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moktor

@lemmy.world

moktor 28 points 2 years ago

Gave it a go. Seems like it has potential. I'm still working through an appeal. My wife ended up in the ER in May and was directly admitted to the hospital for emergency surgery. Ten days afterwards we received a letter from the insurance company saying they had decided it wasn't medically necessary so they wouldn't be paying the $67k bill.

It has been a journey trying to get the appeal together. I had hoped the hospital would at least assist with a letter from one of the many physicians that attended her, but nope. We got laughed at by the surgeons office and told condescendingly "Yeah, that's not how any of this works. "

My biggest concern from the AI generated appeals are being able to confirm the statements it is making isn't just a LLM hallucination. As a lay person, much of the things necessary to make an argument are paywalled out of reach. For example, the insurance company cited the "2023 InterQual criteria for Surgical Conditions" as the reason why they are denying it. The AI appeal that was generated states that per the 2023 InterQual criteria for surgical conditions that hospitalization was medically necessary.

The only way it seems you can actually get access to InterQual is as a medical provider / payer.

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moktor 25 points 2 years ago

I've been fighting with my insurance company since May. My wife had a medical emergency and I had to take her to the ER at 3AM on a Sunday. The team of doctors treating her all agreed she needed to be hospitalized and have emergency surgery. She was admitted and underwent surgery and was out in three days.

A week after she was discharged we received a letter from the insurance company letting us know they had decided not to cover the $67k hospitalization bill because they had decided it wasn't medically necessary.

So yeah, that's great. Not to mention we had finally hit our $6,000 deductible (after I had cardiac issues and ended up in the ER the previous month) so insurance would finally have had to actually pay something.

So glad we pay them $1500 a month for them to make decisions on what is medically necessary and what constitutes an emergency after the fact.

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moktor 20 points 3 years ago

Had my university call me up about a year after I had graduated. I was unemployed and had not been able to find a job post-graduation. I explained to the person that unfortunately I do not have an income at this time and was still living at home with my parents and trying to find a job. Their response: "Well do you have a credit card? You could use that to donate and worry about paying it off later."

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moktor 19 points 4 months ago

Hot take: I dislike Monsanto with a passion and think their soaking the modern agricultural world in roundup, along with their crooked schemes targeting farmers and their 'roundup ready' GMO crops deserve harsh criminal penalties.

However this was the right legal ruling. The crux of the issue is that Federal law, FIFRA (Federal Insecticide, Fungicide, and Rodenticide Act) involves requiring specific labels for such chemicals. For Monsanto to sell Roundup they are required to use the EPA approved label without any changes, and the act also preempts States from requiring different labels.

At issue here is that the individual, Durnell, sued at the state level to require Monsanto to publish a cancer warning label on Roundup.

Were they to do so they would federally no longer be able to sell Roundup because their label now diverged from the EPA approved label. The EPA's continued position (which the EPA has reexamined over the years) is that Roundup does not cause cancer, so the EPA has not required a label changed.

Ultimately current federal law preempts a state from enforcing different label requirements, and the EPA's current guidance is not in agreement with the plaintiff's.

I think the preemption is actually a good thing overall, otherwise every chemical would be labeled with "This product in the State of California is known to cause cancer. In the State of Texas this product is known to cause Minty Fresh Breath and we recommend a minimum of two applications to skin, eyes, and other mucous membranes a day as part of a balanced diet."

I think the EPA is absolutely the weak link here, and they have been gutted and are a withered husk of their former science and evidence-forward selves. But that was not the question posed to the court, which was "Can an individual compel a chemical company at the state level to change their federally standardized and required product labelling?"

The actual ruling is very enlightening. Jackson and Gorsuch were the two dissenters in the 7-2 vote, and their dissent is worth a read as well.

https://www.supremecourt.gov/...*

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moktor 16 points 2 years ago path: 0 16048109, hotness: undefined, score: 16, children: 6
moktor 13 points 5 months ago

I miss Pictures for Sad Children. Such a wild way for it to burnout.

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moktor 12 points a year ago

Same thing!! It sure steamed my broccoli.

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moktor 10 points 3 years ago

I tried. Even got a degree in German Language & Literature. Took additional language courses through the Goethe Institute in DE, etc.

Though I've spent the last twenty years as a software developer (which is classified as an Engpassberuf), I was told that the regulations would only allow me to seek work based on the skills from that degree (Berufsqualifikation).

"We already know how to speak German."

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moktor 8 points 3 years ago

I still use this one! Makes me feel like a fancy lad.

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moktor 8 points 2 years ago

Immigrating to Europe isn't the easy process a lot of people think it is. At least for the countries I tried (Germany, Sweden, Denmark, the Netherlands)...but I do know some things have changed recently, at least for Germany.

My efforts were about ten years ago thought. Despite having a graduate degree from a European institution I still found it impossible.

For Germany, though I had spent the previous 10 years as a software developer (which is classified as an Engpassberuf), I was told that the regulations would only allow me to seek work based on the skills from that degree (Berufsqualifikation). My Master's degree was in a different technical field (European development planning), and my BAs were in europe-related areas and German. I also studied at the Goethe Institute and completed the Oberstufe C2 exam. But none of that was sufficient.

Now I am middle aged, have a wife and kids, chronic health issues...and though I would love to emigrate, I can't imagine uprooting them all, even if I could find a European country willing to take us.

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moktor 7 points 3 years ago

I read this Wired article a couple months ago that though long does do a really good job of covering the company, its culture, and the issues with trying to run a factory in the U.S. : https://www.wired.com/...

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moktor 7 points 2 years ago

My wife to stop drinking.

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moktor 7 points 2 years ago

I bought myself a pair of Reebok Pumps. Always wanted a pair when I was a kid but we were poor. When Reebok re-released them I bought a pair.

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moktor 7 points a year ago

I'm still surviving on my RX580 4GB. Limping along these days, but no way I can justify the price of a new GPU.

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moktor 6 points a year ago

I had forgotten about that. Now I'm angry again.

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moktor 6 points 2 years ago

I hate AI as much as anyone, but as far as AI slop goes, this is one of the few redeeming AI video series I have seen, and is really enjoyable. It is a consist storyline written by the author, he is very upfront about what technologies he is using and how he is incorporating them.

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moktor 5 points 4 months ago

I was curious and looked at tickets for a game in Houston since we could drive. $680 a ticket. Yeah, no thanks.

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moktor 5 points a year ago

How bad of an idea would it be to use this in an Unraid server?

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moktor 5 points a year ago

As great as it sounds, the article is leaving out a lot of information. This drug has been available since 2014 in the US for certain cancers. My Mom was on it before she passed from cancer. The big news from this is that it will now be available in an injection, instead of an infusion.

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moktor 5 points 2 years ago

I am sad about the lack of fun colors. I used to own two orange cars (a subaru crosstrek and a lotus elise), but now I'm stuck in a boring white truck.

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thanks for using Leebra!

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