“… The “dirty secret” of the insurance industry is that most denials can be successfully appealed…”
It’s free for users, though she might eventually charge for added services like faxing appeals.
She should sell the home addresses of health insurance executives.
And golf clubs. She should definitely sell golf clubs.
Unrelated fact, but on the topic of golf clubs, they are pretty slender. I think they may bend if you hit a large object with them.
That’s why Casey Jones traded the golf club for a hockey stick in the first movie. At which point he opened a can of whoop ass all over the foot clan thugs.
The smallest child’s aluminum bats are much much more reliable for more than a single swing, and follow through and reset are magnitudes quicker.
I used to carry what I called a “cracker whacker,” on food deliveries. It was a miniature Louisville Slugger baseball bat. I cut off the last ¼" and used a ⅓" drill bit to create a cavity inside. I then dropped in a 3.5 lb round bar of lead that had about 2" of room on one end to shift back and forth as you swung the bat. I then resealed the bat using the cap I took off, some wood epoxy and 4 finishing nails, just in case.
That thing would easily have shattered a kneecap if I had ever had to actually use it, rather than just brandishing it.
Jesus Christ dude, a Louisville Slugger by itself could shatter a kneecap
I think they’re talking about the small souvenir ones. They may still be able to, but as they’re much shorter the force is weaker. Along these lines, it’d be better to add a larger weight towards the end of the bat instead of a rod all the way through. You want as much mass on the far end as possible, and maybe if you care about weight then less mass closer to you.
You’re correct. It was one of the small souvenir ones. I added the shifting weight so that it would slide to the far end of the bat as I swung it, drastically increasing angular momentum
Camden?
Well these days you should carry a baseball and a glove in your car/home, gives you plausible deniability.
While it sounds extremely effective, your cracker whacker sounds extremely felonious. :)
As all the gun guys say “better to be judged by 12 than carried by 6”.
This quote sounds like a promo for a porno.
Yeah, and those guys have guaranteed never had to fight hostile litigation / prosecution and finance it.
You’d rather be dead than deal with fussy legal shit?
And where did I say that?
financing that shit is free since in a criminal proceeding it would be appointed to you, i think the same might be true in a civil matter, but im not sure how that would even apply here.
You will always need your own separate legal representation in all cases always. My attorney charges $850/hr in six minute increments. Anything having to do with attorneys, judges or courts is never ever going to be free.
Yeah, honestly the appeal is a standard step in the bottom surgery process in the states. I know one lady who had to explain to her insurer why removal of the penis was a necessary step in her vaginoplasty.
“are you sure it needs to be removed? Have you considered just taking it off first?”
The insurance, probably
“We heard that song. Aren’t they all just detachable?”
detachable penis
In an ideal
worldcountry, we would have a different system, but we don’t live in an idealworldcountry, so what I’m shooting for here is incremental progress and making theworldcountry suck a little less,”.It’s a good article. Don’t let that American exceptionalism creep into it.
my brother in christ, “in an ideal world” this string is a fucking turn of phrase.
The turn of phrase refers to things that are natural facts, human nature, stuff like that. This one isn’t any of those things, it’s weird to use it to refer to something specific to one country or place.
“a way of saying or describing something”
hmm.
“Rather, Washington’s national security establishment has unthinkingly internalized a Trump-era turn of phrase that is rife with unrealistic expectations and unvetted assumptions.”
hmmmm.
… I thought most people actually just appealed most denials???
I was pretty sure this was already common knowledge?
90% of the time what happens is that you call up your insurance for some shit like hey my jaw be broken as fuck, and they go “nah thats cosmetic” and then you spend 2 weeks fighting with them until they cave and actually cover it.
you call up your insurance
They’re “solving” this problem with less agents or customer service staff, automating the process so you have a robot to deal with that doesn’t ever seem to understand what you’re saying, and can’t get you to the right place. Basically make it as hellish as possible to even get your issue reviewed. Then, they stone wall you and don’t take yes for an answer no matter what
ah yes, this should be illegal, i don’t care how much money it saves.
We love some good news to start the day
Gave it a go. Seems like it has potential. I’m still working through an appeal. My wife ended up in the ER in May and was directly admitted to the hospital for emergency surgery. Ten days afterwards we received a letter from the insurance company saying they had decided it wasn’t medically necessary so they wouldn’t be paying the $67k bill.
It has been a journey trying to get the appeal together. I had hoped the hospital would at least assist with a letter from one of the many physicians that attended her, but nope. We got laughed at by the surgeons office and told condescendingly "Yeah, that’s not how any of this works. "
My biggest concern from the AI generated appeals are being able to confirm the statements it is making isn’t just a LLM hallucination. As a lay person, much of the things necessary to make an argument are paywalled out of reach. For example, the insurance company cited the “2023 InterQual criteria for Surgical Conditions” as the reason why they are denying it. The AI appeal that was generated states that per the 2023 InterQual criteria for surgical conditions that hospitalization was medically necessary.
The only way it seems you can actually get access to InterQual is as a medical provider / payer.
You go human
Interesting idea, but I imagine it suffers from similar issues to writing legal opinions: by signing your name to it, you’re swearing that it’s all true. Given AI’s propensity for making things up, you need to check everything.
I wouldn’t be surprised if ‘knowingly filing a false appeal’ is a reason to boot you off the plan in the first place.
I wouldn’t be surprised if ‘knowingly filing a false appeal’ is a reason to boot you off the plan in the first place.
For that to be an issue you would have to “know” it was false.
You signed it, verifying that you knew what it entailed. That’s what the comment was pointing out.
What’s the legal code if you THINK something is true and you affirm it, but you are wrong. It can’t be the same as lying since you thought it was true.
I really wonder what the law says on something like that.
At least for something to be perjury there usually has to be “mens rea” (guilty mind).
Usually when signing things off like this, it’s affirming that you believe all statements to be true. They would have to prove you willingly lied, not that you were simply wrong, which is very difficult to prove legally.
That said, IANAL.
‘Reckless disregard for the truth’ shows up sometimes, especially in e.g. defamation.
If the AI cites some legal case from 2015 or a random medical article, you probably need to ensure that those articles actually exist, and not simply assume that the AI is right.
If the AI said that a month’s supply of Fentanyl is the recommended treatment for a headache, no reasonable person is going to believe it. That means that if you say that you believe that, the court isn’t going to consider you a reasonable person.
IANAL either.
I think when you use AI to write the claim and there turn it to be errors even after you checked it, it could still be a case of negligence. Like, not that I think it necessarily should be, but I can see that one could make the argument.
by signing your name to it, you’re swearing that it’s all true.
Lawyers too use qualifiers like ‘To the best of our knowledge’ and ‘in our studied opinion’ to indicate that opinions may differ. That’s why judges exist, and some of them are -so reasonable- that they will accept that people cannot be expected to decide whether a hospital’s decision to operate -immediately- is not good enough.
These US ‘insurance’ companies are in the business of making money from people’s health problems. In MOST OF THE CIVILIZED WORLD that’s not how health-care works. We, the people of the US, let the system get rigged this way … we have to fix that. Permanently.
It’s still a lot easier to review and understand something you weren’t able to write than to also write that same thing without knowing how to write it.
Gender affirming surgery can be the opposite of health care, supporting what neuro-diversity thinks it needs is often harmful to that individual. For example, you wouldn’t prescribe unlimited sleep for someone with narcolepsy.
The states has bad healthcare but this is a misleading article, and not necessarily in support of patient health.
There’s been quite a few reports for this comment, I don’t know if it’s right to remove it, since to me it just comes off as misinformed more than anything and I believe seeing the rebuttals here, coupled with the original comment, is actually more helpful and constructive to the conversation.
Even so, I’ll let the reporters decide if they still wish to hide this comment.EDIT: I’ll give it another 12 hours (ending 09:20) to gather feedback since most haven’t responded, I’ll remove if nobody says otherwise
I agree with this analysis of the reported comment, and chose to leave it as it has provoked a constructive conversation. It does not appear to be malicious in nature. I will keep an eye on this post to make sure things remain civil. Thank you.
Yeah, though I am still quite unsure, the majority were for removing: 2 that have reached out again, against none other than you who agreed on keeping, factoring in the initial reporters, 5, minus 1 who I count from before, I think I should still remove.
I’m actually past the deadline I gave myself but I want to hear what you think firstI appreciate your thoughts on the matter. I understand that the comment is not based on science and speaks of neurodivergence in a negative manner. By removing the initial comment, I believe it would take away the effectiveness of the commenters below. People vote with the down button and the user can see how unpopular his/her comment is. I don’t wish to overly moderate a community if there is no active harm, especially when others have meaningful sub-comments that can help other casual readers understand the different aspects of what gender affirming care entails, hopefully enlightening others to see it is more than just for trans persons. I respect everyone’s thoughts on the matter, even the ones telling me I am wrong for not removing it. I am still sticking with this decision. Thank you for everyone’s input.
By removing the initial comment, I believe it would take away the effectiveness of the commenters below.
This is demonstrably false, bigots thrive on “just asking questions” which is a well documented trolling tactic, and the replies to their comment will remain even if you remove the bigotry.
I don’t wish to overly moderate a community if there is no active harm,
But there IS active harm - you leaving these transphobic ableist comments up lets neurodiverse trans people like myself know that you prioritise your need for “neutrality” and “meaningful debate” (which is not happening here, you’re just providing more platform for a bigot to spread their bigotry and misinformation) over our safety and inclusion.
I respect everyone’s thoughts on the matter, even the ones telling me I am wrong for not removing it. I am still sticking with this decision. Thank you for everyone’s input.
Obviously you only respect your own opinion then.
Thanks for making it clear that people like me are not welcome or safe in communities you run, I’ll be avoiding them all, as I’m sure others will.
But hey, well done you, you defended a bigot!
An opinion that ignores all actual research.
Gender affirming surgery helps 99% of people who receive it! So sure, technically, there’s a tiny minority who regret it. More people regret Lasik and boob jobs, should we ban those too? Many people regret a night out drinking, how about we ban that too. Drinking causes way more harm than giving estrogen or testosterone pills to folks.
On the other hand, I like that my friends have the freedom to express themselves any way they want. They aren’t hurting anyone so let’s let them be free to wear whatever clothes they want and take whatever hormones they want.
So join the side of American freedom and let’s stop policing what clothes people wear or what name they use.
It’s about risk.
I don’t think many people are seriously suggesting banning gender affirming surgery, I certainly am not.
But to your point; yes it would be better if more thought, research, alternatives and wholistic health was put into LASIK, or alcohol, or even just food.
Both individuals and society would benefit, which is why many governments make medicine essentially free.
Like hair plugs? Or Viagra?
Kinda, but more dangerous and political
What does one need im order to get a prescription for unlimited sleep? I gotta get on that
I’ve heard that there are lots of ways to help you take an infinitely long nap.
lol
Here’s your reminder about gender affirming treatments like testosterone pills and jawline surgery and hair transplants: Elon got all three
Ha I wouldn’t use Elon Musk as an example of someone who makes good decisions.
And i think he eats bulking powders enough for Arnold, but forgot the training.
Okay, i happen to actually have narcolepsy & be gender nc, and have a trans partner, i feel like i can speak with some authority on this.
Gender affirming surgery can be the opposite of health care
Every surgery can be, but gender affirming care is one of the least regretted surgeries in existence. By opening this way, you frame the argument as different for trans healthcare. Its not.
We’re also not children. Dont infantilize trans people. We have the same right to make choices others don’t understand, just like cis folks can.
And narcolepsy is a chronic inability to get delta wave sleep. Extra sleep is absolutely treatment. I can see what your getting at, but you’re choosing examples you don’t understand and misinforming people.
I think we agree about surgery, which is kinda the point. And because of that trans healthcare is not different than other health care, that’s also the point.
And I completely agree extra sleep can be used to treat narcolepsy, but it can also make things worse, which is why you need to look at all the options, balence etc.
Medicine is rarely a simple matter of one treatment for all issues.
Maybe take that transphobic take to a community that doesn’t have LGBTQ+ resources as a pinned thread.
Could you please point out how their statement was transphobic? Basically, what they said is just that “gender affirming surgery can sometimes be harmful to health”, and surely that’s just a true statement, not even an opinion, really.
They are saying gender affirming healthcare is often harmful when the medical literature available says the exact opposite. What motivation do you think they have for misrepresenting available medical knowledge?
I didn’t see them say “gender affirming surgery is often harmful”, they said it can be harmful. Regarding “often”, they said that “what neurodivergent people want is often harmful”, which may be wrong, IDK, but is definitely not transphobic.
As for their motivation, we can’t know. They didn’t explicitly indicated and there’s insufficient info to make assumptions.
“Gender affirming surgery can be the opposite of health care, supporting what neuro-diversity thinks it needs is often harmful to that individual. For example, you wouldn’t prescribe unlimited sleep for someone with narcolepsy.”
… Brushing your teeth can be the opposite of healthcare. sometimes idiots mistake electric toothbrushes for dildos and shove them all the way up their ass.
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Gender affirming surgery is healthcare.
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The idea that trans is “neuro-diversity” is… huh? Do you think gay people as “neurodivergent”?
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Neuro-divergent people often have to advocate for themselves.
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Doctors are educated more about the subject than a random lemming and are more suited to making medical decisions. The research says basically nobody regrets it.
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Surgery is harmful. Sometimes the doctor has to cut you open. But the benefits are often much greater for the patient.
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I’m just JAQin off brooooo, I gotta JAQ offffff, im JAQin offffffff, Im just curious bro, I’m JAQin in my jorts bro, im nearly there bro, I just gotta keep JAQ’in offf brooo I’m nearly there bro you gotta help me finish, au au Im
It’s ok, from all the downvotes and lack of genuine answers I already understood that asking questions here isn’t encouraged and I should just treat this as a religion.
But if anybody eventually decides to sincerely answer my question, I’m still interested in expanding my knowledge.
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I’d love to see the double blind white paper that quantitatively shows that.
The thing is gender affirming surgery is for treating a mental state.
That means it isn’t qualitatively different than other surgeries to treat mental states
That doesn’t mean its bad, but it does mean its potentially dangerous, and counter-medicinal, unless carefully vetted and compared against nonsurgical treatments.
Is prescribing sleep surgery?
No but its giving the neuro diversity what it wants, which isn’t always bad, but can worsen an individuals health.
You wouldn’t prescribe complete isolation as a treatment for social anxiety, except in very extreme and uncommon cases.
As someone with IH/N2 (idiopathic hypersomnia/narcolepsy type 2) extra sleep doesn’t do shit.
Exactly.
Pictured: average Lemmy user.
Tag yourself, I’m the dog
I’m calling the oddly placed bosu ball.
I wish the average Lemmy user was writing open source tools that help people fight mega corps. That would be amazing!
might try that tbh, what’re your ideas?
I’m not sure what you can do. But she wrote a cool tool that generates appeal letters automatically. Just find what is bothering you and work on it.
Same thing but to automatically send emails to your local political representative. Bonus points if I don’t even have to know who it is
Not fully automatic, but Resistbot may be up your alley: https://resist.bot/
Too thin
Hehe her dog is a donut hole with a PhD.
I think the PhD may be honorary in Timbit’s case. Though I suppose if she has a doctorate as well, she may have used him as a rubber duck, and therefore given him credit on her Doctorate Thesis, thereby granting him a doctorate as well? I dunno if that would work.
…This is just a network switch/router.
She’s turning into Lain.
Also looks like a few enclosures on a lower shelf (which could be anything) but technically you can run WAN-exposed servers on most routers, not that it’s advised just possible.
You sound like one of them fancy book reading types you get the fuck out! Lol
