I am sorry to say that other side of the coin was omitted in your March 14 cover story, “A Real Class Act.” First, the ultimate responsible party is the “tortfeasor” or third party insurance which you stated but left out the details.The details are this: If Jane Doe is carried by Acadian, then there are two possibilities of reimbursement to which Acadian can pursue with only one being “fully” responsible, the third party insurance. In other words, no matter who Acadian bills, and no matter who pays the bill first, the ultimate pay comes from the third party insurance. This brings me to my second point, which is how the health insurance is reimbursed. The health insurance is “subrogating” the third party insurance for reimbursement. So having said that, technically, the health insurance is fully reimbursed by subrogation. Why should Acadian have to give the discount when the health insurance is receiving all of its money back and is not responsible? Acadian does not have a contract with the third party insurance that is fully responsible. Another way to look at it is this: Acadian is choosing to not involve the health insurance knowing it will subrogate. So the health insurance company is saving money by not having to pay the claim (which costs money), then send out notices of subrogation (which costs), track the claims (which costs) and then reprocess the same payment that was made in the first place, which also costs. All of these steps cost money and involve the health insurance that is ultimately not responsible and is reimbursed anyway. So why can’t Acadian choose who to seek reimbursement from if all the money comes from one place? Finally, this is the first question the health insurance asks once a claim comes across their desk: “Is there a third party responsible or is this a work related injury/accident?” The question is asked for a reason.
Dr. Robert LeJeune
Chiropractor, Lafayette
MAY 24 Blogger Robert Mann posts this entry about the Baton Rouge Chamber's recent report on Louisiana's higher education system. It's critical to economic development, and yet our system is facing a "funding crisis" with no way to resolve it, the report says. The Chamber says control of tuition and fees must be returned to the higher ed governing boards.
MAY 24 Here's a NBC33 story about Tyrann Mathieu. He has signed with the Arizona Cardinals, inking a $3 million, four-year deal. He gets a signing bonus of $265K, but gets another, larger bonus if he doesn't get cut from the team for doing drugs. The deal reportedly includes mandatory tests and meetings for the player.
MAY 24 Jarvis DeBerry posts here about the redonkulus rhetoric that would have us believe NOLA is a safe city with a murder problem. Maybe the city's crime stats don't compare with its murder stats because you can't manipulate a murder, he says: a dead body's a dead body. It just doesn't make sense, he says, and his readers agree: a poll asks if they believe the city is safe, and more than 90 percent say no.
MAY 24 Jindal administration officials announced Thursday that the privatization of public health care is going to cost a lot more than they budgeted for, the Advocate reports here. "I'm so surprised," said no one. Anywhere. The cost they're projecting now is more than $1 billion - a lot more than the $626 million budgeted for it. And, it's more than it cost the state to operate those hospitals. So why are we doing this again?
MAY 24 Blogger CB Forgotston ridicules the recent PR campaign by the state GOP in the wake of a legislative auditor's request to both major parties. The GOP (apparently unaware that the Dems got the same request) started yammering about being targeted because it had "killed" a tax increase. CB finds that laughable, but it's also pretty funny that the GOP was comparing this episode to the IRS scandal (Because the President has so much to do with our state auditor. Right?).
MAY 24 Politico details some recent fund-raising efforts by Sen. David Vitter, which have raised the question of his future political plans. This time, it is a $5,000 per head "bayou weekend" that includes "Cajun cooking" and an all-caps "alligator hunt," the story reports. Funds raised go to a super PAC that can spend money to support Vitter in federal or state races, the story points out.
MAY 24 The pink building on Royal in the quarter was sold at a sheriff's sale Thursday, this Picayune story reports. An injunction that would have halted the sale wasn't enforced because the family failed to post a $150,000 bond, the story reports. So the owner of the mortgages on the building bought it, for nearly $7 million. Now the feuding family will have to negotiate with that company to get a lease on the building that has housed their business for close to 60 years.
MAY 23 This post in Louisiana Voice tells us about a bill by a Winnsboro lege that would require all public high school students to take at least one Course Choice online class in order to graduate. (What?) Blogger Tom Aswell says it's a monument to "waste and corruption," especially in light of the problems he's exposed with the program in recent weeks. Idaho had a similar program, but voters removed it by a 2-1 margin, Aswell says.
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Thanks,
Walter