Tag Archives: provider

#TimesUp: Marvel Creator Stan Lee Accused Of Sexually Harassing His In-Home Nurses

Erika Goldring/Getty Images Call Captain… Stan Lee Accused Of Sexual Harassment A superhero creator is being accused of being a super creep. At the tender age of 95, Marvel’s Stan Lee is facing allegations that he acted inappropriately with his in-home nurses. The Daily Mail is reporting that Lee allegedly harassed and assaulted his home nurses to the point that the provider, Concierge Nursing Care, stopped working with him. A source told The Mail that Lee’s allegedly groped his nurses and asked for sex in the shower in part because he’s “old” and has “lost his way.” “He doesn’t seem to care what people think of him, he’s lost his filter. There has been a stream of young nurses coming to his house in West Hollywood and he has been sexually harassing them. He finds it funny. He walks around naked and is vulgar towards the women, he asks them for oral sex in the shower and wants to be pleasured in his bedroom. He uses the word p***y and f**k in their presence. He’s also very handsy and has groped some of the women, it’s unacceptable behavior, especially from an icon like Stan.” Lee has since responded via his attorney Tom Lallas to BuzzFeed News who told them that the “false and defamatory” allegations are part of a “shake-down” scheme. “Mr. Lee categorically denies these false and despicable allegations and he fully intends to fight to protect his stellar good name and impeccable character,” Lallas said in his statement. “We are not aware of anyone filing a civil action, or reporting these issues to the police, which for any genuine claim would be the more appropriate way for it to be handled. Instead, Mr. Lee has received demands to pay money and threats that if he does not do so, the accuser will go to the media. Mr. Lee will not be extorted or blackmailed, and will pay no money to anyone because he has done absolutely nothing wrong.” Concierge Nursing Care is denying the extortion allegations and people are divided over whether or not the allegations will keep them from supporting Marvel. SMXRF/Star Max/GC Images Mind you “Black Panther” drops February 16—-will you be watching???   Continue reading

Tips On How To Appeal A Denied Health Claim

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Under the 2010 health law, the situation should improve. Health plans will be required to inform members that they can appeal disputed claims internally within the health plan as well as to an independent review organization not affiliated with the health plan.The new rules become effective in July. As the daughter of a woman who had a terminal disease, I can tell you first hand that it pays to appeal. You must stand firm. Here is a simple check list for you to use while you are going through this trying time. 1.      Review the details of your insurance appeals process . Insurance companies are required to give you all the tools you need to properly make an appeal. There are certain timeframes to appeal so make sure you act fast. 2.      Make sure you have all your paperwork in order . Keep records of everything: the bills from your provider, your explanations of benefit, copies of denial letters, your medical records, letters from your provider, etc. 3.      Contact your Human Resources Department. (if you receive coverage through your employer). HR Departments are often equipped to provide you with some direction and can translate the fine print of your policy. 4.      Check your insurer’s medical policy . Ask your physician to review and utilize it to prepare a “Letter of Medical Necessity” to support your case.  Your physician is your best resource in preparing a successful appeal. 5.      Take detailed notes when you speak to the insurance company . Write down the time and date, length of the call, the name and title of the person you speak with, and all the details of the conversation. Make note of any follow-up activities and next steps by all parties. 6.      Write down your argument. Make notes of exactly what happened, when and why. If you are seeking approval for treatment, note any supporting science, clinical evidence, expected benefits, etc. Be clear, firm and concise. Make it clear that you plan to pursue the appeal until it is resolved and the claim is paid or care is approved. 7.      Keep on top of the insurance company. Many appeals take weeks, even months, so call often to check in on the status. And take notes of each call. 8.      An appeal may go through many levels. All insurance companies are required by law to have an appeals process. And most of these have at least three levels. The first level appeals are usually processed and reviewed by the insurance company’s appeals staff or by the insurance company’s medical director responsible for the denial. The second-level appeals are reviewed by a medical director not involved in the original claim decision. And the third-level appeals are usually completed by an independent, third-party reviewer in collaboration with a physician who is board-certified in the same specialty as the patient’s physician.  If your appeal is elevated to the third level and the insurance company continues to deny your claim, you can then take your appeal to the state level. Contact your state’s Insurance Department (contact information is usually found on your state government’s website) for more information. 9.     Seek professional help. If you believe you have a case but are physically unable to handle the appeals process, there are professional health advocacy organizations that can compile and submit the appeal on your behalf. Health Advocate, Inc. and Health Proponent are two of the advocacy industry leaders who can assign a personal health advocate to your case. 10.  Notify your healthcare professionals. If your appeal is successful, you will want to explain the situation to your healthcare providers as soon as possible to avoid any lapse in care or damage to your credit. Before you file an appeal, talk with your insurer to understand why your claim was denied.The biggest mistake people make is that they write an appeal that doesn’t really address the reason for the denial. Good luck. Let me know how  it turns out. Are These BP Artists Good Enough to Get Signed? Lil’ Kim & Nicki Minaj To Perform Together At BET Awards? Sean Kingston Released From The Hospital! DMX “I Don’t Like Drake”

Tips On How To Appeal A Denied Health Claim

FCC’s ‘Net neutrality’ plan would permit super-tiers, network traffic throttling

By Stephen C. Webster Wednesday, December 1st, 2010 — 1:08 pm Internet providers will not be subjected to so-called “Net neutrality” rules and may experiment with tiered, usage-based pricing and “network management” practices, according to new rules being considered by the Federal Communications Commission this month. Advocates of Net neutrality had hoped the regulatory agency would mandate Internet service providers treat all traffic equally: one of the Web's founding principles. Instead, the FCC's Internet regulations adopts many proposals by search and telecom giants Google and Verizon, with the caveat that wireless telephone providers not block competing voice applications. In a speech, FCC Chairman Julius Genachowski specified that the FCC would permit ISPs to charge heavy bandwidth users even more, creating a tiered pricing structure. ISPs would also be able to charge fees to businesses serving large quantities of data. The announcement is a victory for Comcast, the nation's largest cable Internet provider, which recently forced a bandwidth toll upon Netflix partner Level 3. The company called Comcast's move “extortion” but agreed to their conditions to prevent any service interruptions. “With this action, Comcast demonstrates the risk of a 'closed' Internet, where a retail broadband Internet access provider decides whether and how their subscribers interact with content,” the company's chief legal officer said in a media advisory. Comcast insisted the move had nothing to do with Net neutrality. The company has been leading the charge among ISPs to establish tiered-based pricing systems. Comcast admitted in 2008 that it uses “network management” practices to speed up some data transfers and slow down others, and users of peer-to-peer file sharing services have complained to the FCC that the provider has blocked their transfers altogether. Tiered pricing structures are already in place for many communications providers like AT&T and Cricket, which offer wireless broadband services. Verizon said it would implement similar pricing structures in the coming months. The FCC's rules would permit the practice on wired networks as well. Both Comcast and Time Warner, two of America's largest wired broadband providers, have already experimented with the practice. A Texas-based trial run of Time Warner's bandwidth caps saw users paying nearly $30 a month for 768 kilobits-per-second access, with a limit of 5 gigabytes per month and a $1 fee for each gigabyte they went over. One step-up on their pricing tier had users paying nearly $55 for true broadband speeds of 15 megabits-per-second, with a limit of 40 gigabytes per month. Public advocates say the move may ultimately force heavy Internet users to consume less bandwidth and stay tied to television subscriptions over cable and satellite. Comcast, which is in the process of merging with NBC-Universal, stands to benefit tremendously from the arrangement. The American Cable Association's (ACA) claimed the merger “will send monthly cable bills higher by billions of dollars over the next decade.” Major corporations have long sought a way to charge and earn more for bandwidth, ever since Enron attempted to create a bandwidth trading market where space in data pipes would be traded as a commodity like oil or gold. On wired Internet, which is expected to dramatically decrease in relevance in the coming years as fourth-generation wireless networks proliferate, a “public Internet” would be protected from bandwidth throttling. Companies, however, would be permitted to experiment with establishing super-tiers for preferred traffic, but must justify why individual services should be separated from the public Internet. The FCC would additionally require broadband providers to disclose their network management practices. The chairman's proposal lines up closely with a bill proposed by Rep. Henry Waxman (D-CA), who campaigned on pledges to institute Net neutrality rules. His bill, however, completely undermined those principles, but Democrats scrapped the legislation in Sept. The commission was expected to vote on the measure during it's Dec. 21st meeting. http://www.rawstory.com/rs/2010/12/fcc-puts-net-neutrality-dec-agenda/?utm_sourc… added by: treewolf39

Crazy-Off: Sarah Palin-ites vs. Scientologists

Of late the two topics that have garnered us the most spittle-flecked emails have been the rogue and the frauds.

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Crazy-Off: Sarah Palin-ites vs. Scientologists