False Alarms

The hardest part of this story was getting the data.

The WPD gets a big high 5 for handing it over the fastest. They also figured out how many hours those alarms equate  to (41,664 hours) and about how much money they cost each year ($572,308).

But remember THIS: those numbers are based on ONE officer responding. The WPD says that most calls…especially if it’s a bank alarm…require more than one officer. In some cases…they send out the chopper and the dogs ( = $$$$$).

Costs really start to add up when they respond to the same location multiple times in one night. Captain Williamson says that sometimes, after a few calls, they can’t even get the owner to come out and shut off the alarm…even though its THEIR responsibility.

I asked the WPD for names…who are the “worst offenders”…whose business or residence do you have to go to multiple times a night, or multiple times throughout the week? I wanted to ask those people why they can’t better maintain their alarms…and do they feel any responsibility for wasting resources? Unfortunately, the WPD says that they can’t provide any names…due to how their data system operates. That was frustrating but deadline came before I was able to pursue it further. After the ordinance comes out next spring, if there are still “worst offenders” for false alarms…I’ll be pressing for a list of names and addresses.

Each year, the number of false alarms in the city keeps going up. Captain Williamson says that’s likely because of the growth our city has seen (i.e. annexation). Still, if you own an alarm system…its your responsibility and that means making sure everyone in your family knows how to arm and un-arm the system, notifying your alarm company if you will be testing it, educating ALL of your employees about your company’s device and making sure that deliveries are made in a way that does not accidentally trigger the alarm (oh…and STOP BURNING THE POPCORN!).

The purpose of the ordinance is to cut down on these high false alarm rates by penalizing repeat offenders. However, I’ve heard mixed reviews from both city and county staff as to whether or not it will actually come to fruition. Apparently they’ve been working on this ordinance for 3 years. The WPD says that it’s now on their lawyer’s desk and with approval from City Council…it will soon be in effect.

Here are more of the figures:

From the New Hanover County Sherriff’s Office

  2005 2006 2007 2008
Total  Alarm Calls 4545 4586 4278 5059
Total Reports 39 30 26 30
False Alarms 4506 4556 4252 5029
Percentage False 99.14191 99.34584 99.39224 99.407

From the Wilmington Fire Department:

38,642 total alarms in the past 4 years…5,705 false alarms. That means that 14.7% are considered false. OF THOSE….there are two types of alarms: manual (you pull the red trigger on the wall) and automatic (hanging in your ceiling and set off without your control). When its an AUTOMATIC alarm….96% of the time it’s false.

The WFD says it’s very difficult to estimate how much those false calls are costing them because different trucks go to different calls and its hard to estimate fuel and maintenance costs on those trucks. Whatever the case…we’ve all seen a fire truck…its NOT cheap to get it out of the driveway.

The WFD already has an ordinance that fines for false alarms but this new one is a joint project with the WPD. There is a very interesting follow-up I have for this piece…but I can’t tell you about it now…because I am OUT.THE.DOOR to Africa tomorrow!

See you in December.

 

 

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Pay Your Dues…Now Pay Up

Last week a man called me, rather adamant about doing a local story on the ‘evils of socialized medicine.’ He says he’s fighting for his life because of what he went through while fighting for this country. Now he’s *also* fighting our health insurance system to get the care he needs.

He now lives in Wilmington but spent his younger years in Vietnam where he was exposed to Agent Orange. He says it’s because of that exposure that he developed a particularly deadly and aggressive form of cancer that requires intensive oncology treatments to fight.

When he was first diagnosed, he ran his health insurance claims through the Veterans Health Administration. They denied his claim and he spent years appealing it. During that time, he used his Blue Cross Blue Shield benefits to cover the cost of his cancer treatments. With all of the co-pays, he says he’s racked up about $70,000. All of those treatments have been through Hanover Medical Specialists in Wilmington.

He recently was told by the VA that they *would* pay his claims…in FULL. Thrilled…he called his oncologist at Hanover Medical Specialists who told him that they would not accept the VA plan. Of note, they do except other forms of government-funded health coverage (i.e. Medicare, Medicaid).

He was livid. He couldn’t believe that he had risked his life fighting for our freedom…and now he couldn’t get the help *HE* needed.

I called Hanover Medical Specialists who told me that the VA is slow to pay and its their choice as to what plans they would take. From what I’ve now read…the VA has a history of health care headaches. While it is certainly the right of any private facility to choose who they receive their income, this veteran felt it unfair that they would accept some government funded programs and not others. He also didn’t think “slow pay” was an acceptable reason for not helping a patient out. His exact response: “They HAVE a choice…because of the war WE fought for them.”

Hanover Medical Specialists did not want to do an interview…I wasn’t surprised. They repeated that they would get in touch with this man and “work something out.”

The next day, when I was getting ready to head out the door to interview this veteran…he called and said that Hanover Medical Specialists had had a change of heart. They WOULD take his VA coverage. He was happy that he wouldn’t have to leave his oncologist and that he now wouldn’t be saddled with astronomical health insurance bills.

He THEN said that he ALSO had had a change of heart…and didn’t want to go on camera anymore. While I’m glad those phone calls I made seem to have lit a fire under this guy’s case and helped get things moving…I’m very disappointed that he took that help and then bailed.

Still…I wanted to share what happened simply to make that point that with enough pressure and persistance…you CAN get the coverage you deserve and have paid for. Ask questions, know your plan and put them on the spot…it gets things done (obviously). Just please dont do it by confusing your local reporter with a patient advocate….

If You Live In The Ogden Area…This Is For You.

I had put together a story about the Cape Fear Public Utility Authority in the Ogden area…and then our entire computer system here at WECT crashed and every ounce of video I have shot over the past year…was erased. Since we are short staffed right now (that’s putting it mildly) I dont have time to re-shoot so I’ll try to put as much information on here as I can. If you have friends in that area…pass it on.

Many homes in that area still use water softeners…and still shell out about $40 per bag of salt and > $400 when the softener needs to be replaced. Having soft water is a matter of preference. I grew up with hard water, there’s nothing wrong with it, except for that minerals tend to build up in your hair, your clothes are a little harder to whiten and its tough to get soap to ‘sud.’

I got a call from a young couple in Ogden whose softener recently broke. They called the CFPUA with a question about it and were surprised when the technician told them they didn’t actually need one anymore. Why? Because soon the new nanofiltration water treatment plant was coming online for that area and it would make water softening obsolete.

That would be great news…except this couple had *just* shelled out $450 for a brand new softener and were irritated that they were given no notice (according to them) by the CFPUA that the softener wasn’t necessary. Furthermore, if you continue to use a softener (double softening) you may erode your piping if you have older metal plumbing.

Of course, I called the CFPUA about this…they did not want to do an interview. They said they had done their due dilegence in getting the word out and they sent me the media press releases to prove it. Indeed, we had run a little blurb about it on WECT. However, when I drove around some of the area neighborhoods knocking on doors, I couldn’t find anyone who had gotten the message.

So hear me now…if you have metal plumbing you probably do NOT want to be double softening your water. No matter WHERE you live…get in touch with your utility provider to find out if they are already softening your water. You can also buy a kit at most local hardwear stores to test the “softness” yourself.

Remember, soft water is a preference. If you find you have heard water, you dont *need* to soften it.

I had heard a rumor that double softening causes bacteria growth in pipes. According to a UNCW biologist…it really is…just a rumor. If you have bacteria in your pipes its probably coming from somewhere in your plumbing and not from the treated water that runs in from the utility company.

Look into this before you pay hundreds for another softener!

“Denied”

When I expressed interest in trying to tackle some local aspect of the health care debate, a friend suggested I talk to Phyllis Benson about her experience with Humana. It wasn’t easy calling a stranger to talk about their lymphoma…and then asking them to talk about it on camera. But Phyllis was a sport and we both agreed that the message was an important one.

Phyllis is one of the warmest people I’ve ever met. She’s genuinely nice…and brutally honest!

You could only hear a piece of her story (because we have time restrictions) but I’ll try to explain more here…

The denied M.R.I. claim was just the start of her battle with Humana. It was also her first major learning experience with a insurance company…and her first victory against them.

She didn’t hear from Humana that her claim had been denied…she heard from New Hanover Regional Medical Center. They sent her a letter that told her that she was responsible for the +$2,000 bill. Phyllis lives on Social Security and there was no way that she could afford that tab. Plus, she was sure that she was covered for the procedure.

Personally, I would have been going ballistic. But Phyllis sat down (calmly) and wrote a letter to Humana explaining the situation. I have a copy of that letter. Its very polite…but very straightforward.

Humana responded with a letter saying….that she would have to wait…to hear a response. When they DID respond, they said that she had waited TOO LONG to send in her appeal. That might have been true…but remember…there was a long delay in her even finding OUT about the denial because she wasn’t contacted by Humana directly.

She continued to write to both the hospital and Humana.

Bill collectors started showing up at her door.

Humana denied the claim three times. On the fourth appeal, they wrote her an apology letter to say that it had all been a processing error and that her check was in the mail.

She says, “Its a shame to have to fight the insurance companies and hospitals after you’ve been fighting a disease.”

That fight continued…and so did her winning streak.

“If they know that you don’t give up and you’re gonna fight ’em, they’ll usually pay it and it’s terrible to have to do that and I know there’s a lot of people out there that don’t know how…but you can do it.” -Phyllis

Phyllis has gotten creative with the her costs and her dealings with her Humana.  Since she has to pay each time her port-a-cath (PAC) is cleaned (a small medical appliance that attaches a port to a vein near the collar bone to deliver chemo)…she delays her cleaning to every 3rd month, instead of every month. She also orders a higher dosage medicine and cuts them in half.

Its these kinds of “shortcuts” that have hospitals concerned…

Mary Ellen Bonczek is the Chief Nurse Executive at New Hanover Regional Medical Center that you saw in the story. She says shortcuts and delays in treatment are what have people arriving at her doorstep sicker than they would have been if they had sought out care at the appropriate time.

That’s not to say that she’s not sympathetic to what people are dealing with on the insurance side of the equation..

 She says, “I see people AFRAID to NOT have insurance. As the consumer, you think you’re paying a premium to get something and then you get denied and you’re like ‘WHAT? What the heck was THAT?! What happened?!'”

If insurance companies are denying more claims, its not just consumers that are hurting…it also means the hospital is losing revenue that they depend on. So at NHRMC, they have created an entire team of nurses and one physician who work on just insurance claims. That effort helps the hospital but it also helps their patients get coverage.

“It is a full-time job – to manage and advocate for the patient completely…We have had to add that level of DAILY critique to make sure that we stay on top of our revenue.”

 You, the consumer, luckily do NOT need to critique your insurance daily but that doesn’t mean you don’t have to know and understand it. Remember, this is something YOU bought and it comes with a hefty booklet of information outlining everything you are and are NOT covered for…

Mary Ellen advises, “Its important for the community and the consumer to talk to their insurance company to know it and to question it. So many people just accept it and they don’t question it. They don’t ask, they don’t call, they don’t follow up. They just say “Oh no.”

Who can blame them? Have you ever tried to READ one of those booklets? Luckily, every insurance company has a hotline.  YES, it is a pain to press all those numbers and negotiate all those channels…but you CAN find humans at the other end who should be able to clarify your policy.

Mary Ellen actually calls this situation a “tightening of controls” from the insurance company to the hospitals. She also says that its those tighter controls that have HELPED them improve their hospital. She says that when she was a nurse, her team wouldn’t think twice about using sterilized wipes (for patients) to wipe down a counter…or wouldn’t give much thought to running a 10th, 11th, 12th test on something…just because. Now they stick to “best practices” which streamline care and keep costs down.

What Mary Ellen wants people to remember is that the greater cost comes in not seeking care. Let me inject a little of my own personal experience here: I started to get bouts of intense pain starting last November and I ignored it until July. Even though the pain was severe I didn’t want to get saddled with hospital expenses or lose time from work. I ended up in the E.R. in May and later in July for exploratory surgery. I am now down an appendix. If I had waited until my appendix had burst…I probably wouldn’t be writing this right now. I too had to experience a push and pull with my insurance company. But in the end, those hassles, that time and what I DID have to pay was worth every penny because I’m healthy today.

“The biggest thing that I can say is, don’t accept ‘no’ for an answer.” -Pat Payne

Pat told me that many claims are rejected because of “code errors.” When a hospital or doctor submits a claim, its done electronically with a code that dictates patient symptoms, diagnoses, treatment, etc. These codes are what insurance companies review and then match to your policy to make sure you are covered.

Pat says that hospitals and doctor’s offices have to churn out a VERY high volume of claims. They are also under time restrictions because the insurance company’s have deadlines. She says that in the crunch, claims get submitted with missing or inappropriate codes and the insurance company kicks out the claim.

Example: you go to the E.R. in excruciating abdominal pain but they can’t figure out what it is. The code for abdominal pain that is submitted to your insurer could mean a WIDE range of things. Unless your records outline how severe your experience was…the insurer may deny your stay because it doesn’t appear the your symptoms were severe enough to warrant a trip to the E.R..

Another example: perhaps the nurse or doctor forgot to include a code. That’s a missing piece of your health puzzle which could cause the claim to be denied.

“If you send in a claim that’s not clear, they’ll throw it right the trash can because that’s gonna take up too much time for them to process that claim,” says Pat.

Pat says that insurance companies often change codes. So your hospital may submit a code that no longer registers with the insurance company’s system (remember: much of this is done electronically). You the consumer have to get in touch with your insurance company to find out the new code and help make a match.

Pat has had her business for 16 years but she’s been in the health insurance agency for 40 (she jokes that she started when she was 4!). She says that, “Insurance companies actually have departments where they have people – all they do is deny claims all day and they get paid bonuses based on the claims they deny. They’re HOPING that you are going to just go ahead and pay the bill yourself.” That’s a pretty heavy charge…so I called the insurance companies to find out if it was true….

I contacted Blue Cross Blue Shield, United, Aetna, Humana & CIGNA. All of them said that there was no such bonus pay system at their company. All of them said that there was nothing out of the ordinary with their denied claims (i.e. an increase). They said they couldn’t provide specific data on their denials without more information…but they didn’t help me figure out what information they needed…OR I was told that the numbers where on the way…but they never showed up.

Apparently, Pat has a close friend who worked for one of these companies who shared the bonus pay tid-bit. Its hard to confirm this without documentation…if you know of where I can look to figure out whose telling the truth…get in touch.

Another piece of advice from Pat: review your hospital bill like your credit card bill, looking at EVERY transaction to make sure it occurred. You may just get an “amount owed” statement but Pat says you should ask for an itemized list. She says that some of her clients have found erroneous charges on their statements that have significantly affected their bills.

 ************************************************************

Here is a more information on how the State is dealing with denials and insurance company complaints….

The North Carolina Department of Insurance has a Healthcare Review Program that receives requests for External Reviews. Consumers go through an External Review after they’ve gone through the denial appeal process with their insurer and are running out of options (read: it’s a last resort). Here’s a video that explains it:

http://www.ncdoi.com/ER/er_home.asp.

Here are the number of requests for E.R.’s that their office has received over the years. Note that not all requests meet the criteria, so the number in parentheses shows how many E.R.’s are actually granted.

2002 – 59 (21)

2003 – 220 (90)

2004 – 201 (77)

2005 —291 (107)

2006 – 255 (113)

2007 – 264 (133)

2008 – 188 (89)

2009 (so far) – 76 (35)

Grand total – 1554

You can see that over the years, there have been an increase in the number of people who are dealing with their insurers and are ending up looking for that “last resort.” But be critical…perhaps the increase is also due in part to more people finding out that E.R.’s are an option out there. An increase in applicants could be due to an increase in awareness.

NC DOI’s Consumer Services Division receives thousands of written complaints every year. They say the vast majority are Life and Health complaints and are a mixture of denials, late payments and insufficient claims (amount paid to consumer). The following numbers are the denied claims data from their office…these are the number of complaints received. Note that in some cases the insurer was determined to be at fault…but not always. Their system cannot separate those two numbers. Again…an increase has occurred, especially between 2007 and 2008.

2004- 1490

2005- 1410

2006- 1420

2007- 1443

2008- 1802

 

If you would like more information about filing an External Review, go here: http://www.ncdoi.com/ER/ConsumerInfo/er_main.asp

“Cash For Clunkers” IS a Clunker!

We haven’t seen many car commercials in a while (…which is not helping my efforts to get a raise!) but a new kind of ad has emerged on the airwaves touting the “Cash for Clunkers” program. More formally known as the Car Allowance Rebate System (CARS), the $1 billion federal program starts today in an effort to get people to off-load their ‘clunkers’ in exchange for new fuel efficient vehicles. 

Basically, you hand over your ride and the government gives you $3,500 to $4,500 as a discount to a new lease or purchase. The idea is to put some fuel into auto sales (…and the economy). Sounds great huh? Admittedly, I started thinking about trading in my car when I heard about this “deal.” That is, until I remembered that my car is only a few years old and gets outstanding gas mileage…but hey, if its new and shiny…who wouldn’t want a new set of wheels?! 

Not everyone is so enthused however… 

The Wall Street Journal says this initiative IS a clunker! Writer Evan Newmark makes these points:

  1. The program is designed to help U.S. automakers who’ve already absorbed over $100 BILLION of your tax dollars.
  2. The program is too small to make a dent. Initially, it was designed to be quadruple its current size however, Congress backed off when they saw the price tag.
  3. Its $1 billion funding will only cover about 250,000 new cars…less than 3% of current US auto production.
  4. The CARS legislation lowered the mileage requirements for GM, Chrysler and Ford who sell those big ol’ SUVs and trucks (wait…wasn’t this whole thing about getting smaller more fuel efficient cars??!!).
  5. Buyers get a rebate when the new ride has a whopping 4 mpg. But get this…if you buy one of those big box cars, you get the rebate so long as it gets just one measly extra mile per gallon….WOW…Mother Earth takes a huge sigh of relief! 

Cars.gov is the government’s website that outlines the details:

  • Your vehicle must be less than 25 years old on the trade-in date.
  • Only purchase or lease of new vehicles qualify.
  • Generally, trade-in vehicles must get 18 or less MPG (some very large pick-up trucks and cargo vans have different requirements).
  • Trade-in vehicles must be registered and insured continuously for the full year preceding the trade-in.
  • You don’t need a voucher, dealers will apply a credit at purchase.
  • Program runs through Nov 1, 2009 or when the funds are exhausted, whichever comes first.
  • The program requires the scrapping of your eligible trade-in vehicle, and that the dealer disclose to you an estimate of the scrap value of your trade-in. The scrap value, however minimal, will be in addition to the rebate, and not in place of the rebate.

CashForClunkersFacts.com provided a list of frequently asked questions about the bill.

You can check if it qualifies on FuelEconomy.gov.

I’m Sorry…I Have to Pay EXTRA To Enter My Hotel Room??!!

Seeing how and where the travel industry has buried fees into your vacation bill is always a fun find after a relaxing stay. Sometimes I just wish that they would stick those extra costs into the total price so I don’t get that “surprise” at the end. In fact, I once asked United Airways why they didn’t do that…she said, in order to remain competitive, they want customers to see low fairs online and go right for those. If they bury the fees, their prices will look comparatively high versus other airlines.

 Hotels have jumped on the fee bandwagon and as you travel out this summer…be on the lookout and ASK questions before you take your room key…

 Get familiar with some of these phrases: room tax, resort fee, parking fee and yes, even an “occupancy fee.”

 I’m sorry…you want to charge me extra for occupying that room? Is there any other alternative? Didn’t think so…

 Hilton is said to charge an occupancy tax even when guests had canceled their room reservations. There are fees for early departure and fees for checked baggage. Use Hotelchatter.com to scan through some of the “hidden” hotel fees for things such as hospitality, use of a facility’s fitness center and more.

USA Today also has a list

  • Hawaii: The hotel room tax is 8.25 percent…9.25 percent in July 2010.
  • Nevada: The room tax is creeping up to a maximum of 12 percent. In Las Vegas, the hotel tax jumps from 9 percent to 12 percent. Reno’s tax is already 12 percent.
  • New Hampshire: The tax on rooms and restaurant meals is now up to 9 percent and now includes recreational vehicles at campgrounds.
  • Massachusetts: Cities now have authority to raise the hotel tax from 4 percent to 6 percent…that’s ON TOP of the state tax of 5.7 percent. Taxes on eating out will rise from 5 percent to 6.25 percent statewide, plus another 0.75 percent if cities choose.
  • New York City: The city raised its hotel tax in March to 14.25 percent and will start charging more for Internet reservations.

Car rentals are not immune. The Milwaukee Journal Sentinel reported that rental companies are tacking on terminal and fuel charges. Here are some car rental tips related to hidden costs

So before you swipe…actually, before you DECIDE where you are staying….ask what the final, the TOTAL cost is, all fees included and then make your final destination decision…

Thank you Al Poynter for the inspiration behind this article.

“Orbits”..and A Bill That Will Jack Up YOUR Bills

Given that Iran is in crisis, North Carolina is in state budget limbo, the stock market is teetering again and unemployment numbers still rising…I do not have much interest in discussing pop-star deaths at length today. Although, I can promise…even though the crew has yet to arrive this morning…that those stories will lead our newscast today. However there is one tid-bit I have found interesting…that I just learned yesterday from our Executive Producer…a little piece of “behind the scenes” news info as to how a news station works…

Maybe you didn’t notice…but within minutes of announcing Michael Jackson, Ed McMahon and Farrah Fawcett’s deaths…the network news stations were airing memorial video stories. I know how long it takes to edit something like that..its not easy! So I was amazed that they were able to slap something like that together so quickly.

Apparently, every news network keeps an archive or “orbits”…video obituaries for major public figures (i.e. celebrities) on hand and when one of them dies…all they have to do is hit play. Our executive producer here told me that someone has the duty of updating them yearly to keep the content fresh.

I wonder who has that job? The obituary news duty….

Just a little insight into how news works…I may be the only person who finds that interesting…

 

Anyways…there is a bill that’s being discussed in the House today and this is news that IS important…

U.S. House Democratics are hoping for a quick passage of a carbon cap-and-trade law that they say is critical to thwarting greenhouse gases and restoring our country’s image globally. 

Moderates are not that excited…because this bill could start jacking up YOUR bills.

What is “cap-and-trade?” Cap-and-trade limits the amount of carbon that manufacturers and energy producers can emit. If they exceed their limit, they would have to buy credits from those who are UNDER their cap.

The idea is to create free-market trading in carbon credits.

Easier said than done says the American Institute for Economic Research, an independent group. They say that in places where cap-and-trade already exists…the market for carbon credits is less than impressive.  

They also say that the bill could double the price of natural gas, fuel used to heat homes. Electricity costs could rise more than 100 percent in the Midwest. I’m not sure yet what the impact would be in N.C. yet….

But here’s an impact you’ll all care about….gasoline and diesel fuel prices could go up nearly an estimated $1 per gallon just from the effects of this bill, driving up the cost of any good that is delivered by truck or train…read: most every consumer product.

This bill may come at a major cost for you…me…and every other American. However…we are also going to pay a major cost for environmental destruction and natural resource depletion in the near future if we can’t get a grip on it NOW…..

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