Hello! Your friendly mod PassingDuchy again with a few community updates!
Reddit and Discord Hobby Drama communities
I did reach out to both communities. The response from both is that they're not interested in affiliating. As such we won't be linking to either community in the sidebar to respect their wishes. Going forward please don't send either community messages about partnering with this community (though I appreciate everyone who did! It was a big help).
Reposting
Based on the previous discussion post we will be encouraging an opt-out request be sent to authors, but not requiring. The only requirement currently is that the full text is reposted and a link to the original post is included at the top or bottom of the repost.
14 Day Rule
The 14 day rule for all drama being concluded (outside of Round Up) will remain instituted.
Post Titles
As Lemmy doesn't currently have flairs/tags, we will be requiring a little extra work on post titles to help community searchability. Your title must include:
- [Repost] for reposts from another community (reddit or otherwise). Reposts must include the full text and a link to the original post at the top or bottom of the repost. At this time non-text posts (podcasts, YouTube videos, etc) are not allowed. If you want to link those you may link them in the weekly Hobby Round Up.
- A [History] tag if your post is a professional history related to a hobby. History is for only professionals having drama with no hobbyists involved (industry drama). This is a little extra work, but a compromise for people who are solely here to read about hobbyists and not industry drama. Ex. A post about the history of F1 would be [History], but a post about fan efforts to have a specific racer removed would be hobbyist drama.
- [Hobby] please keep this to the general hobby eg video games, knitting, board games, TV shows, music, apparel, etc.
- OPTIONAL [Specific Hobby] this is mostly useful for designating a specific fandom, band, brand, platform, etc (eg if your write-up general hobby is music, you might put Taylor Swift here to note the drama is about her specific fandom).
- We will not be requiring markers for post length. If your post exceeds the character count and needs to be continued in the comments, please link to the continued comment chain in your main post (currently mods can't pin other users' comments so we can't assist here).
- A full title should look something like: [Video Games][Old School Runescape] The hat scandal OR [Repost][History][Music] Fyre Festival controversies.
Hobby Round Up/Scuffles
A general megapost for all breaking hobby drama (14 day rule will not apply), news, chat, posts that don't fit the rules, links to articles/podcasts/videos, etc will go up on Mondays (I'm currently looking into figuring out an automod bot to do this to ensure regularity). I've changed the name to Round Up in the hope that users who use both the Lemmy and Reddit communities will see the different title in their tabs and have less confusion when posting between both.
Hobby Town Hall/Community Discussion
Hobby Community Discussion will be like the subreddit's Town Hall and go up on the first of the month. As we are a smaller community this will go up on the monthly first to be used for a four month period and be pinned for the duration. Community suggestions, improvements and concerns should be posted to Community Discussion. If possible please use reports for any immediate concerns as the mod team can coordinate best for immediate response via the modlog. Our first Community Discussion will go up on September 1st 2023 and last until the next one on January 1st 2024.
I did pharmacy billing for a while and this is a kind of innocent take that people are just being lazy. The training was terrible (I was taught the basics of the software and then given a photocopy of various employees hand written notes for common rejection solutions over the years ....most of which didn't still apply and those employees had long left; when I left in sure my notes were copied to the pile). There were metrics that kept being increased meaning spending more than 30 seconds on a claim was going to put you behind (I did night shift and my boss was talked to about me once or twice because I sometimes had an hour or two where I'd cleared everything I could and had nothing to do because the rest of the world was asleep). And, finally:
The software was designed to actively fight us. My most common reject was insurance won't pay for anything $X or more with X being stupidly low. For many insurances you could not put in a recurring override for monthly maintenance meds. Your options were either give the patient a 2/3/whatever day supply to get the cost down and they'd just have to visit the pharmacy for pickup so much they might as well work there. Or do a one time special override every. Single. Time. Which involved me doing a special code on my end (which wasn't the same for every insurer and sometimes they'd just randomly change it for shits and giggles with no communication, I had a list of codes that were often used I'd try guessing with). Calling their help desk whose employee retention and training were also in the toilet. If the insurance end person knew the process for a one time special override, great. If not I started specifically keeping notes by insurer to teach new people because otherwise I'd be subjected to an hour of phone hockey while they tried to find someone who both knew how to do it and could cram my call into their metrics. Then we'd have to go through generating specific rejects just because we needed it in our logs we tried shit we knew wasn't going to work. Doctor note saying md knows med is expensive and that pt needs it to live regardless attached? Okay run it through as cost doctor approved to get the "fuck the doctor we don't want to pay" reject. Insurance doctor/nurse team reviewed that yes the doctor is correct the patient needs this med to live code put in? Okay run it again to get the fuck our own doctors we still won't pay reject. Now insurance help desk has to message their next level support to get authorization for a one time override for medical necessity. Okay now it'll go through on the insurer end (as long as they didn't fatfinger anything because the override only works for one single attempt). Great, we did it one try team! Now my turn to do it on my end which involves me removing all my codes because the software no longer recognizes the reject so will reject me for needless codes which will make us have to get the One Single Try Authorization again......
You don't have to die to visit hell just work in medical billing.