jas007

I assume that the bill ran over the estimate because the actual cost was more than the estimate. Remember, an estimate is just that, an estimate. I’m sure all parties would agree. How could it be anything other than that? It was prepared before any services were rendered. In any event, to say that the Guarantee of Benefits letter is binding only to the extent of the stated guarantee amount means that there really is no guarantee that all covered services will be paid, even though the guarantee letter itself suggests otherwise. What good does that do the patient? “Here’s a Guarantee of Benefits” letter. You might be insured, or you might only be partially insured.” That’s the gist of it. An illusory guarantee. The patient is in a vulnerable position. Services have been rendered and the hospital expects payment. The patient will not be discharged unless the bill is paid. The patient is an easy target in a vulnerable position. It seems to like the hospital wants all the benefits that it is entitled to as a listed provider, but does not want the obligation it probably agreed to as part of the agreement to be a listed provider. The hospital is able to bill the insurer directly and is assured payment for all covered costs. That’s a benefit for the hospital . On the other hand, the patient is assured that payment will be made for covered charges. I do believe that this arrangement must be part of the contract between the hospital and FEP. Why should the patient be pressed for payment of charges that are covered? If the reasoning is that some of the charges submitted might not be covered for whatever reason, that means the patient has no real guarantee. It puts the burden of possibly having to file a claim back on the patient. But that’s precisely why direct payment procedures were established, I’m afraid. The patient wants a real guarantee, not an illusory one. Anyway, I paid the money because it was no big deal and I was in no position to argue. In the future, I’ll know better than to expect appropriate treatment. For what it’s worth, I currently have a whole stack of paperwork for various routine office visits and tests all performed at that hospital. I have always settled the bills by paying directly, and I have never filed a claim. My tolerance for nonsense claim forms is very low. Almost zero. At some point, I might think about filing a claim, but I certainly wouldn’t do it for just a few hundred dollars. I probably wouldn’t do it even for 21,000 baht. I’m just aggravated at this situation because I don’t think it was handled properly.

I looked into Italy one time. The residency process is not simple. You first have to have a place to live, and lease agreements in Italy are typically longer term leases for several years. The places are usually not furnished. So you are put in the position of having to rent a place you might not like, just to apply for residency. You could also buy a place without being a resident, but how would a person know anything about a particular location without first having lived in the area?

One of my old friends once obtained a large Pace Arrow motorhome for almost nothing. Everything worked, and all he had to do was update the upholstery. He didn’t really want it, but figured that for $1800, he couldn’t pass up the deal. I think he used it once or twice. The rest of the time, it just sat there. He finally got the bright idea to rent it out. And he managed to get a lot of customers. People who wanted a vacation with the family, people who wanted a vacation in a motorhome, and people who didn’t mind that the miles per gallon rate horrendous. I think the thing got five miles per gallon. Anyway, something was always going wrong, but under the rental agreement, people had to pay for whatever they broke. I think the people who only want to rent one once in a while have the right idea.

Sheryl, I could have argued with the staff in the insurance office, but I would have been wasting my time. Anyway, maybe I’m assuming too much. I’m not sure how the system works in Thailand. One thing I know for sure is that trying to argue with a clerk in a hospital will get me nowhere. It will be one excuse after another. I know a little bit about how certain things happen in the USA. Take Medicare, for example. A potential Medicare provider has to go through a series of steps to participate in the Medicare program. Most doctors go through these steps, as do most hospitals and other providers. In order to become a Medicare provider, they have to be properly licensed and certified under state law, they have to make an application to Medicare, and they have to supply supporting documentation. Depending on what type of services they provide, they may have an on site inspection of their premises. And if they are approved, they get a Medicare provider number. When they then treat Medicare patients, Medicare will cover claims for approved care. In some cases, the Medicare providers can also agree to “accept assignment.” That means the patient assigns his Medicare benefit to the provider, who is then allowed to bill claims directly to Medicare. As part of that deal with Medicare, the provider agrees to accept the payment received from Medicare as payment in full for the services or medical equipment provided. The patient is out of the loop, so to speak. Medicare claims filed in this manner are paid immediately, if properly coded. Sometimes, Medicare will subsequently go back and review the submitted claims as part of its audit process. And if Medicare determines that any particular claim should not have been paid, they will seek to recover that money as an overpayment. Sometimes, Medicare will find that the treatment provided was not medically necessary. Sometimes they’ll find that the particular services provided are not covered by Medicare at all. And sometimes they will find that the claims submitted are simply fraudulent. That’s called Medicare fraud, and there’s a lot of it. In my mind, the process of becoming a listed provider under the FEP overseas plan probably works in a similar manner. The hospital or provider enters into an agreement with the FEP plan, and as a part of that agreement, they agree to a direct billing arrangement. The patients obligation is zero, if that’s what is stated in the Guarantee of Benefits letter. The benefit to the hospital is that they are assured payment for covered services. So it seems like the hospital wants the benefits that go along with being a listed provider and the benefit of direct billing, but they also want to keep the patient in the loop as a “backup.”

Tulsi Gabbard is ok. And for that reason, she doesn’t have a chance. She understands what’s going on, but she’s not willing to adhere to the official narrative. She actually thinks for herself. For the Deep State people, Biden has been perfect. Someone they can control like a puppet. Even Putin has said he prefers Biden over Trump. Putin thinks Biden is “predictable.” I can’t imagine why anyone would want the job.

Of course RFK Jr. could win. But the Democrats won’t touch him. They’ve gone out of their way to paint him as a nutcase. An anti-vaxer. A conspiracy theorist. They’ve repeatedly denied him Secret Service protection, and they did everything they could to keep him out of last night’s debate. He won’t follow “the narrative.”

Presnock, Thanks. You’re right, I think, and I will write to the BCBS FEP carrier. Apparently , there are lots of carriers operating under the BCBS banner, so I’ll have to figure out the correct people to contact. In any event, the entire situation sort of irked me. Not because 21,000 baht is a lot of money. It’s not. But what about the guy who uses a particular provider because that provider is a listed provider under the plan? What about the guy who receives a Guarantee of Benefits letter indicating his obligation will be zero, and then goes ahead with the scheduled treatment, only to be hit with a request for a “deposit “ after the services have been provided? What happens if a person just says NO? I’m sure some people simply wouldn’t be able to pay. I understand that the hospital just wants to be paid. It’s a business. But that hospital also has a deal with the Plan as to direct billing and the patient’s obligations once admitted and treatment is completed. It’s a contract. The hospital is paid directly and doesn’t have to try to collect from the patient, and in return the patient has no remaining obligation to the hospital once benefits are guaranteed. It’s simple for everyone concerned.

I wasn’t planning on watching the debate, but since I was in the hospital in Bangkok and didn’t really have anything else to do, I figured “why not?” The hospital’s cable didn’t include CNN, but the debate was simulcast on another channel. Anyway, my take: the moderators seemed decent and unbiased, for a change. Has CNN turned over a new leaf? As for the candidates? Trump was just being Trump, but he seemed more measured and subdued than usual. Biden did better than I thought he would, although that’s not saying much. Occasionally, he could actually finish a sentence. Maybe even two sentences back to back! Nobody watching the debate could reasonably conclude that Biden was fit for the job. And yet there he was, up on stage, presumably a candidate for the presidency. The “Leader of the free world.” What could the Democrats be thinking? Over three hundred million people in America, and this is the best they could come up with? The really shouldn’t be doing this to Joe. Some would call it “elder abuse.”

Here’s the situation in a nutshell: I had surgery as an inpatient and was admitted to a preferred provider for one night. The hospital had previously submitted an “estimate of charges” for pre-approval and in response, GeoBlue approved the amount for the surgery and related costs based on the hospital’s estimates. The hospital would receive everything they asked for. Anyway, all went well with the surgery, but when it was time to leave, the hospital billing office called my room and explained that since the actual charges exceeded the maximum amount set out in the guarantee of benefits letter, I would need to pay the difference of 21,000 baht or so. No big deal, but I was under the impression that the terms of the agreement between the hospital (preferred provider) and Blue Cross provided that the patient’s bill would be paid in full for all covered expenses, and that claims for any amount due would be settled between the hospital and the insurer. Anyway, rather than argue too much with the billing office, I just paid the bill. I was told that when the final charges are finally settled and paid, that I would be reimbursed. Am I wrong in thinking that this is a matter usually settled between the hospital and the insurance company, and that the patient should not be presented with a bill at discharge?

And that’s your problem in a nutshell. “The Hitler of our era.” You really believe that, I think. That’s exactly what they want you to believe. It’s not your fault. Lots of people fall for the propaganda.

And what, exactly, should I be imagining? Yes, I can imagine secondary sanctions. I just don’t see it happening. The U.S. has nothing to gain at this point, other than to further piss off the parts of the world that aren’t already sanctioned for one reason or another.

That’s easy to do, so long as you have active US credit cards, an active U.S. bank, and can use the credit cards in Thailand. Maybe paying rent would be a challenge, but you could probably find a way to pay for just about everything else with a credit card, especially if you mostly get your food from a grocery store that accepts credit cards.

Do I believe the economy is in a Great Depression? No. I believe it is what it is, notwithstanding all the official statistics. The numbers indicate everything is fine. And maybe it is. Or not. They certainly want people to believe everything is fine. We hear it every day. “Wall Street hits another new high.” “The dollar is stronger than ever…” “The economy is doing great.” “Unemployment is down.” “Millions of new jobs have been created…” In any event, I’m pretty sure most people know things aren’t so great. Even the government officials. And yet they like their jobs and want to keep them. I’m one of the ones who personally profits from the fact that there are people who believe the narrative. Everything is great! So, every day when I open my brokerage account, I look to see how much “money” I made doing nothing. It’s not that way every day, but the account does grow over time. So from a personal standpoint, I’m fine with all the statistics. Fiction of not, I hope it continues.

The U.S. economy is robust? Well, not really, but they really would like people to believe that. Have you considered the fact that the only reason things are functioning at all is because the government continues to spend money it doesn’t have? They’re now borrowing money at the rate of a trillion dollars every 100 days. Is that a sign of a robust economy? What about the banking sector? On life support. How about the commercial real estate market? Large buildings selling for a fraction of their original purchase price and a bunch of banks holding the bag. What about the rising consumer debt? Credit cards, auto loans, etc. There’s no end to it. And let’s not forget the continued decline of the middle class. People unable to afford houses, food, education, healthcare, insurance. Is all that also a sign of a robust economy? The economy is whatever it is. For some people, it’s booming. For other people, it’s a major depression. In any event, people who think everything is fine will soon find out otherwise. In the meantime, the party continues!

Trump Defense Syndrome?. If you say so. I don’t have any particular love for Trump, other than the fact that he’s an alternative to all the nonsense currently coming from the left in America. If that means I support Trump, then so be it. I happen to believe in free speech, free elections, the rule of law, the Constitution. Without all that, what do you have? You might as well be in North Korea. I’m also not a warmonger. As for a “convicted felon” having a new dynamic draw? It would seem so. Then again, maybe you miss the point. The only person in the world who would ever have been charged, tried, and convicted in such a case was Donald Trump. The entire thing was manufactured to get Trump. That’s the mentality at work in New York.

Secondary sanctions? I doubt it. I can understand how such a situation might come to pass, but in reality I can’t imagine it. If anything, the U.S. would like a stronger foothold in Asia, and that doesn’t happen when you’re trying to punish much of Asia. To the extent that China is considered a threat, the last thing the U.S. would do would be to impose sanctions on an Asian country simply for expressing an interest in BRICS. If they sanctioned every country that did that, they’d only be hurting the U.S.. They can’t sanction most of the world. I think they’re beginning to realize that. Then again, maybe not. The stupidity of the people seemingly calling the shots is incredible. They seem to think that any problem can be solved through the use of sanctions.

Everyone knows that except, apparently, the people with Trump Derangement Syndrome. All in all, the prosecution helped Trump. Immediately following his conviction, he raised millions. His poll numbers improved. The publicity was priceless.

The open borders issue is critical, right? Millions of people show up in wealthy countries from poorer parts of the world. And those people require food, shelter, medical care, and other necessities. And yet those resources are not free. Milton Friedman once commented that “you can have a welfare state or you can have open borders, but you can’t have both.” Something like that. And it’s true. There are now eight billion people in the world. And most of those people don’t have much of an income. Of course they will come to Europe or to America. Why not? Those showing up in the U.S. seem to get the royal treatment. Free housing, free money, authorization to work, mobile phones, etc. The government could stop that, but it refuses. Perhaps they’re counting on many new democratic voters and they don’t care about the consequences. Or, maybe it’s part of a larger more sinister plan to destroy what’s left of America? My guess is that it’ll all backfire. Whatever the plan, the nonsense will stop, one way or another. As it now stands, the middle class is being eroded. The average person can no longer afford to buy a house. Eating basic food is becoming a luxury. A lot of people don’t realize what’s happening or why. What they do know is that there’s a problem and, from what they hear from the propaganda channels, it’s transitory. Or it’s Donald Trump’s fault. Or it’s the Russians. Or, maybe they’re being told that everything is great. After all, the stock market is hitting new highs.

I don’t follow UK politics, but the Farage guy is interesting. Reform type candidates attract voters who are fed up with the system and aren’t going to take it any more. Someone comes along to buck the system and people listen. Sometimes, it works. It’s understandable. Look at what just happened in Argentina. Trump was elected, in part, because many people would vote for anyone but Hillary. They were fed up. People weren’t voting for Trump. They were voting against Hillary. They were sending a message. And to this day, the Democrats still don’t get it. The message wasn’t received. And so we’re about to have round two. The establishment vs. just about anyone else. In this case, it’ll be Trump again. His popularity increases every time the justice system moves against him, every time some establishment clown opens their mouth in congress. ”The border is secure.” As millions of people pour through. “No one is above the law.” Except for certain people…..

People in the know have known all along about the authenticity and content of the laptop. They absolutely knew it wasn’t “Russian misinformation.” But the election was looming, so, as usual, a narrative was concocted. Is it really all that surprising? Some people will believe anything, I guess. Anyway, the lies and deception have continued to this day. The laptop story is but one example.

Anyone paying close attention to the COVID story since its inception doesn’t need a video to know that the public was fooled. Lie after lie, intense propaganda, etc. To what end? I have my suspicions, but at this point it’s too late for many people. No one can go back. No one can undo the damage. Not everyone in the world remains deluded, though. Authorities in some countries are speaking out. Conspiracy theory? Hardly. The truth is emerging. Anyway, back in January of 2020, Twitter was still Twitter, and its content was still heavily censored to conform to the government’s narrative. But for anyone closely watching, the truth wasn’t censored instantly. At the time, I had my Twitter feed set so that any posts tagged with certain terms were immediately pushed through to my feed. I saw many posts before the censors got to them. Those posts didn’t stay up long, but they were up long enough for me to read them. And what I saw was everything they didn’t want the public to see. The posts may have been deleted within 30 seconds or so, but I saw them. It was obvious a false narrative was being constructed. Delete some posts, allow others. Why would they do that? Surely the authorities would want to solve the problem. Surely they would want the truth to surface. Nope. That’s not what they wanted. They wanted people to believe that a deadly virus had emerged and was spreading around the world like wildfire. People were dropping dead by the thousands, and the only hope for humanity was a vaccine currently being cooked up by the drug companies. It was all an emergency. Listen to information from the authorities and only the authorities. Anything else was “misinformation.” Of course, the authorities pulled out all the stops to silence some people. People were threatened with the loss of their jobs for not being jabbed. Even in court they continued the foot dragging. Was it Pfizer that wanted 72 years to release information about the drug trials? That eventually didn’t work, but that was the intent. Delay. Obfuscate. Lie. I could go on all day about what they didn’t want people to know, but suffice it to say it was obvious to me. The authorities were lying to people. I wasn’t quite sure why, but there was no way I was being injected with anything. I wasn’t working, so they couldn’t threaten me with the loss of my job. I didn’t need any medical treatment, so they couldn’t come at me from that angle. I was a fee human being. As for the mask business? I kept a cheap mask in my car for my short trips to the grocery store, but only to make those people happy. No big deal. Otherwise, life was more or less normal in Arizona. Once travel opened back up in 2022 and I could return to Thailand, I did just that.

I have Apple TV. It’s part of a bundled service. Apple TV, Cloud storage, games, Apple Music. The “individual “ plan is $19.95 a month for the bundle. I’m sure Apple TV alone would be cheaper. Anyway, there are some decent series on the platform, a some good movies. You can also purchase movies for your library. All in all, it’s not a bad deal if you use it.

Probably wishful thinking on my part, but maybe it will end based on terms recently suggested by Russia. A negotiated settlement along those lines would stop the killing, preserve what’s left of Ukraine, and keep Ukraine out of NATO. That’s as good as it’s ever going to get for Ukraine and for the West. And the alternative? WW III.

Neither of those things is going to fix anything. They’ll just tell you what’s wrong, if anything. It sounds as if you already know what you’re doing wrong. Why not just stop? Stop smoking. Stop drinking. That can’t hurt, unless you’re hopelessly addicted to alcohol, in which case you might need some medical help. One of my old friends now has lung cancer. He had surgery a year ago, but the cancer returned. He was a smoker for 50 years, but he refused to quit. He has now quit. It’s funny how the fear of death will motivate people to do the right thing.

Most people have no clue. It’s huge money. I could go into much detail, but I won’t. Just imagine a pile of billions of dollars. Imagine all the vultures, feasting on a daily basis. Imagine the corruption. And much of the process is on autopilot.