Pages

Showing posts with label Medicare. Show all posts
Showing posts with label Medicare. Show all posts

Tuesday, March 22, 2011

violations of civil rights page 22; msprc hiding accepted conditions?

AS of 1/10/89 my permanent accepted medical conditions for  Federal Workers Compensation are: occupational asthma ( sometimes called reactive airway dysfunction syndrome) traumatic onset. This also covers such medical conditions as copd, reactive airways, chemical induced asthma, toxic pneumonia, ABG needle sticks ( paid for in the past) , pulmonary hypertension, emphysema -mucous membrane burned off whole body with resultant kidney disease, heart disease, skin problems, chemical conjunctivitis, oxygen dependent and all the other conditions that have either been accepted and approved for payment or have been pending for initial review for over a decade with 15 judges and 2 hearing officers printing out that they were in file. Lincare is the monopoly compressed oxygen supplier ,refusing care and if they had not bought out Health connections and ACS needed to sign a new agreement they would have continued being paid as I discovered last year and filed a reconsideration that's never been seen due to ACS defying the appellate judges over and over. You sent out recovery letters to ACS in '05, 07 but your parent co refused to let you follow up. The Cigna gvt services sent you the paid O2 claims to collect, ignored. ACS has 11 years of O2 bills and refuses to input them as that will bring the ' dummy' file on line and my medical care would be paid and other initial reviews done on some items that go back to 1989. as I was approved for life. When Illinois blues took over in this area at the same time ACS did they proceeded to stop paying Lincare and posted that no owcp existed and all claims got ' dumped' onto Medicare and refused to turn over the medical necessity file that showed i was approved for life by them als, as with OWCP and then Medicare when cigna took over  as Palmetto GBA had years of invoices they refused to process and never passed on to Cigna. Hardship for my son to haul tanks and us pay out of pocket for me to survive this "death panel order' and that's exactly what it is. Medicare paid each claim 17 times back to 1/06 by Trailblazers. Are you going to recoup that money? Not one claim is listed for doctors/ suppliers for the accepted conditions? Why? Please, do use the date of injury of 1/10/89 as this misleads medical billing people who have been lied to by every party they have tried to get a straight answer out of for over a decade  and told to ignore, me, the judges ( last three said ask me for the facts of the case) and the law. Prior to '08, i was told some claims were paid under a pseudo number on many injury cases starting with a 9. None of this should be occurring. Doctors have tried to file as conditional payments only to be told not to or it was deleted off the claims. So everyone should be held harmless and given the benefits of the doubt in getting paid properly by the correct party. Also, there are some not sending in  for co- pays from part b Medicare not realizing that the deletion of Part B is an error and the hearing file has disappeared. I'm sending you a detailed statement that recaps that occurrence. You need to call Lincare and make things right with them and quit putting this Federal servant of 43 years in harms way because  someone wants to treat me with disparity and violate my civil rights on an established, non- controverted case. Thanks! Please call me for the facts of the case so more errors and  more chaos don't occur. Linda Joy Adams

Saturday, March 12, 2011

violations of civil rights page 14 (see attached) 100% coverage HIPPAA request from billing

These are 100% coverage under  my Federal Blue cross Blues shield contract. If you didn't code this that way then it would be federal workers compensations bills as claims are filed as secodnary issues for the permanently accepted conditions. I've advised you to call The Regional office manager in Dallas for federal workers compensation as to her progress in getting Affilitated Computer services to get my coumputer file set up in compliance with my permanet medcial beneftis at owcp that posts bi-weekly to the medciare computer and what to do with current and past claims after she called me recently.
Why is this preventative care?: Even though some injury related problems can ' show up on the tests'; these tests are well known to detect conditions that I don't have and catch them early such as breast cancer, etc. and are the reason that they are part of the preventative care contract with FEHB. Medicare always second.
HIPPAA REQUEST: I want copies of exact claims sent to OWCP, Federal Blues and Medicare and a written recap summary of why these tests were not billed under the preventative care. I don't see the claims listed on the ACS-billing system at owcp at all.  No response to request on  bills paid 17 times each by Medicare back to 1/1/06 and that you did not get the 16 extra pays. Refer to notices and requests to you.

Monday, February 7, 2011

Violations of Civil Rights Page 4 -Federal Blues x-refer MA09-1406 Medicare DAB

Our medical providers are being 'told' that claims are being denied. Yet, Explanation of benefits, we get, say file with Medicare first and send the results to you. Both are incorrect. The only 'final' decision from the the highest Appellate Judge at Medicare dated 9/29/2010 states Federal workers comp needs to get the claim first, then you and lastly Medicare.  This will continue to be the legal line- up until OWCP gets me on permanent disability which continues to be obstructed as ACS-Xerox has yet to set up my computer file correctly so that the multiple remand orders from the US Dept of Labor judges, ( last  one 2/09) can be carried. out) You claim you got varying dates from OPM, yet their general counsel had the signed agreement with SSA  a few years ago and explained that OWCP law overrides all the other laws and no break in employment nor retirement can be finalized until OWCP is finalized. Many doctors and medical research consider my accepted conditions as permanent and progressive and my pulmonologist informed me at my last visit in 1/11 that regrowth of lung tissue may not happen in his lifetime and he's much younger than me. Even though, I've signed to start a retirement, OWCP has to act first, just as they respond to all medical bills first.

Friday, July 2, 2010

Tom Devine - National security whistleblowers deserve more protection

Tom Devine - National security whistleblowers deserve more protection See my comments posted. Also, mentions Drew Edmundsen , candiddate for Governor who refused to stand up to Feds for either state employees or citizen of his state. Formal complaint still pending!