Getting back to normal

Or, what passes for normal around here. Our guests that arrived on Tuesday have headed home by way of one of their kids’ place near Philadelphia.  They’ve got traveling down to a science.  Having risen probably around 5 am as they have been doing since they got here (as well as going to bed around 9 pm the previous evenings) they were showered, packed and out the door by 9 am.  I can easily say if it were my wife and I in a similar situation elsewhere, we wouldn’t have the car packed, let alone vacated a place before 11.  But then again my wife is not a morning person.   I’ve learned to make accommodations for her preference in this respect.  Late check-outs and changing the way we travel, when we do has helped immensely.  That, and not traveling all that much.

kitty-postThe little guy is catching up on his sleep. For the past 3 1/2 days, he’s been trying to keep up with the goings on of four people, which is double what he normally has to keep track of.  Too, his normal sleeping place here on the table has been used for its intended purposes (eating and socializing) so he really hasn’t had so much of the ability to use it for what he has become used to having it for (sleeping and watching the backyard and the neighbor’s yard beyond).  Like his predecessor (I had a cat named Jeb that lived here as well as all the other houses we lived in while I’ve been in this area, and as a matter of fact Jeb moved with me from the Hudson Valley to here in 1993) he has pretty much the run of the house, there are only three distinct areas to which he doesn’t have constant contact.  The lower basement, which has nooks and crannies he might get stuck in, the guest bedrooms at the top of the stairs and the master bedroom.  My wife is slightly allergic to cat dander, so if we can keep a couple of areas clear, she feels better.  Since she’s amenable to have a cat in the house (she’s a bird person and her cockatiel Oliver lived with us for about 18 years) I’m as accommodating as I can make her in regards to the cat(s).  The only rule in regards to feline companionship is; only one at a time.  That’s acceptable.

I’ve been cobbling together a grocery list for tomorrow from the local flier.  The refrigerator is starting to get a bit bare, and we haven’t shopped since before the guests arrived.  My wife asked me what we were going to have for dinner.  Boom, no clue.  She suggested something to do with ground beef, since we have some sitting in the freezer.  The freezer, unlike the fridge, is packed with stuff.  We need to see about paring down some of that, so we can put new things in it.  I’m still debating on whether or not to get a chest freezer for extras.  Like I’ve been debating for the past two years.  Fortunately, the prices of chest freezers is pretty static.  So waiting isn’t costing me.

Ok, enough of this entry.  Time to get some things accomplished.  It’s not going to be as warm as yesterday, but today is my last day of vacation.  And I need to get some stuff done.  I’ve been having an easy time writing lately.  Nice to feel, it’s been awhile.  Hopefully, it will continue.  I miss being able to blog freely every day.  Or several times a day.

Medical Billing Pachinko

I use a CPAP machine when I sleep.  I have for the past 20 years.   One thing that has always boggled me was the cost of the equipment.  One would think as something becomes more mainstream, the equipment costs would go down.  While that’s true in the case of the machines that pump and filter the air, the masks that direct the air into your nose (and mouth sometimes, depending) are still hideously expensive.  And even with medical insurance, sometimes the costs are ridiculous.

The other thing is the companies that make the masks are incredibly sneaky with the way that they bill them.  Instead of billing as one unit, they break the mask down into 3 or 4 components and then charge a good deal of money for each.  Although attributed to Aristotle, apparently he never said: “the whole is greater than the sum of its parts“.  In this instance, however, the sum of the parts of the mask are greater than if you sold the mask as a whole unit.

Last week I received a bill from the medical supply depot and it broke down the bill into several different medical id codes, which I managed to find online in a PDF that detailed the parts of the mask.  Just coincidentally, nearly identical to the information brochure that came with the mask in its commercial packaging.  Looking at the more informative one, it gave me not only a breakdown of the pieces of the mask and their respective codes, but it also showed me that on my bill (at least it looked to me) that I was charged for the whole mask and two of the respective parts of it.  I’d meant to go there this week to talk to them about it, but with the hullabaloo of what was going on with the car, I had forgotten about it.  At least until I stumbled upon the bill while looking for something else in the pile on my desk.   Seemed like the perfect time to argue my case.

I drove to the supply office and was greeted when I walked through the door.  I asked if there was someone I could speak to about a bill, and the woman who greeted me said she could help.  I laid out my case, showing her the documentation, and the itemized things I was seeing and asking her if she understood what I was getting at.  She did, though she insisted that I had been billed correctly.  She then got out the original bill (which I’d signed the receipt of) and showed me different item codes for the mask.  Sure enough, the mask was broken down into pieces on the bill and charged separately.  Even though the cost of the ‘whole’ mask was more than the cost of the other two pieces.  I still believe I was overcharged.  A facial mask that is made out of cloth, plastic, and silicone should not cost nearly $300.  At least to my mind.   My insurance only covered about $60 (due mostly to my deductible not yet being met) so the rest I had to pay for.  I paid the bill but left dissatisfied.  Not with them, but with what they had to deal with in order to bill patients that come to them.

CPAP masks and machines are huge business nowadays.  25 years ago, I had never heard of them.  But the overabundance of people being obese has ballooned the business to ever greater heights.  More and more companies are getting into the game and charging greater and greater amounts of money.  The costs of the machines is a lot less than it used to be.  The costs of the masks and other equipment involved with the machines have taken up a great amount of the slack.   I equate it to a printer and printer cartridges.  Companies sell a printer for $50-75 and then charge you an arm and a leg for the ink,  since they know you need to have the ink in order to make the printer work.  So you’re somewhat stuck unless you can find a generic seller that can copy the chip that’s used by the printer company.

Fortunately, with the mask that I’m using, the pieces are available on eBay for a LOT less than what the manufacturer charges.  Since it’s (from what I’ve heard and read) one of the most popular models used in the US, there are a good deal of sellers that will vend you the parts, and won’t break the bank.  And the mask is comfortable and doesn’t mark my forehead where the old one did, which is a great improvement.

Just another instance where the way the medical insurance business works here in the US is frustrating.  Even with insurance, it can be a toss-up on getting what you need or getting what you want to make it easier to sleep or live.