What do those first three pints of blood cost?

Posted on December 19, 2013 by Laura

blood cartoon1

An unexpected sticky wicket has crossed my monitor–the Medicare blood deductible!

Unless a private plan picks up the cost, Medicare patients must pay for those first three pints of blood by law (A., B.,) Clearly, this is a health care service no one wants.  However, if one day you find yourself in need of blood products, and didn’t know about Medicare’s blood payment policies, you might be surprised at the hospital’s blood bill.  Medicare doesn’t tell us what that cost may be. Just this:

Part A covers blood you get as a hospital inpatient. Part B covers blood you get as a hospital outpatient.  In 2013, you pay either the provider customary charges for the first 3 units of blood you get in a calendar year, or you must arrange (with limited exceptions) to have the blood replaced (donated by you or someone else) if the provider has to buy blood for you. In general, if the provider doesn’t have to pay the blood bank for the blood, you won’t have to pay for it or arrange for it to be replaced.

Blood processing & handling

Hospitals generally charge for blood processing and handling for each unit of blood you got, whether the blood is donated or purchased. Part A covers this service for an inpatient. Part B covers this service for an outpatient. In 2013, you pay a copayment for blood processing and handling services for each unit of blood you get as a hospital outpatient.

Of course, not all blood is donatable.  Enter the world of confusing and expensive world of private Medigap insurance.  Plans: A, B, C, D, F, G, M and N cover those first three pints 100%. But  K 50% and  L 75%.   (Out-of-Pocket Limits apply in K $4,640 L $2,320.)

Depending on location,  blood itself, sells for under $300 a pint.  A Forbes article about a new company, General Blood, sheds some light on the current blood business but finding the usual and customary charges for transfusions is proving elusive.  Ohio is apparently requiring hospitals to post their charges online but alas, no blood information: See: U Toledo.

But this out-of-pocket calculator for private insurance or uninsured people, is really cool for learning about the procedure’s cost using a CPT codes: 36430.   

http://www.fairhealthconsumer.org/medicalcostlookup/

Medical coding is no easy task since each insurance company has their own transfusuion rules but here are some from Blue Cross.  Other charges will likely to show up.   

For veterans being treated for leukemia or lymphomas, co-payment assistance may be available from charities.  So, I’m still searching for current “usual and customary” charges for blood.  Why, of all things, is blood singled out for special treatment?  If you have experience with this subject, let us know.

Posted in Guest authors, Medicare for VETS | Tagged , , , , , , , , , , , | 5 Comments

What 21.8 million death certificates do–and don’t–tell us about viral hepatitis

Posted on December 17, 2013 by Laura
tests in

H-what? What is it?

ASKNOD members are already well aware that HCV now kills more people than HIV.  This study of data from U.S. recorded deaths held some surprises for me.   Standardized death certificates have two parts and utilize the International Classification of Diseases (ICD) codes.  Part 1 gives the immediate cause of death. Part 2, the contributing/underlying causes of death.  Four main co-morbid conditions were examined: HBV, HCV, chronic liver diseases, alcohol-related illnesses.

Some findings:

  • About 50% of liver cancer deaths (18,910) in 2010 were associated with HCV.
  • National serum surveys indicate about 3.2 million persons in the United
    States are living with chronic HCV.
  • When cause of death was listed as HBV and chronic liver disease, it was strongly associated with these co-morbid conditions in this order: HCV, then HIV, then alcoholic -related illnesses.
  • When cause of death was HCV and chronic liver disease, it was strongly associated with these co-morbid conditions in this order: HBV, alcoholic-related illnesses, then HIV.
  • At the time of death, the researchers estimate that 40%-50% of the decedents with HCV infection were not diagnosed with it.
  • 75% of known HCV-related deaths are in the 46-65 year old age group.
  • Only 44% of deaths among HCV-infected persons were attributed to HCV.  Yet almost all of deaths among HIV-infected persons were attributed to HIV.
  • If someone had HIV and HCV, HIV was listed as cause of death.  HIV is given a priority in reporting cause of death, a bias.
  • It is not always easy to assign cause of death to persons with HCV, HBV, and HIV or any combination of them.
  • Viral hepatitis deaths are under-reported on death certificates and thus inaccurate when compared to death data for HIV infections.
  • There has been no improvement in recognizing viral hepatitis deaths which have reached epidemic proportions.
pool

We’ll deal with the bad stuff next month.

The earlier we start routine testing for the major known lethal viruses, the healthier our American families will be.  Having one of these infections is bad enough for our bodies to fight, but two or three? Public health officials must be too busy planning their next Orlando  party to plan testing clinics.

At least with an Obamacare plan, boomers can receive one free HCV test beginning in 2014. (I don’t know about free HBV and HIV tests.)  In 2007, only 36% of all adults in the U. S. have been tested for HIV, a truly pathetic number. Why such a low percentage? I believe stigma remains the number one mental/emotional barrier because the government continues to target testing services to people who engage in “risky” behaviors.  The Hepatitis C Action Plan is still presented as a side issue on the flashy AIDS website, instead of being front and center as the biggest killer.  It’s illogical. It’s political. It’s all wrong.

Posted in Guest authors, HCV Health, HCV Risks (documented), Jetgun Claims evidence | Tagged , , , , , , , , , , , , , , , , | 1 Comment

BRAIN FOG WITH HCV–IT’S REAL

Posted on December 17, 2013 by asknod

stressed old man holding head at homeHere’s a great article that explains what many a doctor pooh-poohs as being a fig newton of the imagination. Brain fog, or cognitive dysfunction, is real.

Posted in HCV Health, HCV Risks (documented) | Tagged , , , , , , , , , , , , , , , , | Leave a comment

A LEGEND IN HER OWN MIND

Posted on December 16, 2013 by asknod

none

April 2012—Congressman Filner, you have my word that we’ll have this backlog under control by 2015. We now have the tools and the finances to implement the Secretary’s directives.

 

long

July 2013—Congressman Miller, The new VBMS, which converts files over to electronic format, is on schedule to be implemented at the rest of the Regional Offices as planned. Thanks to VA’s new Six Sigma and Kaizen training, we have everything well in hand.

longer

September 2013—Congressman Miller, We have now completed the VBMS installation in all 56 Regional Offices and the backlog is decreasing much faster than any of us imagined. Fortunately, my background at Accenture was of immense help in overcoming innumerable obstacles.  I am proud to report that we are “all systems go, sir”.

longestDecember, 2013—Congressman Miller, fortunately for our disabled Veterans, we are gradually dispensing with the backlog and see some daylight at the end of the tunnel. It appears we will have eliminated the backlog completely before January 2015- well ahead of our earlier projections. Veterans should expect an easy up or down decision within 125 days soon and the accuracy is expected to be a breathtaking 98%. The VA has been able to attain these stupendous figures by working overtime and sending some claims to other, less utilized Regional Offices in Alaska, South Dakota and Montana. Unfortunately, in order to motivate the raters, we had to re- institute the bonuses temporarily but that is a short term setback. May I have some Kleenex, please?

Posted in VA BACKLOG | Tagged , , , , , , , , , , , , , | 1 Comment

GWI-BAD PAPER= NO BENNIES

Posted on December 16, 2013 by asknod

downloadWe’ve probably discussed the effects of bad paper or the Big Chicken Dinner on VA benefits so I just wanted to publish this sent in by Frank. While SPN codes are no longer the anathema they were in the 60s-80s, having a less than honorable discharge is still the hole in the bottom of your boat you’ll never plug. Even if you can manage to pry one out of your military branch, VA does not consider it a viable one equal to compensable benefits or medical care. For VA, your injury during a bad piece of paper, even if you had a prior enlistment with good time, is still an impediment to service connection. That is the barrier that no one can breach. It was enacted by Congress to reward those who stayed the course. For those of us who found it impossible to follow the rules, there is no repair order. BCD, Undesirable- whatever the designation, if it isn’t “under honorable conditions” it’s no dice.

P.S. Here’s recent precedence from the Court that reaffirms this concept of “clemency discharge upgrades”.

RobertsonTW_11-3521

Posted in Veterans Law | Tagged , , , , , , , , , , , , | 5 Comments

2 SQUIDS IN A LIFEBOAT

Posted on December 16, 2013 by asknod
images (1)

Bob and Bubba

Shortly after an Al Quaeda wrecking crew sank their destroyer near the Straits of Hormuz, two gentlemen of the Naval persuasion were floating in their lifeboat awaiting rescue. Bob, from Georgia( and an avowed optimist), found what appeared to be an old fashioned, tarnished brass oil lamp in the survival locker. He vigorously rubbed it and to his amazement, a genie promptly appeared in a cloud of smoke.

Before the two sailors could even say Jack Robinson, he looked at them and said “Hey, you guys are sailors. I only give out one wish to sailors since I got stiffed by that Sinbad joker. What’ll it be?”

Bob, without a second thought,  immediately blurted out, “Turn the entire ocean into beer.”

downloadThe genie clapped his hands with a deafening crash, and immediately the sea turned into beer. Just as quickly as he had appeared, the genie departed along with his lamp.

Only the gentle lapping of beer on the hull broke the stillness as the two men stared out and considered their circumstances. Bob’s shipmate Bubba, from South Carolina,  looked disgustedly at the ocean and then back at Bob whose wish had been granted.

After a long, tension-filled moment Bubba said in  a low, measured tone of voice:

 ” Smooth move, Exlax…Now we’re going to have to pee in the boat.”

Bob and Bubba shortly after their rescue

Bob and Bubba shortly after their rescue

 

Posted in Humor | Tagged , , , , , , , , , | Leave a comment

PUNKIN CHUNKIN’ AT THE NOD RANCH

Posted on December 13, 2013 by asknod

DSC00617Always wondering why I have pumpkins growing all over the pasture in spring. Seems the animals redistribute the seeds. Like Grampa said- “Them fellers are your bread and butter for fertilizer. Always prime the pump and you’ll get your due.” Check out the graphics on this Sony cam. It’s got a gazillion pixels per cm. click on them and you can count the seeds.

Head fertilizer production technician

Head fertilizer production technician

Posted in Food for the soul, Humor | Tagged , , , | 2 Comments

A FUNNY THING HAPPENED ON THE WAY TO THE MAILBOX

Posted on December 13, 2013 by asknod

No rank, no insigniaOn May 15th, 1972,  after two years of banging around the Indochinese Peninsula, I DEROS’d back to the United States of America. DEROS, for those of you unfamiliar with the term, stands for Date Of Return from Over Seas. When I returned, I was missing some paint and had a few rust spots. The USAF, now in its  post war starch-and-shiny-boots mode, didn’t cotton to a Buck Sargent (E-4) strolling in from 30 days leave still sporting camo fatigues and jungle boots in the continental lower 48.

Being horribly naive, I figured they’d give me a  week or so to buy some conventional fatigues that fit and get the legal nomenclature back on my feet. Those beautiful shiny black boots from basic rotted in less than 180 days at Udorn without even being worn. Hell, jungle boots with the green canvas sidewalls lasted an average of 120 days when they were underwater all the time. Sorry, no dice Sgt. Nod.

My new first shirt had served under my dad in 5th AF in Japan and had a stiffy for me. I was always on the wrong side of the fence for every imaginable offense. Putting a water bed in the barracks ( on slab on grade) did not win me any medals for innovation. My back was in an uproar and the military mattresses were no help. I finally discovered that the Air Force and I were not long for a mutually compatible relationship. What happened next took me by surprise.

N199X crash sceneSenior Master Sargent Robert  “Jack” Frost found me out of compliance with the haircut regulations of AFM 35-10 one morning and ordered me out for a tune up. Simultaneously, I went to sick call for my ongoing back injury from an unscheduled landing in a forest a year earlier. The long and the short of it was I came back to the barracks to grab a pack of Marbs and ran into Jack Frost.  Having failed to comply with the haircut order, I was given an Article 15 and lost a stripe shortly thereafter. Shit happens.

And yes, shortly after that, the Air Force decided I was not re-enlistment material and decided to divest themselves of me post haste. This they accomplished lickety spit. In the process, I got a DD 214 which was woefully short of complete.  See my post >>  https://asknod.wordpress.com/2012/03/24/erroneous-dd214/

This would not have been so hard to stomach except for the fact that they annotated absolutely none of my history in Southeast Asia. My 214 stated I received the National Defense Service Medal-period. Knowing I was entitled to much more was not paramount to my existence in 1973. You cannot eat medals so I sucked it up and moved on.

When I reached a breather in my travails with the VA, I noticed that they continually refused or ignored my requests to be granted §1154 (b) combat recognition whereby everything that fell from my lips was Gospel absent any talk of alien abduction. This provoked a quest for my medals. Unfortunately, some of the fellows who  I flew with  and who were witness to my GSW and/or subsequent medical intervention at a small USAID hospital at Lima Site 20 (Sam Thong) had the misfortune to run into aerial misadventures of their own and subsequently become room temperature. I wish to remember them here as I doubt anyone will ever give them their due for their services over the fence:

AirAm Capt (PIC) Benjamin A.  Franklin – pilot of PC-6 Tail # XW-PCB on 21 March 1971 near Lima Site -72 Tha Tam Bleung ( encountered some tall real estate on final to the drop zone)

AirAm PIC Harry E. Mullholland -pilot of PC-6 Tail # N180K on 29 April 1971 near Lima Site 63  (mid-air collision with  U-17A   approximately 1 klic north of  Muong Nam) .

Lt. (Capt. posthumous) Chuck Engle , Raven 26, augured in 22 Feb. 1971 south of 20 Alternate en route to Lima-08 Wattay (Vientiane).

PIC stands for Pilot in charge.

So after 40 years and almost ten months, the United States Air Force has acknowledged that:

1) I was “never in combat” but they nevertheless have decided to award me a Outstanding Unit Medal with 3 Combat Vs for Valor.

2) I was never in Vietnam but I was awarded the Republic of South Vietnam’s Vietnam Campaign Medal with 60-device and the Cross of Gallantry with Palm for service there.

3) I was awarded the Vietnam Service Medal with Silver star for five air campaigns in spite of having no record of even being in  the air.

4) I was awarded the  Small Arms Expert Marksmanship Ribbon in spite of no proof of having qualified for it. It could have been the zipperhead I tagged with  my .357 from 600′ ASL at Lima 108 Muong Soui  one morning during Operation Leapfrog in August 1970 because all the pilots talked about it for months. That was pure luck.

3) They were not going to upgrade my General Discharge to Honorable.

 Well, dang. I’ll just hush my mouth  and not complain. I tried for the other medals but apparently I “wasn’t there” to earn them. I’m still not sure how this works but I’ll get back to you when I figure it out. Seems it’s a lot like filing claims with the VA. If it isn’t in your records then it didn’t happen. The Air Force has issued me a new DD 215 that reflects the changes but continues to deny my presence anywhere in Vietnam or Laos. Go figure. It must have been a fig newton of my imagination all this time. I hate that when that happens. It seems I disremember it.new medal rack

Posted in ASKNOD BOOK, Vietnam War history | Tagged , , , , | 4 Comments

VETERANS FACE PAGE

Posted on December 13, 2013 by asknod

1469877_10152072684254769_2093748816_nNeed I say more?

Posted in All about Veterans, FACE HUMOR | Tagged , , , , , , , | 1 Comment

VA ROLLS OUT NEW FDD PROGRAM

Posted on December 9, 2013 by asknod
images (2)

Hickey arranging her hair before
FDD roll out announcement

 Today,VA Under Secretary for Undeserved Benefits Allison “In Wonderland” Hickey announced a new, exciting concept in VA claims intended to “wipe out the backlog as we know it”. Called the Fully Developed Denial, the expedited process will allow Veterans to advance through the complicated claims process much faster. Veterans Service Organizations representatives from all the major groups welcomed her proposal with loud applause. Hickey also suggested this may be the panacea to VA’s salvation and the continued preservation of their good name.

Said Hickey: “The Department is committed to eliminating the backlog as promised by 2015. Towards that end, we are rolling out yet another initiative to ensure this will happen. Starting in January of 2014, we will be proud to introduce the Fully Developed Denial. The beauty of this is that Veterans will be able to “opt out” of the Regional Offices entirely and proceed directly to appeal. Much like it’s big brother, the Fully Developed Claim, or FDC as we call it, the FDD permits the Veteran to sign away all his legal rights to an adjudication at the local level and proceed directly to appeal in Washington at the Board of Veterans Appeals.  Obviously,  it will permit a much more speedy deniah-decision by a Veterans Law Judge instead of a long, protracted delay at his or her local office. Each Veteran who signs up will be legally entitled to, and indeed, can expect to receive a rapid resolution to their claims- often in less than three years.”

VA officials assured us that the benefit of the doubt will be paramount in these cases and Veterans “will be getting everything that is coming to them” according to one anonymous VA source who begged not to be named.

GeicoCaveman1VA insists the long and the short of this is so elementary that even a cave man can do it. Veterans will fill out a simple twenty six-page VA form wherein they admit their claims have no merit. Concurrently, they will file their NOD citing why they feel the denial is appropriate and any mitigating excuses as to why they think they are entitled to the benefit sought. Specially trained Acting Veterans Law Judges with limited experience will then carefully examine the contentions and issue an appropriate decision based strictly on the standard whim of the moment. In order to prevent a backlog from accruing at the Court of Veterans Appeals, FDD claimants will agree in advance to sign a waiver of appeal to the higher tribunal.

Hickey was positively ebullient about the prospects for “cleaning house” as she described it after she thought the microphone was dead. She insisted later that the comment about “brain-dead Vets” and the “PTSD-109” crowd were taken entirely out of context. “We respect Veterans at the DVA regardless of what Congressman Miller says. Our mission is to deliver benefits to those who have earned them. Just because 85% fail to demonstrate an entitlement doesn’t mean they aren’t out there. We remain committed to identifying them and remunerating them to the full extent warranted whenever possible. Towards that end, we feel the FDD will give them a larger voice much sooner. After all, this is what Veterans Service Organizations continue to stress as their main bone of contention -the interminable wait. The FDD addresses this concern sooner rather than later.”

download (1)To learn more about this new program and how you can sign up, go to uluz.va.gov and click on VA’s New Initiatives. Alternatively, you can contact the Prize Redemption Center at VA’s toll free number (800-827-1000) and talk directly to a trained FDD Navigator. Participation in the program will be voluntary and strictly limited to the first fifty million callers. The FDD will soon be available for e-filing on eBenefits as well. Bon chance, fellow Vets!

Posted in Humor, VA BACKLOG | Tagged , , , , , , , | 5 Comments