Cup of Coffee

July 29, 2014: Training Day

26 Comments

I have to head up to Paradise Valley (a jaunt from here) at 6am today on my day off basically to babysit other people from my store at a training. It doesn't pay to be a high-end salesman all the time.

26 thoughts on “July 29, 2014: Training Day”

  1. Somthing UP has done lately is to feature a particular location on the RR and set it to live music, and the results have been excellent. Here's the latest:
    httpv://www.youtube.com/watch?v=C0E6LeWXhnQ

    From the corresponding article:

    St. Louis bluesman Marquise Knox ... who learned guitar from his grandmother, studied with Grammy Award-winner Henry James Townsend. He released his debut album, Manchild, at the age of 16, and now 23, he has recently completed his second European tour including shows in France, Belgium and Denmark. Appearing in the video with Knox is drummer Mike Battle.

  2. I am up quite early today as I had a sleep study last night. It was an interesting experience. It turns out I have sleep apnea. The bad news is now I have to go back to sleep there another night and I still haven't got all the glue out of my hair from last night. The good news is that this probably explains my near-constant exhaustion.

    Also on the bad side of the ledger: trying to determine how much my insurance will cover it. I have a very, very low out of pocket maximum but I will be changing insurers in a couple of months so I'd like to get this taken care of before then so I don't have to start over and start paying towards deductible and out of pockets again. I hate being an adult sometimes.

    1. From October of last year to January, due to a job change, I had three different insurance policies for my wife. I had insurance through my old job through October, COBRA for her November and December and then coverage through new job starting in January. As you can expect she had lots of medical bills. It was a constant battle to make sure that the dates of service lined up with the right insurance policy. Also since she had to go on COBRA for two months, the insurance company said that all the deductibles had to start over, which sucked because he had hit our max out of pocket already for 2013. In my work on making sure that the dates of service lined up correctly with the right policy, I discovered that the deductible starting over was in error. I pointed this out to Medica and they did a full audit of our entire 2013 billing and subsequently agreed with me. That was cool because (1) I still had about $600 of bills I hadn't paid which now were covered 100%; and (2) I had already paid around $1,400 in copays which the service providers will now reimburse me for.

      Medica was pretty good all around -- they were willing to work with me in figuring out what bills went where and then willing to do the audit and change their orginal decision. Let's face it three insurance policies in 4 months for someone who has $$$$$ in medical bills probably doesn't fit in their normal realm of practice. The whole point of this post (other than to just get it off my chest), is that you have to be diligent with these folks. I have found them willing to help and to look into your issues (if they come up) but you have to initiate the conversation.

      1. free's absolutely right about diligence. We were having our share of nightmares with insurance before I landed my current gig - COBRA for two years ($$$$), then the national exchange that was too convoluted and infuriating to repeat here (thanks, Scott Walker & federal lawmakers). If we hadn't stayed unfailingly diligent, even in the face of despair, our (most importantly, Mrs. Hayes') coverage would have lapsed. It sucks that this is how our society has decided to organize access to affordable healthcare. Just try your best to keep on top of them no matter how demoralizing the process gets.

      2. I was about to chime in that COBRA shouldn't have had you re-do co-pays. It's a continuation of the prior group policy, only the insured pays full freight (no employer subsidy).
        [Part of me says there's an extra upcharge, too, and part of me says no that's not right. Typically COBRA extensions lose the insurers money (because they're more-often picked up by those who need them). Insurers price in COBRA losses into their margin on typical group policies. If it were up to insurers, COBRA extensions wouldn't be offered, which is why it required an act of Congress (the Consolidated Omnibus* Budget Reconciliation Act).]

        *Only time "Omnibus" comes up in my vocabulary: Does that make it an Hapax Legomenon?

    2. They need you to do two separate sleep studies? Interesting; that wasn't my experience. I was diagnosed with sleep apnea when I was in the Marines - my roommate in the barracks got freaked out that I'd stop breathing for half a minute or more, so he urged me to see the battalion doctor. Since there was no obvious cause (I was in great shape, obviously, and didn't have any clear throat obstructions) that doc referred me to the ENT at the naval hospital, who decided to put me in for surgery without a sleep study just based on a deviated septum. So I had a septoplasty & turbinate reduction and haven't breathed normally since. I'm constantly struggling with congestion and the feeling that I can't get enough airflow through my nose. As I understand it, surgery isn't even likely to change apnea symptoms. Don't get surgery if you can avoid it.

      Fast forward a decade. I've learned to cope with crappy sleep and the late-night grad school/teaching grind, but I suffer from the usual symptoms of prolonged exhaustion. I started hitting the wall when Mrs. Hayes got really sick, and I knew it. It took me another year, but I finally forced myself to go to the VA, which was on the hook to treat me because of the surgery & initial diagnosis, for a sleep study. The first couple hours that I was asleep they just observed me, and in the second half they hooked me up to an autoPAP. In the morning they told me I'd had 70+ apnea events in two hours. They issued me an autoPAP a month or so later. Since I got the machine this spring I've been sleeping much better and feel much less fatigue and brain fog(particularly when I don't give in to old studying habits and force myself to get a reasonable amount of sleep each night). I don't snore or make any other noise at night anymore, which has helped Mrs. Hayes get better rest. The machine is very quiet - I can't hear it run and it's less than a foot from my head. Best of all, I'm lowering my risk of cardiac/stroke events and (hopefully) prolonging my life.

      Good luck with the process, Zack. Once you get everything sorted out you'll wonder how you were getting by before you sought treatment.

      1. It had something to do with timing, mostly? Before I went to sleep they said that if they could get they information they needed within 2-4 hours of me falling asleep they would hook me up to a machine. When the tech came in he said that my apnea events were only taking place when I am in the REM phase of sleep. He said it was like a switch. I was fine until I hit that point, and then the events started. He said that my oxygen levels were dipping to the 60-70% range, so that even though they're only happening in that time frame they are pretty significant. They're supposed to call me back today or tomorrow to schedule the next study. That one they'll put me on the mask when I go to sleep and then adjust the pressure to figure out what I will need.

        I'm hoping it's sooner rather than later. I am not exactly a pinnacle of healthiness, but I would like to think that if I'm not dealing with constant exhaustion and brain fog that I will be able to function at a higher level and fix some of those other things.

        1. I expect you certainly would be able to make other adjustments if you can get the fatigue monkey off your back. Good luck with the second test; I hope they get enough info to get you on a helpful course of treatment.

    3. I have sleep apnea.

      The morning when I woke up from sleeping with wires and tubes all over me in a strange hospital/hotel room combo while people watched me snooze…was the most refreshed I had felt in years. It was awesome.

      The insurance bit is a nightmare as always. My first machines lasted 5-7 years or something. When I got the next machine I was on completely different insurance, etc. They required me to "rent to own" the machine because people often don't stick with usage. I insisted that I use it daily, and there's proof in the stats on my prior machine, but they didn't care.

      "Rent to own" turned into a scam where the Allina medical device company just charged "rent forever" to my insurance, who wasn't paying all that much of the total cost anyway. So now our insurance company is winding the long road to recovering money and we should get some of that back, but no one will ever be able to explain to us if this turned out fair. Also, I imagine thousands of elderly people getting charged "rent forever" pricing for 20 years. I guess it could be OK if that meant not upfront lump costs, but I don't remember that being the case.

      Oh, even better is no one actually knew what insurance would cover, so the device company made assumptions in my billing until the benefits came through and then started adjusting. So there's simply no way for any mortal such as myself to figure out what I had truly been charged.

      tl; dnr: make the device company explain to you very clearly what the costs will be. If I did it over again, I think I'd require a true payment schedule (ala a car payment) that I could tick off each month until things were paid, including making the device company actually figure out what _I_ would be charged. And I'd keep all my bills and benefits notices about this specific item in a folder, possibly keeping a ledger as things came in.

      But the sweet nectar of airflow while I sleep was too strong for me to delay the satisfaction and I did none of that.

      1. This morning I attempted to navigate the website of my insurance provider to find how they covered it. I spent around 20 minutes digging before going to chat for help. Chat sent me to a novel-length "bulletin" about what the threshold is for equipment to be "medically necessary." Nothing in there was related to my specific plan or how the costs break down. When I called in on Friday to make sure everything was ready for me to head in today, I was rushed off the phone without getting a clear answer. The chat person asked me if I had any more questions, and while I was typing a response I was disconnected due to "inactivity." I felt this accurately summed up the health insurance experience.

    1. At first I feared he was the one giving up the dinger.
      How cool that Korea gets their own (pitching) Morneau.

      1. Yup.

        Also, I had recruited a BiL to attend the game with my nephews and me, and have repeatedly reminded him about the game(s)* but he has yet buy in so I may have a ticket for you free.

        *Minnesota United takes on the Ottawa Fury following the Guinness Cup match - both games for the price of one apparently.

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