49-jili

49-jili Renuka Rayasam | (TNS) KFF Health News In April, just 12 weeks into her pregnancy, Kathleen Clark was standing at the receptionist window of her OB-GYN’s office when she was asked to pay $960, the total the office estimated she would owe after she delivered. Clark, 39, was shocked that she was asked to pay that amount during this second prenatal visit. Normally, patients receive the bill after insurance has paid its part, and for pregnant women that’s usually only when the pregnancy ends. It would be months before the office filed the claim with her health insurer. Clark said she felt stuck. The Cleveland, Tennessee, obstetrics practice was affiliated with a birthing center where she wanted to deliver. Plus, she and her husband had been wanting to have a baby for a long time. And Clark was emotional, because just weeks earlier her mother had died. “You’re standing there at the window, and there’s people all around, and you’re trying to be really nice,” recalled Clark, through tears. “So, I paid it.” On online baby message boards and other social media forums , pregnant women say they are being asked by their providers to pay out-of-pocket fees earlier than expected. The practice is legal, but patient advocacy groups call it unethical. Medical providers argue that asking for payment up front ensures they get compensated for their services. How frequently this happens is hard to track because it is considered a private transaction between the provider and the patient. Therefore, the payments are not recorded in insurance claims data and are not studied by researchers. Patients, medical billing experts, and patient advocates say the billing practice causes unexpected anxiety at a time of already heightened stress and financial pressure. Estimates can sometimes be higher than what a patient might ultimately owe and force people to fight for refunds if they miscarry or the amount paid was higher than the final bill. Up-front payments also create hurdles for women who may want to switch providers if they are unhappy with their care. In some cases, they may cause women to forgo prenatal care altogether, especially in places where few other maternity care options exist. It’s “holding their treatment hostage,” said Caitlin Donovan, a senior director at the Patient Advocate Foundation . Medical billing and women’s health experts believe OB-GYN offices adopted the practice to manage the high cost of maternity care and the way it is billed for in the U.S. When a pregnancy ends, OB-GYNs typically file a single insurance claim for routine prenatal care, labor, delivery, and, often, postpartum care. That practice of bundling all maternity care into one billing code began three decades ago, said Lisa Satterfield, senior director of health and payment policy at the American College of Obstetricians and Gynecologists . But such bundled billing has become outdated, she said. Previously, pregnant patients had been subject to copayments for each prenatal visit, which might lead them to skip crucial appointments to save money. But the Affordable Care Act now requires all commercial insurers to fully cover certain prenatal services. Plus, it’s become more common for pregnant women to switch providers, or have different providers handle prenatal care, labor, and delivery — especially in rural areas where patient transfers are common. Some providers say prepayments allow them to spread out one-time payments over the course of the pregnancy to ensure that they are compensated for the care they do provide, even if they don’t ultimately deliver the baby. “You have people who, unfortunately, are not getting paid for the work that they do,” said Pamela Boatner, who works as a midwife in a Georgia hospital. While she believes women should receive pregnancy care regardless of their ability to pay, she also understands that some providers want to make sure their bill isn’t ignored after the baby is delivered. New parents might be overloaded with hospital bills and the costs of caring for a new child, and they may lack income if a parent isn’t working, Boatner said. In the U.S., having a baby can be expensive. People who obtain health insurance through large employers pay an average of nearly $3,000 out-of-pocket for pregnancy, childbirth, and postpartum care, according to the Peterson-KFF Health System Tracker . In addition, many people are opting for high-deductible health insurance plans, leaving them to shoulder a larger share of the costs. Of the 100 million U.S. people with health care debt, 12% attribute at least some of it to maternity care, according to a 2022 KFF poll . Families need time to save money for the high costs of pregnancy, childbirth, and child care, especially if they lack paid maternity leave, said Joy Burkhard , CEO of the Policy Center for Maternal Mental Health, a Los Angeles-based policy think tank. Asking them to prepay “is another gut punch,” she said. “What if you don’t have the money? Do you put it on credit cards and hope your credit card goes through?” Calculating the final costs of childbirth depends on multiple factors, such as the timing of the pregnancy , plan benefits, and health complications, said Erin Duffy , a health policy researcher at the University of Southern California’s Schaeffer Center for Health Policy and Economics. The final bill for the patient is unclear until a health plan decides how much of the claim it will cover, she said. But sometimes the option to wait for the insurer is taken away. During Jamie Daw’s first pregnancy in 2020, her OB-GYN accepted her refusal to pay in advance because Daw wanted to see the final bill. But in 2023, during her second pregnancy, a private midwifery practice in New York told her that since she had a high-deductible plan, it was mandatory to pay $2,000 spread out with monthly payments. Daw, a health policy researcher at Columbia University, delivered in September 2023 and got a refund check that November for $640 to cover the difference between the estimate and the final bill. “I study health insurance,” she said. “But, as most of us know, it’s so complicated when you’re really living it.” While the Affordable Care Act requires insurers to cover some prenatal services, it doesn’t prohibit providers from sending their final bill to patients early. It would be a challenge politically and practically for state and federal governments to attempt to regulate the timing of the payment request, said Sabrina Corlette , a co-director of the Center on Health Insurance Reforms at Georgetown University. Medical lobbying groups are powerful and contracts between insurers and medical providers are proprietary. Because of the legal gray area, Lacy Marshall , an insurance broker at Rapha Health and Life in Texas, advises clients to ask their insurer if they can refuse to prepay their deductible. Some insurance plans prohibit providers in their network from requiring payment up front. If the insurer says they can refuse to pay up front, Marshall said, she tells clients to get established with a practice before declining to pay, so that the provider can’t refuse treatment. Related Articles Health | Which health insurance plan may be right for you? Health | Airport authority, Delta unveil $500k multi-sensory room at Metro Airport Health | Your cool black kitchenware could be slowly poisoning you, study says. Here’s what to do Health | Does fluoride cause cancer, IQ loss, and more? Fact-checking Robert F. Kennedy Jr.’s claims Health | US towns plunge into debates about fluoride in water Clark said she met her insurance deductible after paying for genetic testing, extra ultrasounds, and other services out of her health care flexible spending account. Then she called her OB-GYN’s office and asked for a refund. “I got my spine back,” said Clark, who had previously worked at a health insurer and a medical office. She got an initial check for about half the $960 she originally paid. In August, Clark was sent to the hospital after her blood pressure spiked. A high-risk pregnancy specialist — not her original OB-GYN practice — delivered her son, Peter, prematurely via emergency cesarean section at 30 weeks. It was only after she resolved most of the bills from the delivery that she received the rest of her refund from the other OB-GYN practice. This final check came in October, just days after Clark brought Peter home from the hospital, and after multiple calls to the office. She said it all added stress to an already stressful period. “Why am I having to pay the price as a patient?” she said. “I’m just trying to have a baby.” ©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

Bogong High Plains Road facing lengthy closure after truck rollover

Scheffler goes on a run of birdies in the Bahamas and leads by 2Strictly's Shirley Ballas looks unrecognisable as she transforms into Miss Trunchbull for Musicals Week: 'Bravest judge outfit ever!' Have YOU got a story? Email tips@dailymail.com By SEAN O'GRADY Published: 20:08 GMT, 30 November 2024 | Updated: 20:09 GMT, 30 November 2024 e-mail 11 View comments Shirley Ballas left viewers' jaws on the floor as she transformed into Miss Trunchbull on Strictly Come Dancing on Saturday. The usually glamorous head judge, 64, looked nearly unrecognisable as she came out dressed as the famous villain from Roald Dahl 's Matilda for Musicals Week. The dancer ditched her usual evening gowns for a khaki coat which she wore with a chunky brown belt and a white shirt. Most dramatically, Shirley's hair was styled into a high bun and spray painted grey and she also wore makeup to help transform her into the terrifying headmistress. Viewers quicky took to X to react to Shirley's transformation, writing: 'Shirley as Miss Trunchbull is acually sending me! Tbf they all look fab.' 'Oh my God I didn't recognise Shirley'... 'Shirley looks amazing!'... 'Shirley as Miss Trunchbull, I can't!' Shirley Ballas left viewers' jaws on the floor as she transformed into Miss Trunchbull on Strictly Come Dancing on Saturday (Pam Ferris as Miss Trunchbill in Matilda, right) The usually glamorous head judge, 64, looked nearly unrecognisable as she came out dressed as the famous villain from Roald Dahl's Matilda for Musicals Week 'Send everyone else home, Shirley has won tonight'... 'Shirley as Miss Trunchbull, bravest choice of a judge outfit ever, so funny.' It comes after Shirley revealed she hates having the deciding vote as head judge and is always desperate for the other panellists to agree and save her from having to give anyone the boot - and often see her facing backlash. Shirley is often tasked with the final say if Craig Revel Horwood , 59, Motsi Mabuse , 43, and Anton Du Beke , 58, cannot come to an unanimous decision. She told Radio Times : 'I'm sitting there every weekend, thinking, Dear Lord, my saviour, please let the other three make the decision so it doesn't come down to me"'. 'But somebody has to do this job and I try to send them home with as much confidence and affection as I can. My heart does have a little cry when I see them go because I've got to know them, and see them improving'. Shirley joined the judging panel as head judge in 2017, replacing the late Len Goodman and says she has no plans on retiring. 'I want to do Strictly until I pop my clogs. I shall come in on my walking frame, because I'm married to dance!'. But Shirley considered not returning for the 2023 series after an 'overwhelming' amount of hate from vile trolls online. Viewers quicky took to X to react to Shirley's transformation, writing: 'Shirley as Miss Trunchbull is acually sending me!' The dancer ditched her usual evening gowns for a khaki coat which she wore with a chunky brown belt and a white shirt It comes after Shirley revealed she hates having the deciding vote as head judge and is always desperate for the other panellists to agree and save her from having to give anyone the boot But while she called her role the 'icing on the cake' to her career, the abuse that has come alongside it has been extremely difficult to deal with. She told the Sunday Times last year: 'I think I'm getting stronger as the years go by but the trolling got to me last year: it was bad. I think I was just overwhelmed'. 'I think I'm getting stronger as the years go by but the trolling got to me last year: it was bad. I think I was just overwhelmed. 'This year I've taken on a young man called Harry who does all my social media, which is proving to be just fabulous.' Employing someone else to manage her social media accounts means that Shirley has not been scrolling through the negative comments. Shirley Ballas Roald Dahl Strictly Come Dancing Share or comment on this article: Strictly's Shirley Ballas looks unrecognisable as she transforms into Miss Trunchbull for Musicals Week: 'Bravest judge outfit ever!' e-mail Add commentInter Milan boss Simone Inzaghi was critical of his team’s showing in a 1-0 defeat at Bayer Leverkusen in Tuesday’s UEFA Champions League fixture. Speaking to Sky Sport after the game via FCInterNews , Inzaghi admitted the Nerazzurri failed to deal with Xabi Alonso’s heavily motivated team. Almost non-existent as an attacking force, Inter seemed satisfied with a point from the get-go, never putting Matej Kovar to the test. Indeed, Inter finishing the game without an attempt on target best illustrates Simone Inzaghi’s unfathomably conservative approach. For whatever reason, Inzaghi trusted his backline to stand firm for 90 minutes after registering five consecutive European shutouts. However, Inter’s lack of ambition in the final third eventually backfired on them, complicating their pursuit of automatic knockout qualification. After a sub-par performance at the BayArena, Inzaghi must regroup his troops for the league-phase finale. Inter will meet Sparta Prague and Monaco in the last two rounds, probably needing all six points to secure direct progression. But that’s a matter for another day as the Champions League returns for the penultimate round in January 2025. Simone Inzaghi Slams Inter Milan Performances Following Disheartening UEFA Champions League Loss at Bayer Leverkusen “It wasn’t one of our best matches,” Inzaghi started. “But we faced a top-quality team that started better, hitting the crossbar early on. “After that, we controlled the game—perhaps too much, as we should have been more daring. “We lacked quality in the final 25 meters, and once we had the match under control, losing like this is frustrating because it ends our unbeaten streak. “Still, it doesn’t take away from our journey. “Tomorrow, we’ll probably be among the top eight, and in January, our destiny will be in our hands with two challenging matches. “There’s regret about conceding that goal.” Inzaghi also opened up on a chaotic situation in Inter’s box, leading to Leverkusen’s late winner. “Yes, that’s true. There was also a deflection,” he added. “Darmian saw it at the last moment, Mukiele tried a bicycle kick, and then the ball came back into play. “We needed to be more attentive. We played worse in the second half than the first, but there were no warning signs. “There’s regret, but that’s Champions League football. We move forward with our heads held high.” However, Inzaghi is positive tonight’s upset will not derail Inter’s quest to secure a top-eight finish. “Not much, but with a positive result, we would’ve kept Bayer behind us and moved closer to our goal. “Now we’ll see. We’ll think about it in January because, for now, we have the league, Coppa Italia, and Supercoppa. “We’ll analyze this calmly, but it’s unnecessary to overthink – it wasn’t our best game compared to others, but we respect the opponent a lot.” Finally, he agreed with the reporter, admitting Inter were way too passive. “I agree, we did far too little. We only risked the crossbar incident, but we certainly needed to do more. “When we started building possession, it felt like they were struggling to cope with our play. “We should’ve added more quality, but today, we didn’t show the level we’re capable of.”HIGH SCHOOL FOOTBALL: Anderson set for return, trying to help CBA win first State title

Man City stumble again while Arsenal and Bayern Munich earn dominant winsTrump names son-in-law Jared Kushner’s father Charles as next ambassador to France

Cellectar Biosciences Provides Strategic Update on Clinical Development, Pipeline Programs and Corporate RestructuringRed Bulls go into MLS Cup final with distinctly Canadian flavour in front office

35 APL Front protesters in Sangrur jailOnline auction of confiscated booze features hard-to-find bottles of Kentucky bourbonsMusk's millions for Trump make him biggest US political donor

Infamous 'sofa problem' that boggled mathematicians for decades may finally have a solution

Suspect in the killing of UnitedHealthcare’s CEO struggles, shouts while entering courthouse

O'Reilly Automotive Inc. stock underperforms Friday when compared to competitors despite daily gainsNASSAU, Bahamas — Scottie Scheffler birdied every hole but the par 3s on the front nine at Albany Golf Club on Friday and finished his bogey-free round with an 8-under 64 that gave him a two-shot lead in the Hero World Challenge. Two months off did nothing to slow the world's No. 1 player. Scheffler already has eight victories this year and is in position to get another before the end of the year. Scheffler was at 13-under 131, two ahead of Akshay Bhatia (66) and Justin Thomas (67), both of whom had to save par on the 18th hole to stay in range going into the weekend. Scheffler started with a lob wedge to 2 feet for birdie and never slowed until after he went out in 29 to seize control of the holiday tournament against a 20-man field. Scheffler cooled slightly on the back nine, except it didn't feel that way to him. "Front nine, just things were going my way. Back nine, maybe not as much," Scheffler said. "A couple shots could end up closer to the hole, a couple putts go in, just little things." Asked if he felt any frustration he didn't take it lower — he once shot 59 at the TPC Boston during the FedEx Cup playoffs — Scheffler sounded bemused. "I think in this game I think a lot of all y'all are looking for perfection out of us," he said. "Today I shot 8 under on the golf course, not something I hang my head about. A lot of good things out there — clean card, bogey-free, eight birdies. Overall, I think I'm pretty pleased." Thomas felt his 67 was stress-free, particularly the way he was driving the ball. The wind laid down again, rare for the Bahamas, though it is expected to pick up on the weekend. Thomas wasn't concerned to see Scheffler get off to a hot start, especially with three par 5s on the front nine and a short par 4 that at worst leaves a flip wedge to the green. "You literally can birdie every hole as soft as the greens are," Thomas said. "He's a great player, a great wedge player, and you have a lot of birdie holes to start. I'm honestly surprised he only shot 8 under. It's a sneaky course because if you fall asleep on some shots, you can get out of position. But if you're on and focused and really in control of everything — like these last two days with no wind — you can just make so many birdies." Ryder Cup captain Keegan Bradley had a 67 and was four shots behind. No matter how benign the conditions, it wasn't always easy. Cameron Young, who opened with a 64 for a two-shot lead, followed with a 75 despite making five birdies. That included a double bogey on the final hole when his approach tumbled down the bank into the rocks framing the lake that goes all the way down the 18th hole. Patrick Cantlay was trying to keep pace playing alongside Scheffler, but he had three bogeys over the final seven holes and fell seven shots behind with a 71. The tournament, hosted by Tiger Woods, is unofficial but offers world ranking points to all but the bottom three players because of the small field. It's the weakest field in 25 years, but Scheffler at No. 1 gives it enough cachet. He is the first player since Woods in 2009 to start and finish a year at No. 1 in the world. And even after a layoff — giving him time to tinker with a new putting stroke — it looks like it might be a while before anyone changes that. Be the first to know Get local news delivered to your inbox!