Conditional Payment Information - Centers for Medicare & Medicaid Services This is a link to an official government publication.. that is PART OF THE TRUTH ..
Any primary payer could be one who decides to get out of paying the bills they are legally bound to pay... and if here is no one to stop them they can get by with it... and MANY OF THEM HAVE SINCE THE COUP OF 2002 when Congress voted to have no funding for internal audit controls of government contractors and no criminal investigations.
When those reluctant to pay the bills they are liable for currently and the government contractors collude to allow it to occur, then that is theft , a crime- and since 2002 its gotten massive.... It began to deteriorate after 1994 when enforcement was suspended.. The answer to health care reform led by Hillary Clinton , first lady and her co hort Sec of HHS Donna Shalala was the order to "let the health insurance industry 'police itself and the suspension of enforcement of the conditional payment laws was made.. But the government had official control until 2002
Most in the health care medical billing field have no idea what a conditional payment is or even how to do done. The systems are to have a way to bill it electronically, but that was removed in 1/06 and its still not in the system ...
The 2002 Medicare Handbook ( all card holders get yearly ) began to tell less and less what is beginning then and now its ignored. YET THE PATIENTS OWES THE MONEY IF NOT LABELED AS SUCH IF MEDICARE IS NOT THE PRIMARY AND PAYS.. THE PATIENTS HAS NO RIGHT TO KNOW AND PROTECT THEIR RIGHTS.?
And all the medical billing people are now told they have to bill electronically and there is no way to get paid that way... the MONEY FOR A SYSTEM THAT IS LEGALLY COMPLIANT IT MISSING/even from the most recent updates of the last year.. that is still ongoing.. in a complete cyber melt down. as I did not get a post yesterday over all that has been discovered and its still being investigated by me...(the real government is not allowed to ) as there is no one in the government to investigate as its inside the contractors.... and too many have their hands on the system ... is my opinion and some are blatantly stealing and others want to do what is legal.. and being hacked by their own systems partners
If you think an employer group health plan will collude to get out of paying their bills as primary , then no one has been reading this blog.....its been going on and is now collapsing the system as they still do not wish to do so and the owner of the Medicare care system is now standing firm and not hacking in an altering info to facilitates theft..for months no one has been able to get paid, as NO ONE EVEN AT CMS KNEW HOW TO BILL A CLAIM
for YEARS. I HAVE TRIED TO FIND OUT... AND ITS as I knew the law said... if the system cannot do it., no one is denied their right to file for a federally funded benefit due to system failures or system not programed as its to be. THE GOVERNMENT HAS TO ACCEPT A PAPER CLAIM.... But a medical biller has to go in to Medicare. gov, and click on compliance and then ask for a wavier to do at conditional payment when the primaries will not pay. JUST BECAUSE SOME WISHED TO STEAL FROM THE PUBLIC TREASURY AND LEFT THE FIELD OFF THE SYSTEM IN 1/06 AND BEFORE THIS LAST UPDATE, I WAS IN CONTACT WITH THE CODING COUNCIL OF CONTRACTORS AND INSURERS AND THEY KNEW FROM ME THEY NEEDED TO GET THIS IN THE SYSTEM AND DI NOT DO SO .
The original law, not changed is any bill that could be someone else's liability now or in the future is to be filed as a conditional payments to keep track of this and recover the monies now. or in the future. and lots of due process letters get sent out by the recovery contractors. Both Coordination contractor and recovery is Emblem health international, formerly Group Health Inc.
THEY HAVE STOPPED THE HACKING , EXCEPT FOR ONE SUPERVISOR WHO BREACHED THE SECURITY AND CONTRACT WITH CMS AND DID IT ON 10/20/16 and several thousand dollars of clams got illegally paid... is what is suspected and will need to be appealed.
All I have asked since 2002, is that the patients . me and mine, and medical personnel not be at risk for over payments and filing a claim as conditional PROTECTS US ..
When claims paid by Medicare that is not Medicare's bills , one is NOT OVERPAID IF ITS FILED AS A CONDITIONAL PAYMENTS .. IT IS UP THE GOVERNMENT IF THEY WANT TO RECOVER WHAT SOME SAY IS NOW TRILLIONS OF DOLLARS OWED TO MEDICARE BY PRIMARY PAYERS OF ALL KINDS WHO HAVE BEEN ALLOWED TO MAKE DEALS, AND GET OUT OF PAYING.... AND THE CLAIMS GOT PAID ILLEGALLY BY Medicare as the systems were hacked to changed what ones employer sent in ... etc.
Debts against the patients never go away , even after ones estate is probated. as a claim can come against ones heirs.... With no many moving back home with no jobs, etc. that may be the home they live in that is inherited and all they have if we do not get this government back in charge of stopping the ROBBING OF THE USA.
I was sent to a specialist last week and instead of the usual of either no Fed blues on the system or it was flipped to secondary , and the wrong date for injury for federal worker comp meant all claims get missed..... Availity clearing house had no workers comp on what they had received from their clearing House and showed Medicare primary and Fed blues secondary .... In all these years the workers comp has always been on there... high security that follows through from the US Department of Labor;'s own system with own programmers to protect the lives of injured workers like me.. since 1988,.
WHAT HAPPENED?.... AND I WROTE OF THIS LAST FRIDAY HERE I called and found out that Blue Cross /BS had a connection to a Clearing house they have to pay and its big money to get access to the Medicare billing system... and they are paying to get accurate info and have not for years. . SO last Friday .. etc. it was a completely cyber melt down and found Homeland security now over health care... due to the cyber attacks..... or internal hacking... a melt down as every call center for Medicare Coordination has differing info .. and all from one system.. and found out a supervisor had hacked. as NO ONE KNEW HOW ANY ONE COULD GET PAID AND DO A CONDITIONAL Payment they law since 1980 and makes it so easy for every one to turn it over to the government to collect its money fro those who will not pay their bills. .
Availity is the clearing house for most if not all preferred providers for Blue Cross Blue Shield ??and that is one of Lynn Blodgett's management firms who has been the info giver to the clearing houses and he also has owned some... I do not know for sure who owns this one no the others.. There is an approved list from CMS doctors etc. can sign up with and its a big money for them to get access. to the system . MORE HEALTH CARE COSTS THAT SHOULD NOT EXIST.. WHY DOES ANY DOCTOR, ETC. HAVE TO PAY WHEN THE TAXPAYER HAS ALREADY PAID FOR THE SYSTEM TO BE USED.?
Tuesday the bi weekly posting came from employers, which for me is the US Department of Labor system owned and maintained by the real government for me and the Medicare judges got access and ruled that it is legally correct. I am not retired and medicare is not primary and I do have the permanent medical benefits from FECA... . and Since still active duty with the govt , Fed Blues is the other primary and primary for those on my policy that also have Medicare cards.. and they were ignored as the illegal secret deal to hack soon after the post continued until more recently .. with the new system and its lasted 3 weeks last 11/15 and then through Lynn Blodgett's company that pays the Part D prescription drug claims for every one with a card and never sent in a conditional payment to recover from any current or future primary plans for 10 years.
Its been a Medicare free for all, all being the primaries who got out of having to pay and the pharmaceutical companies that got full prices, when most of our primary plans have negotiated prices. A letter using the Humana letter head from his management company admitted they have changed the insurance info so that Medicare could pay first.. as if she had no idea she was admitting to a felony .. by doing so .. of course no budget from Congress to go arrest her. or have her flip of he one who told her to do it as its what Lynn Blodgett wishes the law to be and its going to be his way until Congress allows budget to stop. it
So Yesterday I had a regular visit with one of my doctors and when I went to check out... they were getting ready to ask me for co pays for MY RAILROAD MEDICARES.
I got a copy an thank all that cooperate in this as there is no one else bu the patients to investigate. and I have done Medicare fraud investigations and knew in 2002, criminal activity was going on but not until just before I began blogging did any one know of funding pulled by Congress in 2002.... to stop blatant theft of Medicare or by any other government contractor.. and NO NE IN THE GOVT KNOW NOW STILL KNOWS WHAT IS GOING ON ..
HIDDEN LAWS, STAY HIDDEN AS NO ONE KNOWS WHAT TO DO AND HOW TO USE THEM TO HELP AND STOP THE HARM BEING DONE TO EVERY ONE.
Billions spent on systems and paper still have to be used as the systems were designed to enable theft. BECAUSE THE REAL GOVT HAS NO IDEA WHAT IS GOING ON OR EVEN WHAT THE LAWS ARE.. ANYMORE.
So the sabotage o what my doctor was given yesterday seems more than a complete melt down of systems picking up all the many false retirement dates Lynn Blodgett's company have called and told Emblem health were mine. and all seems to show up every where... at the same time.
Railroad Medicare claim numbers have the letters before the social instead of after as s subscript as the rest of us have. WHAT HAD BEEN ENTERED WAS MY LETTER AND 8 NUMBERS with one additional number included to be consistent with an SSN which is 9 numbers.
The company that sent this to the clinic is another systems company that most doctors have... MORE EXPENSE FOR HEALTH CARE THAT IS NOT DIRECT CARE. and to day I found our that this company gets the info from the clearing house for the insurance info on an open portal and they also provide a means for patients records to be kept, etc.. So what was provided as insurances was only passed on as I have been told so far.... but I am also finding out that ones health insures is also in involved in posting to these system s and of course the incentive is to NOT BE THE PRIMARY IF THEY CAN GET BY WITH IT AND HAVE BEEN ABLE TO DO SO.. Some companies have a worse ethical track records than others.
But mine comes from the federal government and is a real government posting..
SO THIS APPEARS TO BE REAL INTENTIONAL AND A HUMAN MESSING WITH THE SYSTEM DIRECTLY .... and Availity is implicated. here. OR WHO EVERY HACKED AVAILITY .. I do not think we have any medical personnel that are not also Blues preferred
I called Availity and also Zir med another competitor for info and got the phone slammed in my ear several times today ... Zir med has allowed clams to be paid illegally on me in the past... and they have notices from me.. as I am still trying to find out who of all these companies and government contractors is supposed to be providing the billing format software for the doctors, etc. to do a conditional payment to Medicare. The Clearing houses seem to be the most "HYPER" OF ALL RIGHT NOW.. and if they are allowing ones health insurers to hack in and alter the info .... then they are in real trouble... linked to this blog in the past is some info that Lynn Blodgett was the info giver tot he clearing houses, but how and what company is still not real clear. Emblem health has taken his verbal orders in the past ad deleted and destroyed records and altered in do..
IS HOMELAND SECURITY PATROLLING THE AISLES AT EMBLEM HEALTH INTERNATIONAL COORDINATION OF MEDICARE BENEFITS RIGHT NOW? The woman I spoke to did not know where she was from , but its all seems to be under some ones supervision now.
This is only a few trillion dollars to be refiled. and recovered .
HIDDEN LAWS CONFUSED THINGS IN 2007
when laws were passed putting the onerous on attorney to report to medicare when settlements of various legal cases were done so that Medicare got repaid first. and some patients settlement not knowing that Medicare got paid FIRST. and they had little left for themselves.... nothing in the law says the attorney has to notify their client of this .... But workers comp and auto accidents, and other liability cases are not the major issue... OR DID NOT USE TO BE. This is why the law has all clams that may be related are to be coded for a conditional payment and if one does not have the current coverage. listed for when one does and letters go out.. so all know .. Its called the 4TH AMENDMENT OF THE US CONSTITUTIONAL AND CALLED DUE PROCESS AS ALL HAVE RIGHTS IN ALL OF THIS
The major issue even before the law got passed in 1980 was the primary payers not paying their on going obligations. wither workers comp or an employer group health plan, etc.
providers.
Several left messages for a recontact . and will continue to do the governments; job as I was trained to do for them years ago... I may not be getting an hourly wage, but I am still active duty and its a horrific physical toil,, but when ones life and livelihood is at stake, one has to choose life.. and struggle for it..
GOOD NEWS
I called the Medicare Coordination of benefits. contractor line and the automated system had Medicare primary on that menu so I was expecting more bad news when I got to a person. She pulled up my records and also for one family member with a card who was here. and checked things out..
ITS NOT HACKED.... I TOLD HER THE PHONE MENU WAS WRONG AND WHAT COMPANY MAINTAINS THAT. So any one who used that is going to get wrong info ...
TOO MANY WITH ACCESS TO TRILLIONS OF DOLLARS FLOWING IN AND OUT OF A PROGRAM ... and along the way some goes the wrong way and missing.
The system is clearing marked in red not to change anything as an employer is posting. and they even had the real date of injury for federal workers comp of 1/10/89.// and not what has been used that was never what the taxpayer paid for of the entitlement date to Part A Medicare which means nearly every injury cases will NOT BE CAPTURED BY THE SYSTEM FOR A CONDITIONAL PAYMENT IF NOT PAID BY THE PRIMARY PAYER ON THAT. and I was told they have someone going around now making sure every one is obeying the rules.... PRAYERFULLY NO supervisor is going to hack the system any more at Emblem Health just because someone wants them to do so ...
When Medical providers and suppliers are paying billions to these clearing house and getting bogus info , its time TO ALLOW THEM TO GET THE INFO FREE FROM THE GOVERNMENT SYSTEMS, WHETHER A CONTRACTOR OR NOT. THAT IS A BIG RAISE FOR ALL OF OUR GOOD DOCTORS AND OTHER MEDICAL TREATERS WHO KEEP US HEALTHY AND TAKE Care of us when injured or sick.
Its been too long for these companies who have colluded to gouge and steal from the nation for way too long and the free flow of money has ended.. and we need to use the money for health care for direct care and our good doctors paid fairly as now they are gouged by these contractors at every turn ... needlessly .. Very few are the ones stealing... is my observed opinion. Most are struggling.. and not as well paid as one with their education and skills should be.. Incentives... allow them a break for taking a few Medicaid patients each... instead. ,
I DO NOT WORK FOR THE RAIL ROAD NOR DID DOYLE AND WHOEVER DID THAT. I have ridden on a railroad, but that does not give one RAILROAD MEDICARE and its not a number any where like a real one.
Yahusha whom we Christians call Christ Jesus know who did it... time to repent of your sins. and stop it and make things right, even if you "have to give it all up RICH YOUNG RULER in order to save your soul.: as Christ told the one who came to him in the middle of the night and wanted to know how to have eternal life.
When you commit evil against others, one kills their soul. and one does not have to be a Christian to understand the common wisdom of the teaching.
What else in my medical records has been messed with ? that can endanger mine or any ones life.? A congressional study of 10 years ago indicates its massive and real and that data base set up as a government contract in 1999 has skewed medical research and caused deaths of patients with medical errors based on wrong in to in there. I have at least 4 other patients co mingled in mine.. HOW MANY OTHER PATIENTS ARE IN YOURS AND ITS NOT UNDER THE HIPPAA LAW AS YOUR OWN DOCTOR, HOSPITALS, LABS, etc. . HAS TO SPEND HUGE MONIES TO SECURE YOUR RECORDS, YOU MAY NEVER KNOW UNTIL YOU HAVE HAD MEDICAL HARM AS I DID BACK IN 2007 AND THE HOSPITAL TOLD ME, AS I DID NOT DIE AND ONLY HAD TREATMENT DELAYED.. Doyle took me to another hospital where I got seen by an older , common sense doctor, who looked at me... and did what he could to find out... but still issues .... and delays, for surgeries and physical therapies. over it.
Its owned by Emblem Health since 1999, and its a awful deadly mess... One cannot get a copy and no one has any way to correct errors or intentional errors either... as this messing with my insurance is NOT SOME COMPUTER GLITCH OR SYSTEM MELTDOWN... THIS WAS HUMAN SABOTAGE ON THIS. Unless we have artificial intelligence that has become evil and attacking humanity etc.. and so far I DO NOT THINK THIS IS IT.
I am exhausted and forgive any grammar that is not quite as it should be... This blog is how all that are interested and can help get notified daily I am looking forward to no longer having to appeal every medical bill to get our from under he overpayments.. a lot to be recovered and do not forget from 1/06 thought 11/12 every claim was paid 17 times that went through S C blues and subsidiaries who pay Medicare claims and that includes Palmetto GBA who pays the RAILROAD MEDICARE CLAIMS. Before Congress does anything on health care, they have to know what the fiscal soundness really is of these companies and are they broke or just stealing and stowing the money somewhere?? 68 times voting for what? overturn and replace with what? the same bunch getting by with the same stealing this has to get real folks.. and get the health care dollars back into being used or health care.
Linda Joy Adams 10/27/16
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