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Allowed Amount – Medical Billing Terminology

Hello and welcome to another issue of my blog!  Just as a reminder I have 4 kinds of blogs and you can find out all about them at the bottom of this post. 🙂

This post is for my medical billing series.  Whether you are in the medical industry or not, this post IS FOR YOU!!  Everyone visits doctors – either because they are sick are trying to prevent sickness.  Either way, this series is to help you understand the crazy world of medical billing.  I will be posting on everything from billing terminology to crazy diagnosis codes.

img_5317Today, I am discussing something that many people do not understand – Allowed Amount.  What does this mean?

If you read my post, How to Read Your Medical Bills – Is it Even a Bill? then you may already understand what this means.  (And if you haven’t read it, you should grab a cup of tea – or coffee if you aren’t allergic to the bean like me,☹ find a comfy spot and read it.)

However, whether you have read it or not, I Continue reading

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No insurance. Ugh!! (Warning! Scary pics of my throat!)

**Before I get started I must warn you, there are pics of my throat in this post and they are nasty!

Being a work from home mama means I haven’t had the opportunity to get medical insurance on myself. I mean, I’m a mom! I don’t have time to be sick! I have insurance on my kiddos. You know…my little goblins that go to school every day, don’t wash their hands near enough and Lord, lets not discuss how bad their bathroom can get!! And you guessed it…yep, I’m the one who cleans all their messes, wipes their brow when their sick and tries to keep them healthy.

Now me? Yeah, I hardly ever get sick. (But boy when I do – its a doozy!) So insurance is just not something I’ve thought was necessary. (Although as I get older I know it will be mandatory.)

What does all of this mean? It means that when I do get sick (and it isn’t something I can just sleep away) I have to pay an arm and a leg to be seen at an urgent care clinic or sit in the ER. Today I chose the ER, because everyone knows it takes forever to get through that mess. This means I’ll get to take a nap! Without the oldest 2 arguing and the youngest one slapping me in the face saying, “Mama? Mama?” wanting me to play.

Here was my experience:

12:00 noon – Admitted. People watching can be fun. In the ER, not so much, it was just sad. There was an elderly woman that was in a wheelchair and she just kept repeating, “Help me, help me, help me” over and over in a tiny little frail voice. Her daughter was there holding her hand telling her it would all be ok. Then there was a couple. The girl was checking her boyfriend in for depression. She was pregnant and obviously on some type of drug. And then there was Mr. Tattoo. Covered from head to toe with tats (not tasteful ones) with crazy hair and a face mask on, popping wheelies in the wheel chair someone had put him in. Ugh.

12:10 – Triage done. Lets move to a room. (What already?! I didn’t even close my eyes yet!)

12:13 – Oh hell no! The room they put me in had some kind of crusty white stuff on the mattress…

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And someone else’s hair on the pillow…

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I will not be taking a nap on that! I thought they changed these or had some kind of paper sheet in between patients! Gross!

12:15 – Nurse Ellen is here. Nice enough I suppose. She gave me ice chips so I was pretty excited about that. 🙂

12:25 – admitting is here: how are you going to pay for this? Out of pocket…sigh.

12:30 – Doc is here. Super nice guy. Looked in my throat for all of 2 seconds and said, “Oh goodness”. Because that’s what you want to hear all the doctors say.

This is what the right side looked like:

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This is what the left side looked like:

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The weird part is…it’s the right side that really hurts! Not the side that looks like I have a tooth growing in my throat!

Then basically said he wanted to give me a shot of penicillin in the butt to clear it up. And I could have a shot of steroids to reduce swelling faster (I opted out of that. I hear steroid shots really burn.) then a script for some liquid pain meds? Yeah…I don’t know about that.

1:06 – Still waiting on that shot. And starving. And can’t lay down.

1:10 – Nurse Ellen comes in to release me with my prescriptions. Um, yeah…so I still haven’t had that shot that is supposed to make me all better. And can you please switch the pain meds to pill form. Liquids are not really for me unless its Alka Seltzer – which is my go to drug.

1:12 – Dr. is back. He says “This isn’t really a question of what you prefer (pills or liquid). It’s simply what is sensical. (Is that even a word? I’m sure he meant sensible.) If your throat is swollen you shouldn’t try to swallow pills because they could get stuck and try new problems.” Thanks so much for saying I’m dumb – but I’ll take my chances with the pills. I know I don’t like liquid meds.

1:27 – Nurse Ellen comes in sporting a ginormous needle and no joke says, “You’re gonna be sorry you asked for this. It really hurts.”!!!! Are you kidding me? Then she says I need to pull down my pants because this has to go in your butt. So I do and then she tells me to just hang out a minute while she gets the computer on. I’m not an FML kind of person…but right there…in that moment with Evil Nurse Ellen behind me I was repeating ‘FML’ like a mantra!!

1:30 – The shot was not fun, but it wasn’t that bad. Now I have to hang around for 20 minutes to make sure I don’t have a reaction to the shot. So what the heck am I supposed to do! I’m flippin tired as hell but am not getting on that mattress (ok so I did sit on the very edge – I couldn’t stand there for 20 minutes.) And I am starving.

1:41 – These rooms have no doors…just curtains so you overhear everything. Somebody has a ringtone that says, “Ding, ding, ding, hey you want a taco?” For their text tone. (I love tacos and today is Taco Tuesday, but there is no way I could swallow taco shells. DAMMIT!) The nurse just asked the guy across from me if he smokes. He’s like, “You mean cigarettes?”

1:51 – And outta here. Nurse Ellen says my tush will be really sore tomorrow. Awesome.

So no nap. I’m going to get something to eat and going home to research personal medical insurance.