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Dealing with insurance for behavioral health services can be a daunting task for providers and patients. The landscape of insurance coverage for mental health and substance use disorders has its own set of complexities. Understanding these intricacies is crucial to ensure that patients receive the care they need while providers are fairly compensated.
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hislop3 · 5 months
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Value-Based Care: What it is and How it Can Work for Post-Acute Providers
I get asked about value-based care a lot. It is a buzzword or term these days, somewhat driven by the rise in Medicare Advantage enrollment. Frankly, it is a bit of a catch-all concept that has its origins in Medicare and various demonstration projects (e.g., bundled payments) and the implementation of quality measures to “improve care” (theoretically). The goal of value-based care is simply to…
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elizabethgrofskyramos · 9 months
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I bought this book for my dad. We have different taste in books. When he finished this one he wanted me to read it. Nice call. I finished it within a day. I laughed a lot.
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chakiryshka · 6 months
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— Mystra would consider...forgiveness?
— She would consider what she considers to be forgiveness.
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arthritiscenterstl · 1 year
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Medicare Advantage plans are often advertised as being a "better" option than traditional Medicare. However, there are a number of ways in which these plans can be misleading. One way is that they often tout their low premiums, but they don't always mention that these premiums may increase over time. Additionally, these plans may have higher copays and deductibles than traditional Medicare. Another way that Medicare Advantage plans can be misleading is that they may not cover all of the same benefits as traditional Medicare. For example, some plans may not cover prescription drugs or vision care. Finally, Medicare Advantage plans may also be misleading about their network of doctors. Some plans have very limited networks of doctors, which can make it difficult for patients to find a doctor who is in their plan. It's important to do your research before enrolling in a Medicare Advantage plan. Make sure you understand all of the terms and conditions of the plan, and that it will meet your needs. If you're not sure whether a Medicare Advantage plan is right for you, you can always talk to a licensed insurance agent.
Your physician's fees are just one part of the overall cost of healthcare. However, your physician can play a role in helping you to control your healthcare costs. By following your physician's advice and taking care of your health, you can reduce your risk of developing costly health problems. You can also talk to your physician about ways to reduce your healthcare costs. For example, your physician may be able to help you to get a prescription for a generic drug instead of a brand-name drug. Your physician may also be able to help you to find a hospital or clinic that offers lower prices for services. It is important to remember that your physician is there to help you. Physicians have no say when it comes to the cost of a medication. They prescribe medications that have clinically proven to help patients that are experiencing similar symptoms or have the same disease. At the end of the day, your health insurance decides what they will and will not cover, how much they will pay leaving the remaining coinsurance for the patient to pay. They also create barriers to avoid having to pay for high cost treatments. Here are some of the ways health insurance is creating barriers for physicians to treat their patients:
Low reimbursement rates: Health insurance companies reimburse physicians at rates that are often below the cost of providing care. This can make it difficult for physicians to make a living, and can force them to reduce the number of patients they see or the services they provide.
Burdensome paperwork: Health insurance companies require physicians to fill out a lot of paperwork, which can be time-consuming and take away from the time they spend with patients.
Administrative complexity: Health insurance companies have complex rules and regulations that can be difficult for physicians to understand. This can lead to errors and delays in the processing of claims.
Preauthorization requirements: Some health insurance plans require physicians to obtain preauthorization before providing certain services. This can delay care and make it difficult for patients to get the care they need when they need it.
Network restrictions: Some health insurance plans only allow patients to see physicians who are in their network. This can limit patients' choices of physicians and make it difficult for them to get the care they need.
These barriers can make it difficult for physicians to provide quality care to their patients. They can also make it difficult for patients to access the care they need.
There are many factors that contribute to the high cost of prescription drugs, including:
The high cost of research and development
The high cost of manufacturing
The high cost of marketing
The high cost of insurance
The high cost of government regulation
Your doctor is not responsible for any of these factors. They are simply trying to provide you with the best possible care. Meanwhile, insurance companies' profits are increasing and patients are paying more for their insurance coverage but often realize they are paying more money for less coverage. They are able to do this:
Raising premiums. Insurance companies have been raising premiums for years, and this trend is likely to continue. This means that patients are paying more for their health insurance, even though the quality of their coverage is not always improving.
Reducing benefits. Insurance companies are also reducing the benefits that they cover. This means that patients are paying more for their health insurance, but they are getting less coverage in return.
Increased deductibles and copays. Insurance companies are also increasing the deductibles and copays that patients have to pay. This means that patients are paying more out of pocket for their health care, even though they are paying more for their health insurance.
Denying claims. Insurance companies are also denying more claims than ever before. This means that patients are paying for their health insurance, but they are not getting the care that they need when they need it.
Using loopholes to avoid paying out on claims. Insurance companies are also using loopholes in their contracts to avoid paying out on claims. This means that patients are paying for their health insurance, but they are not getting the benefits that they are paying for.
It is important to be aware of these practices so that you can make informed decisions about your health insurance. The Medicare Advantage program is a federal program, but it is administered by private insurance companies. These companies are not subject to the same regulations as traditional health insurance companies, and they are not required to disclose the same information about their plans. Medicare Advantage companies often advertise their plans with catchy slogans and promises of low premiums and comprehensive coverage. However, they often do not explain the difference between their plans and traditional Medicare. This can be confusing for consumers, who may not understand the implications of the different plans.
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novelconcepts · 2 years
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The defintion of hell is knowing a show is incredibly well-received in its first season, but if people don’t become machines churning out tweets, content, and rewatching 24/7, there’s no likelihood it’ll get a chance to tell its whole story. This shit is madness. Shows in different genres shouldn’t have to pit-battle for dominance. First seasons are MEANT to be baselines establishing worlds and characters, not complete storylines. The idea that this golden age of television has turned into “get it done in one or get out” is revolting.
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ireonic · 3 months
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Me: how do I study as a neurodivergent person?
Google: how to help your autistic child study
Me: how to study as an autistic adult/teen
Google: teachers guide to how to deal with autistic children
Me: how do I study as an autistic teen/adult
Google: study tips for autistic people(-written by this allistic man that will talk about autistic people like they're zoo animals)
Me: how to study as a neurodivergent adult, tips from neurodivergent person to neurodivergent students, on how to study independently as an autistic person, no reliant support needed
Google: high functioning autism and school
Me: fuck just. How do I focus during this test that I'm in rn as an AuDHD person
Google: ok, so, to focus on this thing that you currently are doing and need to get done TODAY; weeks before the test you'll need to eat healthy and exercise, meditate, study, set timers, take breaks, drink water, sleep, find the secrets to a happy life, adopt five children, sacrifice a goat, take short showers, brush your teeth
Executive dysfunction:
My fucking deadline:
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flamingpudding · 4 months
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Substitute City Ghost
Clockwork had a plan. Their young king needed to learn how to take care of people without the kind of hero like fighting he did in Amity Park. There was a lot to learn for the young halfa and his king classes could only cover so much. Thus he had found a plan that would give his king the perfect learning expirence while also helping out his recently new friend. Well not that new since his friend was quite an old ghost of their own. But he had only recently made direct contact with her.
Lady Gotham was an old and powerful ghost. Born from the beliefs of her city and strengthened by the once living and protecting it. But she was stretching herself thin. Managing her city, helping the dead find their way, looking out for the shades, and protecting the weaker entities, was already a lot of responsibilities for a city ghost. But Lady Gotham has added more to her plate, supporting those that protect her city. Mortals that she called her knights. Aiding them by controlling the shadows, guiding those that need help toward them, or the other way around, guiding her knights to those that needed help. She was strong, but even a ghost like her could grow exhausted. His friend needed rest and recharge. Surely Lady Gotham wouldn't say no if he invited her to a vacation to the Realms, and in that same invitation, he would direct his king to his new hands on training.
The bats and birds knew something was different about Gotham lately. It was strange and slightly unsettling. The change felt like it had just happened overnight. They were suspicious, wondering if they were sensing one of their rogues planning something big. Jason and Duke appeared to sense it the most.
At first, it didn't appear to be too big of a problem, but then strange things started to happen. Their rogues started tripping over, seemingly nothing. And if that wasn't enough it appeared like their rogues were a whole lot more inattentive to their surroundings. Now the Bats and birds were good at sneaking, but they had human limits. Yet there were times they snuck up on them like they weren't even seen.
Dick swore that one of the goons had stared at him and didn't see him, even though he had tried to pull the tap their shoulder and greet them before punching them act. The guy had turned around and stared at him before looking around like no one was even there until he punched the guy anyway.
And that wasn't even the weirdest part. Bullets, throwing knives or anything aimed and thrown at them never hit their marks. Not for the lag of them dodging but for the things they were sure they shouldn't have been able to react in time for. Tim espacially had pointed out that a bullet should have hit him once but it never even graced him. Yet when he checked the place after the arrest. There had been a clear bullet hole in the wall where he had been.
They weren't sure if it was a blessing or a curse. They had even tried to get a member of the Justice League Dark to look into it. But strangely enough Constantine had refused to even set foot into Gotham for once, and even insisted that the other do not either.
To say that Batman was not amused would have been a very big understatement. The man was brooding. And of course Dick had to jinx them too. The eldest bat kid had to mention that it at least wasn't getting worse.
And don't you know it. It got worse. Like weirdly alarming strangely worse.
Because, how else would you define it when you're in the middle of a briefing with your patrol partner for the night when suddenly a Lazarus Pit look alike portal opens below your feed swallowed you up and the freaking drops you into the middle of a crime scene or mugging.
It was only thanks to their training that they were able to react quickly enough after a bound of disorientation. But fuck did that gave them all a good damn heart attacks when that happened the first time to Damian of all people.
Something was definitely wrong with their city. Thankfully they had some sort of hint, because the first time the Pit portal happened to Duke, he claimed that he saw a white haired figure right before it had swallowed him hole and spit him out at a bank robbery.
Danny was honestly believing he was doing a good job as substitute city spirit while Lady Gotham was enjoying her vacation. Sure , he still had trouble with some things, but he was sure he was getting the hang of the whole supporting the cities vigilantes gig Lady Gotham had going on. The whole managing the shades and the dead spirits was still up in the air, though. But at least he had figured out a way easier way to guide the vigilantes towards the once that needed help.
Now he just needed to figure out what was wrong with that one guy in the red helmet and he was sure that both Clockwork and Lady Gotham would be proud of him and how he had managed her city during her vacation.
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lazycranberrydoodles · 8 months
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you’d think after 800 years he’d learn his lesson about taking afternoon naps. / prev comic / follow for more sleepy xie lian
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unepersonnelouche · 5 months
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Narumitsu taking 5 of their 10+ children on a trip (dudes really need to stop collecting traumatised teens)
Original ->
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Everyone from babies to young adults suddenly disappears from Amity Park, and the ghost portal self-destructs as well. The GIW and the Fentons obviously come to the conclusion that it’s ghosts but realize that this issue is way bigger than they can handle, so they call in the big guns, The Justice League.
Of course, they don’t tell the Justice League everything when they come. No matter how much they thought themselves to be heroes, they were simply glorified police in spandex. And with how they operate, they are all too small-minded and won’t be able to see the bigger picture. They also knew fully well that a lot of their methods weren’t even remotely close to being morally or ethically right, and if the JL found out, they would be screwed. So they simply told them enough to get them on their side. 
Besides, how could they not help with how many people were missing? This was going to be easy.
_______
The Justice League didn’t trust the GIW. Something about them was just off. But so many missing people were on the line, so many kids! 
Ghost?
Should they call in the JLD?
_______
Jason knew something was off with Crime Ally.
Nothing was wrong per se. In fact, everything was going great. Crime was at its lowest in like… forever. The general atmosphere was more calm, if not a bit chilly. He himself was calmer. And there were fewer kids on the streets. Which would have been a good thing if this wasn’t fuckin’ CRIME ALLY!
Jason’s been stressing himself out, trying to find out what was going on. He’s been searching up and down, talking to people left and right. No one was reporting anything amiss. Some even told him that they still saw the kids walking around, though not as often as before. And they also looked like they were being well taken care of.
He even saw and talked to some of the kids himself and it was the truth. 
But when he asked where they went, they only laughed and ran away from him. Shouting that he would know soon before they disappeared around the corner. At this point, he was sufficiently freaked out and was so close to getting Batman to contact the JLD, but something told him otherwise.
A few days later Jason was in bed. He had ended patrol early that night and intended to get a full eight hours if he could.
But as fate would have it, he would not. Because just before he could hit the hay he heard it. Well, felt it would be more accurate but how could you feel a siren’s song? Pulling you? Drawing you in. Telling you that it would give you your deepest desire.
He didn’t even bother to suit back up into Red Hood. He just followed it. Followed and followed, Until he got to a dead-end alleyway. But there was no ‘end’. All there was, was darkness. 
He began to get skeptical and took a few steps back. But the feeling was still there. Pulling, telling that all of his answers were in that darkness. Everything he wanted, needed, awaited beyond it. 
He did the stupid thing and went into the darkness.
He didn’t know what he was expecting, but it wasn’t the feeling of walking through thick goop. But the feeling didn’t last long, and he eventually stepped out.
Again, he didn’t know what he was expecting, but it wasn’t this. 
Kids running around without a care in the world, unrestricted. Teenagers just hanging out and being kids too. Whatever adults he saw all looked pretty young, but they were all happy. 
He looked around and noticed that it looked like a weird mix between a suburb and a night market, but it worked quite well. The stalls were all unmanned, and it seemed whoever could just take whatever they wanted. Dim but pretty lights connected all the stalls to as far as his eyes could see. And the sky.
In Gotham, there’s so much smog and bad weather you’d be lucky to even see a piece of blue during the day so no wonder people often forget about the night. But this, the night sky wherever he was, was beautiful, beyond what words and even thoughts could convey.
“Hello, Mr. Red Hood.”
Jason jumped. Was he so out of it that he didn’t even notice someone coming up behind-
Forget what he just said about the sky. The woman right here that was now standing before him? She- She-
“Are you single?”
There was silence. Then she giggled. Guess Jason didn’t need his helmet huh? His face was enough.
He also wanted to die again but hey, at least she laughed!
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honeytonedhottie · 6 months
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fun things to do INSTEAD of scrolling°❀⋆.ೃ࿔*:・🍈
the point of this post is to help u maybe limit ur phone usage and to give ur time purpose and feel more fulfilled.
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learn something new online : start following up with an online course, theres this website (coursera.org) where u can engage in some courses and learn something new. CONTINUOUS LEARNING is probably something that i'd advocate for the most. there r so many things that u can learn online literally dont limit urself, i learned a whole LANGUAGE online. u can learn thru youtube, websites, reading online books, academic journals and articles, my girlblog :) etc
make a video to ur future self : like literally sit in front of ur camera and just chat as if ur chatting to ur future self (this can also double as a manifestation exercise) just TALK to ur future self, its sm fun when u look back and have a conversation with ur past self and to see all the things that u manifested materialized. its a lot of fun fr. this is especially good if ur the kind of person who struggles to see the progression that you've made. looking back on this SHOWS u ur progression.
turn ur phone into a productivity MACHINE : delete apps that make u feel distracted, get rid of old numbers on ur phone, unfollow ppl that give off negative energy/make u distracted. use notion (i love notion with my life) make schedules and to-do lists.
get a hobby : learn something new, start a hobby or continue one that you've had in the past. its genuinely so fulfilling to have something to do. (lately i've been into photography) if u can't find a hobby right at this moment then dedicate ur time and energy into something that'll serve u in the future. for me, i've been putting a lot of my time towards community service bcuz thats something that'll serve me in the future.
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poorly-drawn-mdzs · 7 months
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Introvert adoption
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turtleblogatlast · 1 month
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I love Raph and haven’t said that enough so to be more specific I love that Raph is a soft boy who loves bear plushies, a gross boy who eats an assortment of things that are definitely better left alone, a smart boy who is more than capable of taking down villains through planning and fortitude alike, a strong boy who is dedicated to training his muscles and fighting prowess, a teenage boy who loves his brothers but is more than happy to tease and roughhouse with them, an angry boy who sometimes lets his anger take a hold of him to cover the fear, a gentle boy who is generous with hugs and affirmations to those he loves, a capable boy who takes on more than should ever be expected of a teenager, a good boy who just wants to be a hero and slowly comes to realize the cost of that duty, a good boy who has no reservations about putting himself in the way of harm coming to his family, a good boy who’s a great brother and son and person and deserves only the best the world has to offer.
#rottmnt#rise of the teenage mutant ninja turtles#rottmnt raph#rise raph#he’s so wonderful frfr#my poor boy is traumatized but still so proud of what they accomplished because they’re HEROES#what started as something fun - Saturday morning cartoon-like heroes vs villains esque - soon becomes his calling#and he loses himself a little along the way#because the world is TERRIFYING now#if they don’t do something about the bad things in the world then worse things will come#and Raph CARES too much to let it happen#even at the expense of his own happiness and youth#and he luckily reigns back that fear - knowing his family is there to keep an eye out with him#and he finally lets himself be a kid again#he’s very well rounded and his flaws are so good because (like the others) they are ALSO his strengths#I like how it’s softly implied that bears are his fav animal too bc that’s cute af#headcanon that he likes them so much because a stuffed bear was the first toy splinter managed to get Raph#but yeah one of my favorite things about tmnt is that the characters are well rounded and rottmnt exemplifies that immensely#with raph being no exception!!#amazing big brother and character#there’s a REASON in my tmnt main character tierlist he’s S tier!!!!#hot take but in terms of who should be leader I think it should be less who’s the better leader-#-and more who’s the better leader FOR THIS SPECIFIC MISSION#bc all four can be great leaders fight me on that#APRIL can as well 100%#doesn’t need a designated leader for them to succeed#they just need ~communication~#one of my favorite things tying Raph and Leo together is that they both *hide*#I’ve talked about Leo’s many masks a lot but Raph has one too#and it’s the mask of a hero - the mask of the protector
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egophiliac · 9 days
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Serious question.
Do you think we’ll see the parents/family of each of the guys???
Like, We’ve been TEASED with Ace’s brother, that I’m starting to think it’s just a reference to that Alice in Wonderland park character in Japan and nothing else….
Jack’s family, Ruggie’s grandma, Falena, Maleficia, Ms.Rosehearts, Just now Vil’s dad is in the picture which I am really happy but now I’m wondering about his mom, and so Deuce’s mom.
I mean, some HAVE a silhouette!! It could mean they do have a design in the making/ready to show. They could’ve shown us Falena in the Tamashina (hope I said that correctly) event, but didn’t (prolly to make Leona not so σ(▼□▼メ) and it’s understandable)
Anyhow, any idea/headcannon about this? Who do you want to see first?
I'm wondering if everyone might eventually get a travel event? like they've now introduced with Vil's that it doesn't have to be specifically hometowns, so that opens things up a lot! (especially if they have to figure out how to do three separate Coral Sea visits) (how would that even work otherwise)
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but yeah, I hope everyone gets a chance! there's a lot of backstory characters I would LOVE to meet. :D :D :D though I do think some of them don't really suit the more light-hearted tone of the events (pretty sure you're right about that being why Falena wasn't in Tamashina-Mina, that would've just been. too much for Leona.) so like...we're probably not ever going to meet the Rosehearts. or Maleficia (although I maintain that this would be THE funniest possible way to introduce her outside of the main story, and actually I would love this a lot, can we please Twst) (I need to see her to put Malleus in a froofy little outfit and tell him what a handsome boy he is). but they've sprung surprises like Kifaji on us, and honestly anyone who shows up and tells embarrassing stories about characters' childhoods is good in my book!
characters off the top of my head who I most want to meet: literally any of the Zigvolts, Azul's mom, Ace's brother, Che'nya's grandfather (<- I think he would be a good one for Riddle) (please just any non-terrible adult in his life), any member of Rook's family because I need to see how they managed to produce him, and...really just whoever they can come up with for Silver.
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nelkcats · 9 months
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Refuge
Danny was not retired, technically he came when people needed him, he helped or protected them as the case may be. It just turned out that over the years they stopped needing him.
And that was fine, it meant humanity could take care of itself, it meant they were safe. That was what had to matter, no matter that deep down, the halfa was hurt by the information.
It was harder to accept change when you weren't part of it. Danny was immortal, eternal, and powerful, things that no longer fit the world. Not with all the heroes and wizards running around, not with Amity Park fading away, becoming nothing more than a part of his memories.
He fit in perfectly in the Realms, sure, but he knew that if he stayed there too long he'd stop feeling human, and that was dangerous.
So, no, Danny wasn't retired. But he lived in a simple house in Metropolis, though sometimes he got tired of Superman being able to hear literally everything and moved to his house in Fawcett. He used to switch between the two houses frequently, not that it was difficult since he had figured out how to make portals.
He had a few friends, like the orphan boy who lived at the train station and Conner, a teenager who sometimes just needed a house to stay in when he couldn't stand his father.
Neither Conner nor Billy minded his age, which was comforting, although they both got curious when he visited the other house. Danny didn't know how to explain that Eternity Rock and Superman made him nervous if he stayed too long (he didn't like feeling watched), so he just shrugged and told them he had two houses.
Neither of the kids understood but they accepted it. They both had a habit of calling him "Uncle", Danny thought it was odd, given that his appearance wasn't exactly...adult, but it seemed they were comfortable with that, and he left them alone.
Apparently his house (occupied or not) had become a haven for them. Danny always greeted them with a sandwich, or cookies, even though he felt like a grandmother doing so. He smiled for the first time in years, feeling happy to fit into someone's life.
That's why it was quite disconcerting to find the Justice League outside his door asking him to join them. Danny chuckled internally, because the current heroes actually believed they could force him into something, but he accompanied them anyway.
Superboy and Captain Marvel scowled at the League as soon as they entered the Watchtower, when they were told they were bringing in a "dangerous individual" they didn't expect to see their unofficial uncle.
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