To pay or not to pay

It may not be a bill, but it shows which services and how much money your doctor is asking your insurance company to pay. You should care because chances are you're paying a premium for your health insurance. In the insurance world, premium amounts are affected by the number of claims filed on your behalf, which can mean that your premium may increase, due to excessive appointments and health services provided. Also, if your doctor is billing your insurance company for services you didn't receive, then that's a red flag, indicative of fraud.

Sometimes, doctor's office staff will bill you directly for the entire amount, instead of billing your insurance company. Is it fair? Maybe not. But you have to do your homework to determine that. Try verifying your benefits yourself, and do it before you step foot in the doctor's office; it's customary that office staff verify benefits before an appointment is made, but often times, it's NOT done.

When you verify your benefits, you will be better equipped to educate office staff about whether you are obligated to pay. Since it's customary that office staff verify services covered by your insurance policy, knowing your coverage and payment amount will help you avoid confusion and frustration, while also keeping money in your purse or wallet.

So, be careful not to get talked into paying full price for health care services, especially when you have a health insurance policy in force. Otherwise, you're paying for a service unnecessarily, and may be due a refund.


Now, if you do not understand the insurance documents with the statement "This is not a bill" across the top that come in the mail, let's fix that right now! Yes, there may be some medical codes on there that you may not understand. However, you certainly understand dates and dollar amounts. So, take a look at the dates on your EOB or Explanation of Benefits and confirm whether you went to the doctor on those dates. Read the summary of health services, and make sure that the services billed for were indeed delivered to you or for your benefit. Also, look for the physician's name on the EOB, making sure that the doctor or health care provider listed is correct, as well as the amount "due" by the patient, which would be you.

In the event that you locate information on the EOB that is wrong, call your insurance company. It's okay to also call your doctor's office, but understand that whatever explanation is provided to you over the telephone needs to be backed up in writing. By this, I am referring to receipts, EOB's, letters (on appropriate letterhead) from your insurance company and doctor's office.

Golden rule: If it's not in writing, it didn't happen.

I hope this helps! If you have questions, e-mail me at adminbydom@gmail.com

Have a safe weekend, and don't take any wooden nickels =)

Sex with no condoms

HLN Reports that 45% of teens who are having sex do NOT use condoms. This takes us back to my first published newspaper article, "Teenage Sex Epidemic." My article points out various contributing factors to sexual behavior of teens. Some of the examples stated include: Lack of wise counsel from parents and guardians to teens and peer pressure. The reported outcomes are Sexually Transmitted Infections (STI or STD), unplanned pregnancies, unwanted children, and abortions... which brings us to my latest piece on teen sex to mind (School list: Things to do & know), as it discusses the availability of Human Papilloma Virus (HPV) vaccines for children as young as 9 years old.

School list: Things to do & know can be viewed by clicking the above title or by copying and pasting this URL in your browser... http://opinionmatters.flatoday.net/2011/08/school-list-things-to-do-know.html

Sex Drive Influences

Sexual desire or appetite for sexual activity is referred to as "libido." Libido can be affected by numerous factors, such as self-esteem, diet, physiology, culture, and timing,just to name a few.

Research shows that men have stronger libidos than women. It's also been reported that men fantasize about sex more and masturbate more frequently than women; not to say that women don't masturbate, men just tend to do it more than us.

Women have also been reported as more likely to be distracted by environmental factors than men, while also making more of an emotional connection with their sexual partner. For example, women tend to require house chores to be done, and a little ambiance and romance before getting aroused. Men, on the other hand, tend to be more direct and specific about their sexual desires.

Interestingly, women tend to be more likely to engage in sexual activity with the same sex than men. However, cultural indicators, such as attending church and worshiping God, have been reported as an influence on women's sexual habits, unlike men. It's also been reported that the sexual habits of women are more likely to be influence by their friends than men.

Foods that have been reported as libido enhancers include: Celery, oysters, watermelon, avacados, bananas, acai berries, and almonds.

Learn more about libido at www.webmd.com or by clicking the title above.

In case you get a DUI

The weekend is here! For many, this means it's time to party. But in doing so, be sure to coordinate a safe ride home. Whether your ride is with a designated driver, taxi, or limo service, just make sure it's in place before you start drinking your favorite alcoholic beverage; I like Asti Spumante, myself =)

If you get caught driving with an open container of alcohol (i.e. cup of cognac), even if you are not intoxicated, you could still be accused of DUI. Remember, your family and friends love you, and when something happens to you, it affects them. So, please be careful.

If you don't have an attorney on retainer, perhaps you can at least keep a business card for one in your purse or wallet; I'll gladly share the names of some upon request.

TGIF! Have a happy and safe weekend =)

Eartha Shoemaker: Brevard's Unsung Hero

Read about Brevard County's Unsung Hero, Ms. Eartha Shoemaker. She made her mark in history through her work at NASA. ~7/18/52-9/6/2011~
http://opinionmatters.flatoday.net

Toxic Shock Syndrome

TSS, also known as Toxic Shock Syndrome and Toxic Shock-like Syndrome, is a rare and sometimes fatal disease that is associated with the vaginal use of tampons during menstruation. It’s a serious disease caused by the bacteria Staphylococcus aureus and Streptococcus pyogenes. The Streptococcus pyogenes involvement may have attributed to yet another nickname for TSS, Streptococcal Shock Syndrome.

Signs of TSS infection can vary. However, common signs include low blood pressure (i.e. Systolic of 90), fever (102 degrees Fahrenheit), and a rash that peels off after 10 to14 days. TSS can affect the liver and kidneys.

Since 96% of reported TSS infections reported in the past were found in women under the age of the 30 years old down to teen-aged girls, it is safe to say that minimal use of tampons is a good idea. Even Tampax recommends that women alternate their use of tampons with sanitary napkins. Furthermore, Tampax reports that the higher the absorbency, the higher the risk of developing TSS. In addition, the use of tampons should be avoided, in order to prevent the development of TSS infection. Another helpful hint for preventing TSS is to avoid wearing a tampon or sleeping with an inserted tampon for more than 8 consecutive hours.

In the past, the CDC provided details about TSS cases, such as incidences where race was reported. Among Blacks, Whites, Hispanics, Native Americans, and Asians, TSS was found most commonly in Whites at a rate of 97%.

Thankfully, TSS is treatable. However, treatment should be initiated as early as possible. Initially, an inserted tampon should be removed from the vagina. Once hospitalized, patients may receive IV fluids and antibiotics. Removal of abscesses and infected tissue may also be necessary.

If you or someone you know uses tampons during menstruation, seek medical attention from a licensed health care provider if any signs are present or if symptoms such as vomiting, diarrhea, dizziness, or muscle ache occurs.

Learn more about TSS at www.tampax.com and http://www.cdc.gov/mmwr/preview/mmwrhtml/00000119.htm

MY BOOKS!

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"A pepper unpicked" is a story about perseverance through adversity.  Dysfunctional family dynamics, rejection, and deceit have tremendous ability to affect anyone's emotional and mental health.  Read this one to see it from an interesting perspective.

"Blood on the other side" is also a story about the importance of perseverance.  However, family dynamics are further complicated by politics, federal government bureaucracy, and a malicious ex-family member with Washington, D.C. ties.  Read this one to see how it plays out.♥

The books I've authored, so far, are now available at www.amazon.com.

A Heart Skip

 

The U.S. Food and Drug Administration (FDA) is informing the public of an ongoing safety review of the anti-nausea drug Zofran (ondansetron, ondansetron hydrochloride and their generics). Ondansetron may increase the risk of developing abnormal changes in the electrical activity of the heart, which can result in a potentially fatal abnormal heart rhythm (including Torsade de Pointes).

Patients at particular risk for developing Torsade include those with conditions like congenital long QT syndrome, those who are predisposed to low levels of potassium and magnesium in their blood, and those taking other medications that lead to QT prolongation.

The manufacturer of Zofran (GlaxoSmithKline) is being required to conduct a thorough QT study for further assessment. The results from this study are expected to be available during the summer of 2012. Afterward, additional label changes may occur. Currently, the labels are being revised to include a warning to avoid use in patients with congenital long QT syndrome because these patients are at particular risk for Torsade.

Additionally, recommendations for ECG monitoring in patients with electrolyte abnormalities (i.e. low potassium, calcium, or sodium), congestive heart failure, slow heart rate, or in patients taking other medications that can lead to QT prolongation, are being included in the labels.

* Do not stop taking Zofran (ondansetron) without talking to your healthcare professional;
* Discuss any questions or concerns about Zofran (ondansetron) with your healthcare professional;
* While taking Zofran (ondansetron), your healthcare professional may occasionally order an electrocardiogram (ECG, EKG) to monitor your heart rate and rhythm;
* Seek immediate care if you experience an irregular heartbeat, shortness of breath, dizziness, or fainting while taking Zofran (ondansetron);
* Report any side effects you experience to the FDA MedWatch program.

Learn more at http://www.fda.gov/Drugs/DrugSafety/ucm271913.htm

Grieving and coping

There are a series of events that cause stress in our lives. Whether it’s good stress or bad stress, it impacts our health. Today, we remembered the lives lost in the September 11th Catastrophe, back in 2001. We all remember what we were doing that morning. It’s a moment that the people of our United States, and the rest of the world, will never forget. Likewise, yesterday is a day that my good friend will never forget, as her mother was funeralized.

Like the heroes who lost their lives in the September 11th Catastrophe, who are now commemorated by the Tribute in Light and the new Waterfall Pool, Eartha Shoemaker was also hero. She was the first woman and the first African American to work on the Close-out Crew at NASA, in Titusville, Florida. Her life was celebrated yesterday, as her family, co-workers, and friends gathered to exchange stories and grieve together. Ms. Eartha Shoemaker passed away on September 6, 2011.

Howbeit difficult, hopefully, today was well-spent in commemorating our country’s heroes, while remembering that we all grieve and cope differently. Customarily, it is said that we generally encounter five phases of grieving: (1) Denial, (2) anger, (3) bargaining, (4) depression, and (5) acceptance.

In the Denial phase, it’s common to be in the state of disbelief and rebellion about the death, incarceration, divorce, or similar crisis. The event may even bring about feelings of anger and frustration, which may be coupled with or in lieu of bargaining; individuals often rationalize with themselves during the bargaining phase, proposing that if they had done something different, the crisis would not have occurred. With acceptance, feelings of powerlessness can promote cooperation and willingness to carry on with whatever life brings.

Personally, denial is usually my first response, when I have grieved in the past. Unlike others, the denial phase may not be a part of their grieving and coping process. Perhaps, depression is the first expressed emotion for some. On the other hand, some nay not go through the process of anger or bargaining at all. Mainly, it depends on the individual and the circumstances surrounding the crisis.

No matter what your crisis is, let us remember to adhere to a balanced diet, drink plenty of non-alcoholic fluids, exercise, and get plenty of rest. Let us not feel pressured and avoid pressuring others into hiding their true feelings. Let us grieve in our own way, support one another in our different processes of grieving, and pray. Failure to do so may have a negative impact on our health and the health of those around us.

To learn more about grieving, make an appointment with a spiritual leader, therapist, or counselor. Also, visit www.ekrfoundation.org

God bless the families of our lost heroes, and God bless the United States of America.

Feel better soon, Venus!

             They say you learn something new everyday.  So, what about this rare autoimmune disease called Sjorgen’s Syndrome that Venus Williams has been enduring?  Autoimmune diseases, such as Sjorgen’s Syndrome, Lupus, and Rheumatoid Arthritis, cause the body to basically attack itself.  Sjorgen’s Syndrome can be characterized by a syndrome or group of symptoms, found predominately (90%) in women. 

            It’s a strange condition.  Half of individuals suffering from Sjorgen’s Syndrome do not endure difficulties from autoimmune diseases.  Instead, they endure blurred vision, probably due to the lack of moisture and dryness in the eyes.  Itching also tends to persist in vaginal and oral areas, and nasal passages, as well.  Other signs and symptoms can include bronchitis, fungal infections, enlarged parotid glands, and anemia.             As if complications from autoimmune diseases aren’t troublesome enough, 50% of patients living with Sjorgen’s Syndrome also have an increased risk of cancer of the lymph glands.

           

            Treatment commonly includes Non-Steroidal Anti-inflammatory Drugs (NSAIDS), such as the active ingredients in Aleve and Motrin.  Good oral hygiene, use of toothpaste with fluoride, artificial tears, and sugarless gum and candy are also on the treatment list.  Individuals diagnosed with Sjorgen’s Syndrome are encouraged to wear glasses or shades, in order to protect their eyes from wind.

            Last I checked, Venus Williams has been recovering adjusting to her condition.  Although Sjorgen’s Syndrome is said to mostly affect “middle-aged women,” Venus Williams was recently diagnosed at 32 years old.  Hopefully, she will be able to play tennis competitively again, soon. 

~ FEEL BETTER SOON, VENUS ~

            You can learn more about Sjorgen’s Syndrome at http://www.sjogrens.org or by simply looking it up in a Taber’s Medical Dictionary.

It's Labor Day! Work on your breath!

Have you routinely noticed people backing away from you when you are talking?  If you have bad breath, it can cause people to be taken aback.  The foul odor, though it may be coming from your mouth, may originate from somewhere else.  For example, gastrointestinal disorders may cause bad breath.  Likewise, left over food on dentures and between teeth, failure to floss and brush your tongue, and even use of tobacco products may also cause bad breath.  Certain foods can cause bad breath as well, when they are absorbed into the bloodstream, which flows through the lungs, where foul odor can then be exhaled; onions and garlic are common culprits.  Another possible way to create a foul odor from your mouth is by wearing gold grills or permanent gold teeth, depending on the type.  As long as gold grills are worn intermittently, and oral hygiene is good, then bad breath may not be a problem.  However, depending on the type of grill or permanent teeth, bacteria can get trapped within the gold covering, which can create a foul odor.  A condition known as "Halitosis" is exhibited by similar symptoms, and can be diagnosed by a dentist or physician. 

Whatever the circumstance, causes of bad breath should be identified and corrected as soon as possible, as its cause may adversely affect your health. Once your condition is identified, treatment can vary, depending on numerous factors.  For example your tolerance for certain medications and procedures, cause and magnitude of bad breath, and status of your oral health are all possible considerations.  Ask your dentist to help you determine the cause and treatment of your condition.  If your dentist is unable to help, you may be referred to an oral specialist or physician.  Meanwhile, please remember to floss and brush your teeth and tongue after every meal.

Additional tips for oral hygiene can be found at www.ada.org

Opinion Matters: Government v Culture

My latest contribution to Florida Today is posted!
Opinion Matters: Government v Culture: Every 3 minutes, a person is killed by injury or violence. In fact, 75% of deaths among our youth occur, as a result of i...