink tops, pink headbands, matching socks and pink glasses.  We really thought we might look CrAzY, but didn’t even come close to some of the other runners on the course.  I didn’t come in first, but I didn’t come in last either and my time was respectable for the 50-59 age bracket.  According to several sources, there were approximately 50,000 people running today.  And to say that all of them were FULLY DRESSED  would be lying!  I think this just gives a “free pass” to those who like to flaunt it. 

Why did I do this?  I’ve gained a few too many pounds in the last 20+ years and never seem to keep it off when I do lose it. I love my chocolate and ice cream and need to find a happy balance. I had been “training” for a half-marathon since the first of November, 2011.  I had a little set-back at the end of December, as I had to have emergency gallbladder surgery and was in the hospital 4 days and 3 nights.  Since it was laparoscopic surgery, my surgeon pretty much released me back to full activities within 2 weeks.  Of course, I thought differently as still took it easy for at least 3 weeks before I felt like going back to training and at that, it wasn’t right where I left off either.  I had to ease back into it gradually to catch up to where I had already gotten to.  To make a long story short, we failed to sign up in time for the half marathon (13.1 miles) and didn’t get in.  Hmmmm, now what?  I managed to squeak a 10k in on the beach last weekend, so why not graduate to something a little harder with a extremely long hill to climb….hence  the Bay to Breakers in San Francisco.  Seeing how none of us were really “runners”, this sounded much better than the half-marathon anyway.  Well, we signed up, and did it.  It was a lot of fun, and just having a lot of people running with us and around us, motivated us to keep going. In fact, we’re already talking about finding another race, maybe a 10k (6.2 miles), as I’m still not sure I’m ready for a half-marathon yet. 

To prepare for any kind of event takes planning and training.  You also need the proper tools to be successful.  There are several website online where you can find training guides.  This site from Merrell seems to be a good start.  Just type in trainer.active.com and it will come up with a really great website on training programs/plans.  Another one of my favorite websites is Walk Run Jog,   http://www.walkjogrun.net/  You can map out your own routes, figure out your mileage and save your routes.
Last of all, you’ll need the tools to make yourself successful.       
Shoes:   A good pair of running shoes is first in order.  You don’t have to spend buko bucks for these, but it’s probably a good idea if you talk to fellow runners or look over running magazines for suggestions.  You can even go to your local department store and buy a pair.  It was suggested to me that you buy a pair ½ size too big.  This is because your feet may swell during a run and because you should be wearing some good running socks. 
Socks:  My sister only wears and swears by thorlo socks.  I myself haven’t tried them yet, but plan on picking up a pair soon.  I just wear a nice low cut cushiony sock and seem to do fine.  Just like the shoes, you can spend a little or a lot, depending on your preference. 
Sports Bras:  A good supportive sports bra should be at the top of the list for women.  It makes all the difference in the world.
Fanny pack:  I just upgraded my fanny pack.  The one I had before used to slide all over my backside when I ran.  I seemed to spend more time readjusting it then running.  My newest one is of a neoprene material and has two zipper pockets.  I love it.  It’s light- weight and snug, yet I don’t feel like I’m even wearing it.  Fanny packs can vary and can go from simple to fancy.  Some can hold as many as 4 water bottles (for you very long distance runners to be).  Mine was pretty basic.  I can clip on my small water bottle, have room for my cell phone, I.D, a little money, car keys and inhaler.
Goo:  Goo seemed to be everywhere at the race.  Basically it seems to be a high caloric tube of energy food that replaces some of your electrolytes that you lose while exercising.  I haven’t tried any yet, but there are several brands and flavors out there.
Diet:  I haven’t really devilled into the whole “what should I eat before and after my race” thing yet.  I usually try to make sure I have protein and carbs before I run, but I don’t like to eat too much before I run either.  I just do what’s comfortable for me so far.  The best bet would be to talk with your physician, nutritionalist or sports trainer for ideas.  I’m sure the web has many rules of thoughts on this as well.

Well, I hope this gets you moving and motivated.  I know I’m not moving very well today, but will be hitting the pavement tomorrow and looking for my next racing adventure.

Monday, May 14, 2012

Understanding Your Medical Claims: The Women’s Health and Cancer Rights Act of 1998 (WHCRA)

Understanding Your Medical Claims: The Women’s Health and Cancer Rights Act of 1998 (WHCRA)

http://www.dol.gov/ebsa/

The Women’s Health and Cancer Rights Act of 1998 (WHCRA)

What every woman should know about
The Women’s Health and Cancer Rights Act of 1998 (WHCRA)

The Women’s Health and Cancer Rights Act of 1998 was put in to protect individuals who elect to have breast reconstruction surgery after mastectomies due to breast cancer.  This law states if your group health plan covers mastectomies, the plan must provide certain reconstructive surgery and other post-mastectomy benefits to rebuild/reconstruct a woman’s breast after a mastectomy; to produce a symmetrical appearance, (looks almost identical to the other breast), and prostheses and treatment of physical complications at all stages of the mastectomy.  Even if you’ve had a mastectomy for a non-cancerous condition the rule still applies.  As always, there are exceptions to this law.  Certain plans that are church plans or governmental plans may not be subject to this law, so it would be in your best interest to check with your plan administrator to verify if you have this benefit. All your health benefits costs would still apply to this service, such as co-insurance cost, deductibles and out-of-pocket expenses.  For more information about your WHCRA rights, contact the U.S. Department of Labor’s Employee Benefits Security Administration @ 866/444-3272 or visit the EBSA Website @ http://www.dol.gov/ebsa/ and click on the Contact Us for the addresses of the 15 field offices that can assist you.  You can also request a copy of Your Health Plan and HIPAA…Making the Law Work for You and a list of all publications from the Employee Benefits Security Administration.

Friday, May 11, 2012

I'm back......

I’m back.  Yes, I know it’s been a long time since I’ve posted, and yes I could rattle off tons of excuses, but I’ll save you all wear and tear on your eyes and just start blogging again.  New changes are coming to my blog.  I’ll be altering the format somewhat.  Not only will I post about understanding your insurance claims, but I’ve decided to add some general health information.  I wish I could say I was abreast of all the current issues there are today, but just like you, I get my information from many sources.  Many of these ideas will come from the internet, magazines, newspapers, television and my own personal experiences.  I’ll try to consistently blog on Monday’s again, hence the word try.   If there are any health-related topics you would like me to blog about, please feel free to email me as well.  My next blog will be about Women’s Health and Caner Rights Act of 1998.  Looking forward to seeing you on Monday.