A homemade alternative such as a simple rice dish or burritos can be easy to make in batches and store away for the week. Another simple way to slowly decrease your intake of processed foods is to check food labels what do you need to buy propecia for excess amounts of salt or sugar. Instead of sodas, Passerrello suggests opting for orange juice or milk that are fortified with calcium and vitamin D.Ultimately, choosing healthy foods is a matter of providing your body with the proper nutrients it needs while also incorporating your personal tastes and preferences.
A handful of chips and a frozen pizza may not be the healthiest treat, but they won't do serious damage as long as ua-processed foods aren't your main and only form of nutrients.Like many people, what do you need to buy propecia Stephanie Holm made holiday cookies with her family last year. Her daughter found a recipe on the internet, and the two of them set to making them in the kitchen of their apartment.Together, they mixed the dough, rolled it out, put the cookies on a pan and popped it in the oven â âliterally covered in sprinkles on the outsideâ¦cute, and very delicious,â says Holm, a pediatric environmental medicine specialist at UC San Francisco.But as the cookies baked, Holm noticed that the cute sugary coating burned a little in the oven, though not enough to ruin the cookies. Then Holm heard her daughter exclaim, âMama, itâs purple!.
 and she saw that the air what do you need to buy propecia quality sensor she keeps in their apartment had indeed turned from green (good air quality) to purple (very unhealthy). Could a single batch of slightly singed cookies have been to blame?. What happened with Holmâs cookies wasnât a fluke.
All cooking releases a complex mixture of chemicals, some of what do you need to buy propecia which would be classified as unhealthy pollutants. As for whether cooking is hazardous to your health â the short answer is, it depends. But generally, if you have good ventilation, you should be fine.âWe all cook, what do you need to buy propecia and the average life expectancy is 78 or 79 years old.
So we shouldnât get too worried,â says Delphine Farmer, an atmospheric chemist at Colorado State University. ÂBut it is an opportunity to think about how to reduce your exposure to pollutants.âOut of the Frying PanFarmerâs research found that cooking releases a mixture of hundreds of different chemical compounds into the air. Every ingredient gives off its own what do you need to buy propecia unique blend of particles and gases.
Proteins in meat can break down and give off ammonia. Roasting can what do you need to buy propecia produce isocyanates. Oils from frying and sautéing can aerosolize (thatâs how your counters end up with a fine layer of grease on them).
The airborne molecules can continue to react and change as they drift around your kitchen and bump into each other.âYou can see some of these really interesting compounds,â Farmer says. ÂBut are they at levels that what do you need to buy propecia are toxic?. We don't know.â Part of the uncertainty when it comes to health effects comes from the fact that most air quality studies and standards are based on outdoor air â despite our world where people today spend an estimated 90 percent of their time indoors.
While Canada and the World Health Organization have indoor air quality guidelines, the U.S. Does not.In general, indoor air what do you need to buy propecia chemistry fluctuates a lot more than outdoor air. The average air quality can be good, but as Holm and her daughter experienced, some activities â like cooking and cleaning â can cause dramatic changes.
Pollutant levels will what do you need to buy propecia spike in the kitchen while cooking is actively happening and then drift back down as the airborne molecules disperse.âThe pattern of exposure is different. And we really don't have great scientific data on what the difference of that pattern of exposures means for people's health.â Holm says.Acquiring that scientific data is no easy task. Variables that can affect cooking fumes and their contents include how often a person cooks, what they cook, how they cook it, what kind of appliance they use, what kind of ventilation they have and maybe even the type of pots and pans they use, says Iain Walker, an engineer at Lawrence Berkeley National Lab who studies home air quality and ventilation.
The best researchers can do what do you need to buy propecia is try to gauge the relative impact of each factor. Gas stove or electric?. Boiling or frying?.
Meat what do you need to buy propecia or vegetables?. Nonstick pan or stainless steel?. Into the FireThe main pollutant of concern linked to cooking what do you need to buy propecia is particulate matter.
This catchall term refers to a complex mix of microscopic solid bits and uafine liquid droplets that could be made up of hundreds of different chemical compounds. The chemistry doesnât matter nearly as much as the size. Particles smaller than 10 microns (less than 1/5 the width of a human hair) can make their way into the lungs and lodge what do you need to buy propecia there.
Even smaller particles can make their way into the bloodstream.Particulate matter is the reason you donât want to breathe in smoke or car exhaust. Chronic exposure to high levels of particulate matter what do you need to buy propecia exacerbates asthma, but also makes it more likely that a child will develop asthma, says Holm. Itâs also linked to changes in childhood growth, metabolism and brain development, and itâs classified as a carcinogen by the WHO.All cooking produces some particulate matter in the form of aerosols and tiny bits of char generated from food and dust being heated up.
If you can smell burning, youâre likely breathing in quite a bit of particulate matter. ÂAnything with a red-hot element is going to generate particles,â says what do you need to buy propecia Walker. That includes most stovetops, ovens and even small appliances like toasters.
Frying and roasting cook methods both produce a lot more particulate matter than boiling or steaming. And fatty foods give off more what do you need to buy propecia than veggies.Gas stoves are particularly bad for indoor air quality. Not only do they produce more particulate matter by virtue of creating an open flame, but the actual fossil fuel combustion also generates other gases, such as carbon dioxide and nitrogen dioxide.
From a health perspective, the thing that raises the biggest concern in this scenario is nitrogen what do you need to buy propecia dioxide.Nitrogen dioxide, like particulate matter, contributes to breathing problems like asthma and is regulated in outdoor air. The gas has also been linked to heart problems, lower birth weight in newborns and shorter lifespans for people who are chronically exposed.A 2016 study from Lawrence Berkeley National Lab found that simply boiling water on a gas stove produces nearly twice the amount of nitrogen dioxide as the EPAâs outdoor standard. Considering that about a third of American homes use natural gas for cooking, thatâs a lot of potential exposure.âSomehow, we've just become used to an unvented fossil fuel device in our homes,â says Brady Seals, who manages the carbon-free buildings program at the Rocky Mountain Institute, a clean energy think tank.
She wants what do you need to buy propecia to raise awareness of nitrogen dioxideâs health risks as a way to discourage natural gas use in homes. And sheâs not alone in this mission. The Massachusetts Medical Society passed a resolution in 2019 to recognize the link between gas stoves and pediatric asthma.
Several cities in California, including San Francisco, have passed bans on natural gas in new construction, citing both climate and health what do you need to buy propecia hazards.If you have a gas cooktop, Seals and Walker recommend swapping it out for an electric one if you have the means and ability to do so. ÂNot only are you reducing carbon impact [on the environment], but you can have a healthier home if you get rid of combustion appliances,â Walker says.The best option from both an energy-efficiency and air-quality perspective, he says, is an induction stove, which uses magnets to transfer heat directly to your pots and pans. No red-hot elements what do you need to buy propecia means less particulate matter.
If you canât replace your gas stove, Seals recommends a plug-in induction cooktop.Vented AirRealistically, few people are going to swear off stir frying or using their oven for the sake of producing less particulate matter. ÂEverybodyâs going to cook what theyâre going to cook,â says Farmer, noting that people use whatever kitchen appliances they have. Thatâs why all these experts stress the importance of good ventilation.Holm was part of a 2018 study looking at particulate matter in the what do you need to buy propecia homes of children with asthma.
One of the most surprising findings. In homes that never used a range hood or range fan, people were exposed to unhealthy levels of particulate matter for roughly 10 percent what do you need to buy propecia more time than in homes that used range ventilation.Walker, the ventilation expert, recommends that people should use a high setting on their kitchen range hood whenever possible, since the quieter low settings capture only about half of pollutants. Since most range hoods donât extend over the front burners, you might want to consider using the back burners, especially if you have a gas stove.
Walker also advises that people keep the ventilation on for about 15 minutes after theyâre done cooking. Thatâs about how long it takes for all of the air in the room to be replaced what do you need to buy propecia. But that only applies if your vent is sending fumes outside, which is not often the case.Unless you have a new, higher-end kitchen and stove, your built-in range ventilation might essentially be a fan.
Itâs just pushing the fumes around the room, which helps disperse the concentration of pollutants more quickly but doesnât actually remove them from your house. Many homes and apartments, including Holmâs, donât even what do you need to buy propecia have that option. In that case, Holm recommends opening some windows if the outside air quality is good, or using a portable air purifier with a HEPA filter.In the end, there are still a lot of unknowns about how cooking fumes affect us.
To some extent, we simply have to accept them as a byproduct of enjoying our favorite foods, much like we accept pet hair as a part of having a furry friend. ÂYou start realizing how pollutants are a part of our life,â Seals says. ÂLetâs reduce pollution wherever we can.
But Iâm not going to give up my dog and Iâm not going to stop cooking.â[Correction. A previous version of this story erroneously stated the findings of Holm's 2018 air quality study and the type of portable air purifier that Holm recommends using in homes. We apologize for the errors, which have been corrected in this current version.].
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Police are seeking assistance can you buy propecia over the counter usa in locating a missing man.Police said Gary Cohen, of Greenburgh, was last propecia pill cost seen or heard from on Tuesday, Nov. 24.His clothing description is unknown. Cohen has a history of depression propecia pill cost and should be considered endangered, Greenburgh Police said.Anyone with information is asked to contact Det.
Bridges of the Continue Greenburgh Police Department Special Victims Unit. She can be reached at 914-989-1700 propecia pill cost or 989-1735. Click here to sign up for Daily Voice's free daily emails and news alerts..
Police are seeking assistance in locating a missing man.Police said what do you need to buy propecia Gary Cohen, of http://www.ec-cath-bischheim.ac-strasbourg.fr/documents-a-destination-des-parents/ Greenburgh, was last seen or heard from on Tuesday, Nov. 24.His clothing description is unknown. Cohen has a history of depression and should be considered endangered, Greenburgh Police said.Anyone with information is asked what do you need to buy propecia to contact Det. Bridges of this hyperlink the Greenburgh Police Department Special Victims Unit. She can be reached at 914-989-1700 or what do you need to buy propecia 989-1735.
Click here to sign up for Daily Voice's free daily emails and news alerts..
Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
REDWOOD CITY, http://dpfcleaningkent.co.uk/how-to-order-cipro-online/ Calif.--(BUSINESS buy propecia in canada WIRE)--Oct. 7, 2020-- Guardant Health, Inc. (Nasdaq. GH) (âGuardant Healthâ), a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary blood tests, vast data sets and advanced analytics, announced today the pricing of an underwritten public offering of 7,000,000 shares of its common stock at a public offering price of $102.00 per share, before deducting underwriting discounts and commissions, all of which are being sold by SoftBank Investment Advisers.
In addition, SoftBank Investment Advisers has granted the underwriter a 30-day option to purchase up to 700,000 additional shares of common stock at the public offering price, less underwriting discounts and commissions. Guardant Health is not selling any of its shares in the offering and will not receive any of the proceeds from the sale of shares in the offering by SoftBank Investment Advisers. The offering is expected to close on October 9, 2020, subject to the satisfaction of customary closing conditions. J.P.
Morgan Securities LLC is acting as sole book-running manager of the offering. The public offering is being made pursuant to an automatic shelf registration statement on Form S-3 that was filed by Guardant Health with the U.S. Securities and Exchange Commission (the âSECâ) and automatically became effective upon filing. A preliminary prospectus supplement and accompanying prospectus relating to and describing the terms of the offering have been filed with the SEC and are available on the SECâs website at www.sec.gov.
Copies of the final prospectus supplement and accompanying prospectus, when available, may be obtained by contacting. J.P. Morgan Securities LLC, c/o Broadridge Financial Solutions, 1155 Long Island Avenue, Edgewood, NY 11717, or by telephone at (866) 803-9204, or by email at prospectus-eq_fi@jpmchase.com. This press release shall not constitute an offer to sell or a solicitation of an offer to buy these securities, nor shall there be any sale of these securities in any state or other jurisdiction in which such offer, solicitation or sale would be unlawful prior to the registration or qualification under the securities laws of any such state or other jurisdiction.
Source. Guardant Health, Inc. View source version on businesswire.com. Https://www.businesswire.com/news/home/20201007005593/en/ Investors.
Carrie Mendivilinvestors@guardanthealth.com Media. Anna Czenepress@guardanthealth.com Source. Guardant Health, Inc.REDWOOD CITY, Calif.--(BUSINESS WIRE)--Oct. 6, 2020-- Guardant Health, Inc.
(Nasdaq. GH) (âGuardant Healthâ), a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary blood tests, vast data sets and advanced analytics, announced today the commencement of a proposed underwritten public offering of 7,000,000 shares of its common stock being offered for sale by SoftBank Investment Advisers. In addition, SoftBank Investment Advisers expects to grant the underwriter a 30-day option to purchase up to 700,000 additional shares of common stock at the public offering price, less underwriting discounts and commissions. Guardant Health is not selling any of its shares in the offering and will not receive any of the proceeds from the sale of shares in the offering by SoftBank Investment Advisers.
The proposed offering is subject to market and other conditions, and there can be no assurance as to whether or when the offering may be completed, or as to the actual size or terms of the offering. J.P. Morgan Securities LLC is acting as sole book-running manager of the offering. The public offering is being made pursuant to an automatic shelf registration statement on Form S-3 that was filed by Guardant Health with the U.S.
Securities and Exchange Commission (the âSECâ) and automatically became effective upon filing. A preliminary prospectus supplement and accompanying prospectus relating to and describing the terms of the offering will be filed with the SEC and will be available on the SECâs website at www.sec.gov. When available, copies of the preliminary prospectus supplement and accompanying prospectus may be obtained by contacting. J.P.
Morgan Securities LLC, c/o Broadridge Financial Solutions, 1155 Long Island Avenue, Edgewood, NY 11717, or by telephone at (866) 803-9204, or by email at prospectus-eq_fi@jpmchase.com. This press release shall not constitute an offer to sell or a solicitation of an offer to buy these securities, nor shall there be any sale of these securities in any state or other jurisdiction in which such offer, solicitation or sale would be unlawful prior to the registration or qualification under the securities laws of any such state or other jurisdiction. Source. Guardant Health, Inc.
View source version on businesswire.com. Https://www.businesswire.com/news/home/20201006006087/en/ Investors:Carrie Mendivilinvestors@guardanthealth.com Media:Anna Czenepress@guardanthealth.com Source. Guardant Health, Inc..
REDWOOD CITY, what do you need to buy propecia http://dpfcleaningkent.co.uk/how-to-order-cipro-online/ Calif.--(BUSINESS WIRE)--Oct. 7, 2020-- Guardant Health, Inc. (Nasdaq. GH) (âGuardant Healthâ), a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary blood tests, vast data sets and advanced analytics, announced today the pricing of an underwritten public offering of 7,000,000 shares of its common stock at a public offering price of $102.00 per share, before deducting underwriting discounts and commissions, all of which are being sold by SoftBank Investment Advisers. In addition, SoftBank Investment Advisers has granted the underwriter a 30-day option to purchase up to 700,000 additional shares of common stock at the public offering price, less underwriting discounts and commissions.
Guardant Health is not selling any of its shares in the offering and will not receive any of the proceeds from the sale of shares in the offering by SoftBank Investment Advisers. The offering is expected to close on October 9, 2020, subject to the satisfaction of customary closing conditions. J.P. Morgan Securities LLC is acting as sole book-running manager of the offering. The public offering is being made pursuant to an automatic shelf registration statement on Form S-3 that was filed by Guardant Health with the U.S.
Securities and Exchange Commission (the âSECâ) and automatically became effective upon filing. A preliminary prospectus supplement and accompanying prospectus relating to and describing the terms of the offering have been filed with the SEC and are available on the SECâs website at www.sec.gov. Copies of the final prospectus supplement and accompanying prospectus, when available, may be obtained by contacting. J.P. Morgan Securities LLC, c/o Broadridge Financial Solutions, 1155 Long Island Avenue, Edgewood, NY 11717, or by telephone at (866) 803-9204, or by email at prospectus-eq_fi@jpmchase.com.
This press release shall not constitute an offer to sell or a solicitation of an offer to buy these securities, nor shall there be any sale of these securities in any state or other jurisdiction in which such offer, solicitation or sale would be unlawful prior to the registration or qualification under the securities laws of any such state or other jurisdiction. Source. Guardant Health, Inc. View source version on businesswire.com. Https://www.businesswire.com/news/home/20201007005593/en/ Investors.
Carrie Mendivilinvestors@guardanthealth.com Media. Anna Czenepress@guardanthealth.com Source. Guardant Health, Inc.REDWOOD CITY, Calif.--(BUSINESS WIRE)--Oct. 6, 2020-- Guardant Health, Inc. (Nasdaq.
GH) (âGuardant Healthâ), a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary blood tests, vast data sets and advanced analytics, announced today the commencement of a proposed underwritten public offering of 7,000,000 shares of its common stock being offered for sale by SoftBank Investment Advisers. In addition, SoftBank Investment Advisers expects to grant the underwriter a 30-day option to purchase up to 700,000 additional shares of common stock at the public offering price, less underwriting discounts and commissions. Guardant Health is not selling any of its shares in the offering and will not receive any of the proceeds from the sale of shares in the offering by SoftBank Investment Advisers. The proposed offering is subject to market and other conditions, and there can be no assurance as to whether or when the offering may be completed, or as to the actual size or terms of the offering. J.P.
Morgan Securities LLC is acting as sole book-running manager of the offering. The public offering is being made pursuant to an automatic shelf registration statement on Form S-3 that was filed by Guardant Health with the U.S. Securities and Exchange Commission (the âSECâ) and automatically became effective upon filing. A preliminary prospectus supplement and accompanying prospectus relating to and describing the terms of the offering will be filed with the SEC and will be available on the SECâs website at www.sec.gov. When available, copies of the preliminary prospectus supplement and accompanying prospectus may be obtained by contacting.
J.P. Morgan Securities LLC, c/o Broadridge Financial Solutions, 1155 Long Island Avenue, Edgewood, NY 11717, or by telephone at (866) 803-9204, or by email at prospectus-eq_fi@jpmchase.com. This press release shall not constitute an offer to sell or a solicitation of an offer to buy these securities, nor shall there be any sale of these securities in any state or other jurisdiction in which such offer, solicitation or sale would be unlawful prior to the registration or qualification under the securities laws of any such state or other jurisdiction. Source. Guardant Health, Inc.
View source version on businesswire.com. Https://www.businesswire.com/news/home/20201006006087/en/ Investors:Carrie Mendivilinvestors@guardanthealth.com Media:Anna Czenepress@guardanthealth.com Source. Guardant Health, Inc..
Adam Woodrum was out for a bike ride with his wife and kids on July 19 when his then 9-year-old buy propecia online safe son, Robert, crashed. ÂHe cut himself pretty bad, and I could tell right away he needed stitches,â said Woodrum. Because they were on bikes, he called the fire department in Carson City, Nevada buy propecia online safe. ÂThey were great,â said Woodrum.
ÂThey took him on a stretcher to the ER.â Robert received stitches and anesthesia at Carson Tahoe Regional Medical Center buy propecia online safe. Heâs since recovered nicely. Then the buy propecia online safe denial letter came. The Patient.
Robert Woodrum, covered under his buy propecia online safe motherâs health insurance plan from the Nevada Public Employeesâ Benefits Program Total Bill. $18,933.44, billed by the hospital Service Provider. Carson Tahoe Regional Medical Center, part of not-for-profit Carson Tahoe Health buy propecia online safe Medical Service. Stitches and anesthesia during an emergency department visit What Gives.
The Aug buy propecia online safe. 4 explanation of benefits (EOB) document said the Woodrumâs claim had been rejected and their patient responsibility would be the entire sum of $18,933.44. This case involves an buy propecia online safe all-too-frequent dance between different types of insurers about which one should pay a patientâs bill if an accident is involved. All sides do their best to avoid paying.
And, no buy propecia online safe surprise to Bill of the Month followers. When insurers canât agree, who gets a scary bill?. The buy propecia online safe patient. The legal name for the process of determining which type of insurance is primarily responsible is subrogation.
Could another policy â say, auto or home coverage or workersâ compensation â be obligated to pay if someone buy propecia online safe was at fault for the accident?. Subrogation is an area of law that allows an insurer to recoup expenses should a third party be found responsible for the injury or damage in question. Health insurers say subrogation helps hold down premiums by reimbursing them for their medical costs. About two weeks after the accident, Robertâs parents â both lawyers â got the EOB informing them of buy propecia online safe the insurerâs decision.
The note also directed questions to Luper Neidenthal &. Logan, a law firm in Columbus, Ohio, buy propecia online safe that specializes in helping insurers recover medical costs from âthird parties,â meaning people found at fault for causing injuries. The firmâs website boasts that âwe collect over 98% of recoverable dollars for the State of Nevada.â Another letter also dated Aug. 4 soon arrived from HealthScope Benefits, a large administrative firm that processes claims for health buy propecia online safe plans.
The claim, it said, included billing codes for care âcommonly used to treat injuriesâ related to vehicle crashes, slip-and-fall accidents or workplace hazards. Underlined for emphasis, one sentence warned that the denied claim would not be reconsidered until an enclosed accident questionnaire buy propecia online safe was filled out. Adam Woodrum, who happens to be a personal injury attorney, runs into subrogation all the time representing his clients, many of whom have been in car accidents. But it still came as a shock, he said, to have his buy propecia online safe health insurer deny payment because there was no third party responsible for their sonâs ordinary bike accident.
And the denial came before the insurer got information about whether someone else was at fault. ÂItâs like deny now and pay buy propecia online safe later,â he said. ÂYou have insurance and pay for years, then they say, âThis is denied across the board. Hereâs your $18,000 bill.ââ Although Adam Woodrum is a personal injury attorney, he says it still came as a shock to have his health buy propecia online safe insurer deny the claim after his son, Robert, got stitches in July following a bike crash.
(Maggie Starbard for KHN) Woodrum and his son, Robert, get ready to bike near their home in Carson City, Nevada, on Nov. 7. (Maggie Starbard for KHN) When contacted, the Public Employeesâ Benefits Program in Nevada would not comment specifically on Woodrumâs situation, but a spokesperson sent information from its health plan documents. She referred questions to HealthScope Benefits about whether the programâs policy is to deny claims first, then seek more information.
The Little Rock, Arkansas-based firm did not return emails asking for comment. The Nevada health planâs documents say state legislation allows the program to recover âany and all payments made by the Planâ for the injury âfrom the other person or from any judgment, verdict or settlement obtained by the participant in relation to the injury.â Attorney Matthew Anderson at the law firm that handles subrogation for the Nevada health plan said he could not speak on behalf of the state of Nevada, nor could he comment directly on Woodrumâs situation. However, he said his insurance industry clients use subrogation to recoup payments from other insurers âas a cost-saving measure,â because âthey donât want to pass on high premiums to members.â Despite consumersâ unfamiliarity with the term, subrogation is common in the health insurance industry, said Leslie Wiernik, CEO of the National Association of Subrogation Professionals, the industryâs trade association. âLetâs say a young person falls off a bike,â she said, âbut the insurer was thinking, âDid someone run him off the road, or did he hit a pothole the city didnât fill?.
Ââ Statistics on how much money health insurers recover through passing the buck to other insurers are hard to find. A 2013 Deloitte consulting firm study, commissioned by the Department of Labor, estimated that subrogation helped private health plans recover between $1.7 billion and $2.5 billion in 2010 â a tiny slice of the $849 billion they spent that year. Medical providers may have reason to hope that bills will be sent through auto or homeownerâs coverage, rather than health insurance, as theyâre likely to get paid more. Thatâs because auto insurers âare going to pay billed charges, which are highly inflated,â said attorney Ryan Woody, who specializes in subrogation.
Health insurers, by contrast, have networks of doctors and hospitals with whom they negotiate lower payment rates. Resolution. Because of his experience as an attorney, Woodrum felt confident it would eventually all work out. But the average patient wouldnât understand the legal quagmire and might not know how to fight back.
ÂI hear the horror stories every day from people who donât know what it is, are confused by it and donât take appropriate action,â Woodrum said. ÂThen theyâre a year out with no payment on their bills.â Or, fearing for their credit, they pay the bills. After receiving the accident questionnaire, Woodrum filled it out and sent it back. There was no liable third party, he said.
No driver was at fault. His child just fell off his bicycle. HealthScope Benefits reconsidered the claim. It was paid in September, two months after the accident.
The hospital received less than half of what it originally billed, based on rates negotiated through his health plan. The insurer paid $7,414.76 of the cost, and the Woodrums owed $1,853.45, which represented their share of the deductibles and copays. Adam Woodrum and his son, Robert, bike near their home in Carson City, Nevada, on Nov. 7.(Maggie Starbard for KHN) The Takeaway.
The mantra of Bill of the Month is donât just write the check. But also donât ignore scary bills from insurers or hospitals. Itâs not uncommon for insured patients to be questioned on whether their injury or medical condition might have been related to an accident. On some claim forms, there is even a box for the patient to check if it was an accident.
But in the Woodrumsâ case, as in others, it was an automatic process. The insurer denied the claim based solely on the medical code indicating a possible accident. If an insurer denies all payment for all medical care related to an injury, suspect that some type of subrogation is at work. Donât panic.
If you get an accident questionnaire, âfill it out, be honest about what happened,â said Sean Domnick, secretary of the American Association for Justice, an organization of plaintiffs lawyers. Inform your insurer and all other parties of the actual circumstances of the injury. And do so promptly. Thatâs because the clock starts ticking the day the medical care is provided and policyholders may face a statutory or contractual requirement that medical bills be submitted within a specific time frame, which can vary.
ÂDo not ignore it,â said Domnick. ÂTime and delay can be your enemy.â Bill of the Month is a crowdsourced investigation by KHN and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us?. Tell us about it!.
Julie Appleby. jappleby@kff.org, @Julie_Appleby Related Topics Contact Us Submit a Story TipBrandon Hudgins works the main floor at Fleet Feet, a running-shoe store chain, for more than 30 hours a week. He chats with customers, measuring their feet and dashing in and out of the storage area to locate right-sized shoes. Sometimes, clients drag their masks down while speaking.
Others refuse to wear masks at all.So he worries about hair loss treatment. And with good reason. Across the U.S., hair loss treatment hospitalizations and deaths are hitting record-shattering new heights. The nation saw 198,633 new cases on Friday alone.Unlike in the early days of the propecia, though, many stores nationwide arenât closing.
And regular hair loss treatment testing of those working remains patchy at best.âIâve asked, what if someone on staff gets symptoms?. âYou have to stay home,ââ said Hudgins, 33, who works in High Point, North Carolina. But as an hourly employee, staying home means not getting paid. ÂItâs stressful, especially without regular testing.
Our store isnât very big, and youâre in there all day long.âTo the storeâs credit, Hudgins said the manager has instituted a locked-door policy, where employees determine which customers can enter. They sanitize the seating area between customers and administer regular employee temperature checks. Still, thereâs no talk of testing employees for hair loss treatment. Fleet Feet did not respond to multiple requests to talk about its testing policies.The federal Centers for Disease Control and Prevention issued guidance to employers to include hair loss treatment testing, and it advised that people working in close quarters be tested periodically.
However, the federal government does not require employers to offer those tests.But the board overseeing the California Division of Occupational Safety and Health, known as Cal/OSHA, on Thursday approved emergency safety rules that are soon likely to require the stateâs employers to provide hair loss treatment testing to all workers exposed to an outbreak on the job at no cost to the employees. Testing must be repeated a week later, followed by periodic testing.California would be the first state to mandate this, though the regulation doesnât apply to routine testing of employees. That is up to individual businesses.Across the nation, workplaces have been the source of major hair loss outbreaks. Meat-processing plants, grocery stores, farms, schools, Amazon warehouses â largely among the so-called essential workers who bear the brunt of hair loss treatment s and deaths.The U.S.
Occupational Safety and Health Administration inspects workplaces based on workersâ complaints â over 40,000 of which related to hair loss treatment have been filed with the agency at the state and federal levels.Workers âhave every right to be concerned,â said Dr. Peter Chin-Hong, an epidemiologist at the University of California-San Francisco. ÂThey are operating in a fog. There is little economic incentive for corporations to figure out who has hair loss treatment at what sites.âWaiting for symptoms to emerge before testing is ill-considered, Chin-Hong noted.
People can exhibit no symptoms while spreading the propecia. A CDC report found that, among people with active s, 44% reported no symptoms. Email Sign-Up Subscribe to KHNâs free Morning Briefing. Yet testing alone cannot protect employees.
While workplaces can vary dramatically, Chin-Hong emphasized the importance of enforcing safety guidelines like social distancing and wearing face masks, as well as being transparent with workers when someone gets sick.Molly White, who works for the Missouri state government, was required to return to the office once a week starting in July. But White, who is on drugs to suppress her immune system, feared her employerâs âcavalier attitude toward hair loss treatment and casual risk taking.â Masks are encouraged for employees but are not mandatory, and thereâs no testing policy or even guidance on where to get tested, she said. White filed for and received an Americans With Disabilities Act exception, which lasts through the end of the year, to avoid coming into the office.After a cluster of 39 hair loss treatment cases emerged in September in the building where she normally works, White was relieved to at least get an email notifying her of the outbreak. A few days later, Gov.
Mike Parson visited the building, and he tested positive for hair loss treatment soon after.Following pressure from labor groups, Amazon reported in a blog post last month that almost 20,000 employees had tested positive or been presumed positive for hair loss treatment since the propecia began. To help curb future outbreaks, the online retailing giant, which also owns Whole Foods, built its own testing facilities, hired lab technicians and said it planned to conduct 50,000 daily tests across 650 sites by this month.The National Football League tests players and other essential workers daily. An NFL spokesperson said the league conducts 40,000 to 45,000 tests a week through New Jersey-based BioReference Laboratories, though both organizations declined to share a price tag. Reports over the summer estimated the seasonâs testing program would cost about $75 million.Not all companies, particularly those not in the limelight, have the interest â or the money â to regularly test workers.âIt depends on the company how much they care,â said Gary Glader, president of Horton Safety Consultants in Orland Park, Illinois.
Horton works with dozens of companies in the manufacturing, construction and transportation industries to write exposure control plans to limit the risk of hair loss treatment outbreaks and avoid OSHA citations. ÂSome companies could care less about their people, never have.âIGeneX, a diagnostic testing company in Milpitas, California, gets around 15 calls each day from companies across the country inquiring about its employer testing program. The lab works with about 100 employers â from 10-person outfits to two pro sports teams â mainly in the Bay Area. IGeneX tests its own workers every other week.One client is Tarana Wireless, a nearby telecommunications company that needs about 30 employees in the office at a time to operate equipment.
In addition to monthly hair loss treatment tests, the building also gets cleaned every two hours, and masks are mandatory.âItâs definitely a burden,â said Amy Beck, the companyâs director of human resources. ÂWe are venture-backed and have taken pay cuts to make our money extend longer. But we do this to make everyone feel safe. We donât have unlimited resources.âIGeneX offers three prices, depending on how fast a company wants the results.
$135 for a polymerase chain reaction (PCR) test with a 36- to 48-hour turnaround â down to around $100 a test for some higher-volume clients. One-day testing costs $250, and itâs $400 for a six-hour turnaround.In some cases, IGeneX is able to bill the companiesâ health insurance plan.âAbsolutely, itâs expensive,â said IGeneX spokesperson Joe Sullivan. ÂI donât blame anyone for wanting to pay as little as possible. Itâs not âone and done,â which companies are factoring in.âPlus, cheaper, rapid options like Abbottâs antigen test, touted by the Trump administration, have come under fire for being inaccurate.For those going into work, Chin-Hong recommends that companies test their employees once a week with PCR tests, or twice a week with the less sensitive antigen tests.Ideally, Chin-Hong said, public health departments would work directly with employers to administer hair loss treatment testing and quash potential outbreaks.
But, as KHN has reported extensively, these local agencies are chronically underfunded and overworked. Free community testing sites can sometimes take days to weeks to return results, bogged down by extreme demand at commercial labs like Quest Diagnostics and LabCorp and supply chain problems.Hudgins, who receives his health insurance through North Carolinaâs state exchange, tries to get a monthly hair loss treatment test at CVS on his own time. But occasionally, his insurance â which requires certain criteria to qualify â has declined to pay for it, he said.âBeing in the service industry in a state where numbers are ridiculously high,â he said in an email, âI see volumes of people every day, and I think getting tested is the smart and considerate thing to do.â Hannah Norman. hannahn@kff.org, @hnorms Related Topics Public Health States hair loss treatmentCalifornia Gov.
Gavin Newsomâs maskless dinner with medical industry lobbyists and others at a Napa County restaurant where meals cost a minimum of $350 per head was just about the last straw for some beleaguered California small-business owners.With their livelihoods on the line, a growing number of them are openly defying the latest orders to shut down as hair loss treatment cases skyrocket in California â and pointing to Newsomâs bad behavior.âWe are definitely not complying. We have enough information to make an educated decision. The data do not back another shutdown,â said Miguel Aguilar, founder and owner of Self Made Training Facility, based in Temecula, California, which leases space to physical trainers and nutrition advisers and has 40 locations across 11 states, including 15 in California.The news of Newsomâs Nov. 6 dinner at the French Laundry in Yountville only strengthened Aguilarâs resolve.
ÂYes, we all make mistakes, but his apology was pathetic,â Aguilar said. ÂHe told us he was outdoors, but then the photos surfaced. He can attend in-person gatherings, but we canât?. Thereâs absolutely no trust there.â Email Sign-Up Subscribe to KHNâs free Morning Briefing.
New hair loss treatment cases and hospitalizations have surged at an alarming rate in California, with a seven-day average of over 11,500 cases Saturday, more than triple the number of a month earlier. Hospitalizations have doubled over the same period, according to the Los Angeles Times, part of a national trend that has pushed total hair loss treatment s in the U.S. Above 12 million.In most California counties, restaurants, fitness clubs, yoga studios, churches, movie theaters and museums that have already been through two previous shutdowns and reopenings since March are once again required to cease indoor operations â just as winter hits. Some are laying off workers for the third time this year.Add to that the failure of Congress to pass another stimulus package and, in many cases, a preexisting mistrust of government mandates.
It all amounts to more disgruntled entrepreneurs.Larry McNamer, owner of Majorâs Diner in the tiny San Diego County community of Pine Valley, said he is continuing to serve people indoors, even though the county closed indoor dining on Nov. 14 in accordance with state regulations. He doesnât believe the government has the right to impose such an ordinance on him. And, he said, Newsomâs dinner fiasco helped him make his decision to stay open.âWeâre having to deal with all of the lying, the hypocrisy â youâve got a governor thatâs running around ignoring his own mandates,â McNamer said.McNamer knows the propecia is real, he said.
He is seating only a quarter of his normal indoor capacity and has added distance between tables. But after closing the restaurant from March 15 to May 23, laying off half his employees and falling $200,000 behind on rent and other bills, McNamer isnât sure how much more his business can take.Last Wednesday, he was hit with a cease-and-desist order from the county, threatening him with a fine of $1,000 for each offense. San Diego County law enforcement officers are aggressively pursuing violations of public health orders, and the county has issued at least 83 citations to businesses since Nov. 16.In many other counties, including Riverside, Orange, San Bernardino and Placer, sheriffs and police departments have rejected the hair loss treatment ordinances or expressed reluctance to enforce them.Last week, Newsom announced that 41 of Californiaâs 58 counties â representing 94% of the population â were in the stateâs âpurpleâ tier â the most severe of four color-coded risk levels that impose increasingly restrictive limits on business activities.
That was up from 13 purple counties the week before.A few days later, the governor ordered a curfew, requiring people in the purple counties to stay at home between 10 p.m. And 5 a.m. Unless theyâre performing essential activities, including certain jobs, grocery shopping or going to the doctor.Los Angeles County went a step further Sunday, banning outdoor dining for at least three weeks. Unlike earlier in the year when that measure was ordered, now no federal financial aid is available to restaurants or their employees.
Indoor dining has been shut down in the county for months.Despite plunging revenue, mounting debt and the frustrating uncertainty of shifting goal posts, many small-business owners are not defying the latest public health restrictions, either out of a sense of responsibility or fear of enforcement actions â or of contracting the propecia themselves.Those who do flout public health ordinances are doing so for a variety of reasons, with economics topping the list.âThere are people who are protecting their employment, protecting their income,â said Vickie Mays, a clinical psychologist and professor of health policy and management at UCLAâs Fielding School of Public Health. ÂThere are no stimulus checks coming. Thereâs no alternative.âMany people who own their own businesses âhave taken other risks in their lives, and the risks they have taken have paid off, so thereâs a belief that despite this risk, youâre not going to get infected,â Mays said.Many business owners, whether they comply with the health orders or not, believe their industries are being unfairly targeted and that the risk of viral spread in their establishments is not as great as officials say.Scott Slater, who owns two restaurants in San Diegoâs seaside community of La Jolla, said he was frustrated by the public health focus on restaurants when a lot of hair loss treatment transmission is happening in private home gatherings.âWeâre a perfect scapegoat,â Slater said. ÂThey can control us, but they canât control someoneâs own home.â He called Newsomâs dinner âa slap in the faceâ but said he and his wife are complying with the new restrictions, scraping by on catering, takeout and delivery â though he estimates they are $200,000 behind on rent.Francesca Schuler, CEO of Stockton, California-based In-Shape Health Clubs, which has more than 60 fitness centers and just laid off most of its staff for the third time this year, said gyms should be viewed as part of the solution, not the problem.âI look at people who are dying of hair loss treatment, and itâs people who are overweight, who have high blood pressure or diabetes,â said Schuler, who is respecting the closure orders despite her objection to them.
ÂThere are a lot of people who are trying to exercise to stay healthy, yet they shut down gyms while people can still go to tattoo parlors, to McDonaldâs and to liquor stores. I just donât get it.âMays, however, said gyms are considered high-risk because âpeople are breathing hard. They are expelling air further.âAnd there are multiple ways people can stay fit without going to a gym, though outdoor exercise can be difficult sometimes because of heat and wildfire smoke, or in high-crime areas.In many cases, the propecia restrictions are crushing enterprises small-business owners have struggled to build over a lifetime. Theyâve invested their savings, time, sweat and dreams in building something from the ground up, and now itâs threatened.Aguilar, who owns the training facility company, said he comes from a broken family, was homeless and penniless at age 16 and later got his start giving physical training lessons out of his garage.
From that, he built his coast-to-coast chain.âAt this point,â he said, âif Iâm going to lose it all, I might as well go down fighting.â This KHN story first published on California Healthline, a service of the California Health Care Foundation. Bernard J. Wolfson. bwolfson@kff.org, @bjwolfson Anna Almendrala.
aalmendrala@kff.org, @annaalmendrala Related Topics Public Health hair loss treatmentJournalists from KHN and the Guardian have identified 1,413 workers who reportedly died of complications from hair loss treatment they contracted on the job. Reporters are working to confirm the cause of death and workplace conditions in each case. They are also writing about the people behind the statistics â their personalities, passions and quirks â and telling the story of every life lost.Explore the new interactive tool tracking those health worker deaths. More From This Series.
Related Topics Health Industry hair loss treatment Doctors Investigation Lost On The Frontline Nursing HomesThis story is part of a partnership that includes KCUR, NPR and Kaiser Health News. This story can be republished for free (details). Registered nurse Pascaline Muhindura has spent the past eight months treating hair loss treatment patients at Research Medical Center in Kansas City, Missouri.But when she returns home to her small town of Spring Hill, Kansas, sheâs often stunned by what she sees, like on a recent stop for carryout food.âNo one in the entire restaurant was wearing a mask,â Muhindura said. ÂAnd thereâs no social distancing. I had to get out, because I almost had a panic attack.
I was like, âWhat is going on with people?. Why are we still doing this?. 'âMany rural communities across the U.S. Have resisted masks and calls for social distancing during the hair loss propecia, but now rural counties are experiencing record-high and death rates.Critically ill rural patients are often sent to city hospitals for high-level treatment and, as their numbers grow, some urban hospitals are buckling under the added strain.
Kansas City has a mask mandate, but in many smaller communities nearby, masks arenât required â or masking orders are routinely ignored. In the past few months, rural counties in both Kansas and Missouri have seen some of the highest rates of hair loss treatment in the country.At the same time, according to an analysis by KHN, about 3 in 4 counties in Kansas and Missouri donât have a single intensive care unit bed, so when people from these places get critically ill, theyâre sent to city hospitals.A recent patient count at St. Lukeâs Health System in Kansas City showed a quarter of hair loss treatment patients had come from outside the metro area.Two-thirds of the patients coming from rural areas need intensive care and stay in the hospital for an average of two weeks, said Dr. Marc Larsen, who leads hair loss treatment at St.
Lukeâs.âNot only are we seeing an uptick in those patients in our hospital from the rural community, they are sicker when we get them because [doctors in smaller communities] are able to handle the less sick patients,â said Larsen. ÂWe get the sickest of the sick.â Email Sign-Up Subscribe to KHNâs free Morning Briefing. Dr. Rex Archer, head of Kansas Cityâs health department, warns that capacity at the cityâs 33 hospitals is being put at risk by the influx of rural patients.âWeâve had this huge swing thatâs occurred because theyâre not wearing masks, and yes, thatâs putting pressure on our hospitals, which is unfair to our residents that might be denied an ICU bed,â Archer said.A study newly released by the Centers for Disease Control and Prevention showed that Kansas counties that mandated masks in early July saw decreases in new hair loss treatment cases, while counties without mask mandates recorded increases.Hospital leaders have continued to plead with Missouri Republican Gov.
Mike Parson, and with Kansasâ conservative legislature, to implement stringent, statewide mask requirements but without success.Parson won the Missouri gubernatorial election on Nov. 3 by nearly 17 percentage points. Two days later at a hair loss treatment briefing, he accused critics of âmaking the mask a political issue.â He said county leaders should decide whether to close businesses or mandate masks.âWeâre going to encourage them to take some sort of action,â Parson said Thursday. ÂThe holidays are coming and I, as governor of the state of Missouri, am not going to mandate who goes in your front door.âIn an email, Dave Dillon, a spokesperson for the Missouri Hospital Association, agreed that rural patients might be contributing to hospital crowding in cities but argued that the strain on hospitals is a statewide problem.The reasons for the rural hair loss treatment crisis involve far more than the refusal to mandate or wear masks, according to health care experts.Both Kansas and Missouri have seen rural hospitals close year after year, and public health spending in both states, as in many largely rural states, is far below national averages.Rural populations also tend to be older and to suffer from higher rates of chronic health conditions, including heart disease, obesity and diabetes.
Those conditions can make them more susceptible to severe illness when they contract hair loss treatment.Rural areas have been grappling with health problems for a long time, but the hair loss has been a sort of tipping point, and those rural health issues are now spilling over into cities, explained Shannon Monnat, a rural health researcher at Syracuse University.âItâs not just the rural health care infrastructure that becomes overwhelmed when there arenât enough hospital beds, itâs also the surrounding neighborhoods, the suburbs, the urban hospital infrastructure starts to become overwhelmed as well,â Monnat said.Unlike many parts of the U.S., where hair loss treatment trend lines have risen and fallen over the course of the year, Kansas, Missouri and several other Midwestern states never significantly bent their statewide curve.Individual cities, such as Kansas City and St. Louis, have managed to slow cases, but the continual emergence of rural hot spots across Missouri has driven a slow and steady increase in overall new case numbers â and put an unrelenting strain on the statesâ hospital systems.The months of slow but continuous growth in cases created a high baseline of cases as autumn began, which then set the stage for the sudden escalation of numbers in the recent surge.âItâs sort of the nature of epidemics that things often look like theyâre relatively under control, and then very quickly ramp up to seem that they are out of hand,â said Justin Lessler, an epidemiologist at Johns Hopkins Bloomberg School of Public Health.Now, a recent local case spike in the Kansas City metro area is adding to the statewide surge in Missouri, with an average of 190 hair loss treatment patients per day being admitted to the metro regionâs hospitals. The number of people hospitalized throughout Missouri increased by more than 50% in the past two weeks.Some Kansas City hospitals have had to divert patients for periods of time, and some are now delaying elective procedures, according to the University of Kansas Health systemâs chief medical officer, Dr. Steven Stites.But bed space isnât the only hospital resource thatâs running out.
Half of the hospitals in the Kansas City area are now reporting âcriticalâ staffing shortages. Pascaline Muhindura, the nurse who works in Kansas City, said that hospital workers are struggling with anxiety and depression.âThe hospitals are not fine, because people taking care of patients are on the brink,â Muhindura said. ÂWe are tired.âThis story is from a reporting partnership that includes KCUR, NPR and KHN. Alex Smith, KCUR.
@AlexSmithKCUR Related Topics Health Industry Multimedia Public Health States Audio hair loss treatment Hospitals Kansas Missouri Rural Medicine.
Adam Woodrum was out for a what do you need to buy propecia bike ride with his wife and kids on July 19 when his then 9-year-old son, Robert, crashed. ÂHe cut himself pretty bad, and I could tell right away he needed stitches,â said Woodrum. Because they were on bikes, what do you need to buy propecia he called the fire department in Carson City, Nevada.
ÂThey were great,â said Woodrum. ÂThey took him on a stretcher to the ER.â Robert received stitches and anesthesia at Carson Tahoe Regional Medical Center what do you need to buy propecia. Heâs since recovered nicely.
Then the what do you need to buy propecia denial letter came. The Patient. Robert Woodrum, covered under his motherâs health insurance plan from the Nevada Public Employeesâ Benefits what do you need to buy propecia Program Total Bill.
$18,933.44, billed by the hospital Service Provider. Carson Tahoe Regional Medical Center, part of not-for-profit Carson what do you need to buy propecia Tahoe Health Medical Service. Stitches and anesthesia during an emergency department visit What Gives.
The Aug what do you need to buy propecia. 4 explanation of benefits (EOB) document said the Woodrumâs claim had been rejected and their patient responsibility would be the entire sum of $18,933.44. This case involves an all-too-frequent dance between different types of insurers about which one should pay a patientâs bill if an accident is what do you need to buy propecia involved.
All sides do their best to avoid paying. And, no what do you need to buy propecia surprise to Bill of the Month followers. When insurers canât agree, who gets a scary bill?.
The patient what do you need to buy propecia. The legal name for the process of determining which type of insurance is primarily responsible is subrogation. Could another policy â say, auto or home coverage or workersâ compensation â be obligated to what do you need to buy propecia pay if someone was at fault for the accident?.
Subrogation is an area of law that allows an insurer to recoup expenses should a third party be found responsible for the injury or damage in question. Health insurers say subrogation helps hold down premiums by reimbursing them for their medical costs. About two weeks after the accident, Robertâs parents â both lawyers â got the EOB informing them what do you need to buy propecia of the insurerâs decision.
The note also directed questions to Luper Neidenthal &. Logan, a law firm in Columbus, Ohio, that specializes in helping insurers recover medical costs from âthird parties,â meaning people found what do you need to buy propecia at fault for causing injuries. The firmâs website boasts that âwe collect over 98% of recoverable dollars for the State of Nevada.â Another letter also dated Aug.
4 soon arrived from HealthScope Benefits, a large administrative firm that processes claims what do you need to buy propecia for health plans. The claim, it said, included billing codes for care âcommonly used to treat injuriesâ related to vehicle crashes, slip-and-fall accidents or workplace hazards. Underlined for emphasis, one sentence what do you need to buy propecia warned that the denied claim would not be reconsidered until an enclosed accident questionnaire was filled out.
Adam Woodrum, who happens to be a personal injury attorney, runs into subrogation all the time representing his clients, many of whom have been in car accidents. But it still what do you need to buy propecia came as a shock, he said, to have his health insurer deny payment because there was no third party responsible for their sonâs ordinary bike accident. And the denial came before the insurer got information about whether someone else was at fault.
ÂItâs like what do you need to buy propecia deny now and pay later,â he said. ÂYou have insurance and pay for years, then they say, âThis is denied across the board. Hereâs your $18,000 bill.ââ Although Adam Woodrum is a personal injury attorney, he says it still came as a shock to have his health insurer deny the claim after his son, Robert, got stitches what do you need to buy propecia in July following a bike crash.
(Maggie Starbard for KHN) Woodrum and his son, Robert, get ready to bike near their home in Carson City, Nevada, on Nov. 7. (Maggie Starbard for KHN) When contacted, the Public Employeesâ Benefits Program in Nevada would not comment specifically on Woodrumâs situation, but a spokesperson sent information from its health plan documents.
She referred questions to HealthScope Benefits about whether the programâs policy is to deny claims first, then seek more information. The Little Rock, Arkansas-based firm did not return emails asking for comment. The Nevada health planâs documents say state legislation allows the program to recover âany and all payments made by the Planâ for the injury âfrom the other person or from any judgment, verdict or settlement obtained by the participant in relation to the injury.â Attorney Matthew Anderson at the law firm that handles subrogation for the Nevada health plan said he could not speak on behalf of the state of Nevada, nor could he comment directly on Woodrumâs situation.
However, he said his insurance industry clients use subrogation to recoup payments from other insurers âas a cost-saving measure,â because âthey donât want to pass on high premiums to members.â Despite consumersâ unfamiliarity with the term, subrogation is common in the health insurance industry, said Leslie Wiernik, CEO of the National Association of Subrogation Professionals, the industryâs trade association. âLetâs say a young person falls off a bike,â she said, âbut the insurer was thinking, âDid someone run him off the road, or did he hit a pothole the city didnât fill?. Ââ Statistics on how much money health insurers recover through passing the buck to other insurers are hard to find.
A 2013 Deloitte consulting firm study, commissioned by the Department of Labor, estimated that subrogation helped private health plans recover between $1.7 billion and $2.5 billion in 2010 â a tiny slice of the $849 billion they spent that year. Medical providers may have reason to hope that bills will be sent through auto or homeownerâs coverage, rather than health insurance, as theyâre likely to get paid more. Thatâs because auto insurers âare going to pay billed charges, which are highly inflated,â said attorney Ryan Woody, who specializes in subrogation.
Health insurers, by contrast, have networks of doctors and hospitals with whom they negotiate lower payment rates. Resolution. Because of his experience as an attorney, Woodrum felt confident it would eventually all work out.
But the average patient wouldnât understand the legal quagmire and might not know how to fight back. ÂI hear the horror stories every day from people who donât know what it is, are confused by it and donât take appropriate action,â Woodrum said. ÂThen theyâre a year out with no payment on their bills.â Or, fearing for their credit, they pay the bills.
After receiving the accident questionnaire, Woodrum filled it out and sent it back. There was no liable third party, he said. No driver was at fault.
His child just fell off his bicycle. HealthScope Benefits reconsidered the claim. It was paid in September, two months after the accident.
The hospital received less than half of what it originally billed, based on rates negotiated through his health plan. The insurer paid $7,414.76 of the cost, and the Woodrums owed $1,853.45, which represented their share of the deductibles and copays. Adam Woodrum and his son, Robert, bike near their home in Carson City, Nevada, on Nov.
7.(Maggie Starbard for KHN) The Takeaway. The mantra of Bill of the Month is donât just write the check. But also donât ignore scary bills from insurers or hospitals.
Itâs not uncommon for insured patients to be questioned on whether their injury or medical condition might have been related to an accident. On some claim forms, there is even a box for the patient to check if it was an accident. But in the Woodrumsâ case, as in others, it was an automatic process.
The insurer denied the claim based solely on the medical code indicating a possible accident. If an insurer denies all payment for all medical care related to an injury, suspect that some type of subrogation is at work. Donât panic.
If you get an accident questionnaire, âfill it out, be honest about what happened,â said Sean Domnick, secretary of the American Association for Justice, an organization of plaintiffs lawyers. Inform your insurer and all other parties of the actual circumstances of the injury. And do so promptly.
Thatâs because the clock starts ticking the day the medical care is provided and policyholders may face a statutory or contractual requirement that medical bills be submitted within a specific time frame, which can vary. ÂDo not ignore it,â said Domnick. ÂTime and delay can be your enemy.â Bill of the Month is a crowdsourced investigation by KHN and NPR that dissects and explains medical bills.
Do you have an interesting medical bill you want to share with us?. Tell us about it!. Julie Appleby.
jappleby@kff.org, @Julie_Appleby Related Topics Contact Us Submit a Story TipBrandon Hudgins works the main floor at Fleet Feet, a running-shoe store chain, for more than 30 hours a week. He chats with customers, measuring their feet and dashing in and out of the storage area to locate right-sized shoes. Sometimes, clients drag their masks down while speaking.
Others refuse to wear masks at all.So he worries about hair loss treatment. And with good reason. Across the U.S., hair loss treatment hospitalizations and deaths are hitting record-shattering new heights.
The nation saw 198,633 new cases on Friday alone.Unlike in the early days of the propecia, though, many stores nationwide arenât closing. And regular hair loss treatment testing of those working remains patchy at best.âIâve asked, what if someone on staff gets symptoms?. âYou have to stay home,ââ said Hudgins, 33, who works in High Point, North Carolina.
But as an hourly employee, staying home means not getting paid. ÂItâs stressful, especially without regular testing. Our store isnât very big, and youâre in there all day long.âTo the storeâs credit, Hudgins said the manager has instituted a locked-door policy, where employees determine which customers can enter.
They sanitize the seating area between customers and administer regular employee temperature checks. Still, thereâs no talk of testing employees for hair loss treatment. Fleet Feet did not respond to multiple requests to talk about its testing policies.The federal Centers for Disease Control and Prevention issued guidance to employers to include hair loss treatment testing, and it advised that people working in close quarters be tested periodically.
However, the federal government does not require employers to offer those tests.But the board overseeing the California Division of Occupational Safety and Health, known as Cal/OSHA, on Thursday approved emergency safety rules that are soon likely to require the stateâs employers to provide hair loss treatment testing to all workers exposed to an outbreak on the job at no cost to the employees. Testing must be repeated a week later, followed by periodic testing.California would be the first state to mandate this, though the regulation doesnât apply to routine testing of employees. That is up to individual businesses.Across the nation, workplaces have been the source of major hair loss outbreaks.
Meat-processing plants, grocery stores, farms, schools, Amazon warehouses â largely among the so-called essential workers who bear the brunt of hair loss treatment s and deaths.The U.S. Occupational Safety and Health Administration inspects workplaces based on workersâ complaints â over 40,000 of which related to hair loss treatment have been filed with the agency at the state and federal levels.Workers âhave every right to be concerned,â said Dr. Peter Chin-Hong, an epidemiologist at the University of California-San Francisco.
ÂThey are operating in a fog. There is little economic incentive for corporations to figure out who has hair loss treatment at what sites.âWaiting for symptoms to emerge before testing is ill-considered, Chin-Hong noted. People can exhibit no symptoms while spreading the propecia.
A CDC report found that, among people with active s, 44% reported no symptoms. Email Sign-Up Subscribe to KHNâs free Morning Briefing. Yet testing alone cannot protect employees.
While workplaces can vary dramatically, Chin-Hong emphasized the importance of enforcing safety guidelines like social distancing and wearing face masks, as well as being transparent with workers when someone gets sick.Molly White, who works for the Missouri state government, was required to return to the office once a week starting in July. But White, who is on drugs to suppress her immune system, feared her employerâs âcavalier attitude toward hair loss treatment and casual risk taking.â Masks are encouraged for employees but are not mandatory, and thereâs no testing policy or even guidance on where to get tested, she said. White filed for and received an Americans With Disabilities Act exception, which lasts through the end of the year, to avoid coming into the office.After a cluster of 39 hair loss treatment cases emerged in September in the building where she normally works, White was relieved to at least get an email notifying her of the outbreak.
A few days later, Gov. Mike Parson visited the building, and he tested positive for hair loss treatment soon after.Following pressure from labor groups, Amazon reported in a blog post last month that almost 20,000 employees had tested positive or been presumed positive for hair loss treatment since the propecia began. To help curb future outbreaks, the online retailing giant, which also owns Whole Foods, built its own testing facilities, hired lab technicians and said it planned to conduct 50,000 daily tests across 650 sites by this month.The National Football League tests players and other essential workers daily.
An NFL spokesperson said the league conducts 40,000 to 45,000 tests a week through New Jersey-based BioReference Laboratories, though both organizations declined to share a price tag. Reports over the summer estimated the seasonâs testing program would cost about $75 million.Not all companies, particularly those not in the limelight, have the interest â or the money â to regularly test workers.âIt depends on the company how much they care,â said Gary Glader, president of Horton Safety Consultants in Orland Park, Illinois. Horton works with dozens of companies in the manufacturing, construction and transportation industries to write exposure control plans to limit the risk of hair loss treatment outbreaks and avoid OSHA citations.
ÂSome companies could care less about their people, never have.âIGeneX, a diagnostic testing company in Milpitas, California, gets around 15 calls each day from companies across the country inquiring about its employer testing program. The lab works with about 100 employers â from 10-person outfits to two pro sports teams â mainly in the Bay Area. IGeneX tests its own workers every other week.One client is Tarana Wireless, a nearby telecommunications company that needs about 30 employees in the office at a time to operate equipment.
In addition to monthly hair loss treatment tests, the building also gets cleaned every two hours, and masks are mandatory.âItâs definitely a burden,â said Amy Beck, the companyâs director of human resources. ÂWe are venture-backed and have taken pay cuts to make our money extend longer. But we do this to make everyone feel safe.
We donât have unlimited resources.âIGeneX offers three prices, depending on how fast a company wants the results. $135 for a polymerase chain reaction (PCR) test with a 36- to 48-hour turnaround â down to around $100 a test for some higher-volume clients. One-day testing costs $250, and itâs $400 for a six-hour turnaround.In some cases, IGeneX is able to bill the companiesâ health insurance plan.âAbsolutely, itâs expensive,â said IGeneX spokesperson Joe Sullivan.
ÂI donât blame anyone for wanting to pay as little as possible. Itâs not âone and done,â which companies are factoring in.âPlus, cheaper, rapid options like Abbottâs antigen test, touted by the Trump administration, have come under fire for being inaccurate.For those going into work, Chin-Hong recommends that companies test their employees once a week with PCR tests, or twice a week with the less sensitive antigen tests.Ideally, Chin-Hong said, public health departments would work directly with employers to administer hair loss treatment testing and quash potential outbreaks. But, as KHN has reported extensively, these local agencies are chronically underfunded and overworked.
Free community testing sites can sometimes take days to weeks to return results, bogged down by extreme demand at commercial labs like Quest Diagnostics and LabCorp and supply chain problems.Hudgins, who receives his health insurance through North Carolinaâs state exchange, tries to get a monthly hair loss treatment test at CVS on his own time. But occasionally, his insurance â which requires certain criteria to qualify â has declined to pay for it, he said.âBeing in the service industry in a state where numbers are ridiculously high,â he said in an email, âI see volumes of people every day, and I think getting tested is the smart and considerate thing to do.â Hannah Norman. hannahn@kff.org, @hnorms Related Topics Public Health States hair loss treatmentCalifornia Gov.
Gavin Newsomâs maskless dinner with medical industry lobbyists and others at a Napa County restaurant where meals cost a minimum of $350 per head was just about the last straw for some beleaguered California small-business owners.With their livelihoods on the line, a growing number of them are openly defying the latest orders to shut down as hair loss treatment cases skyrocket in California â and pointing to Newsomâs bad behavior.âWe are definitely not complying. We have enough information to make an educated decision. The data do not back another shutdown,â said Miguel Aguilar, founder and owner of Self Made Training Facility, based in Temecula, California, which leases space to physical trainers and nutrition advisers and has 40 locations across 11 states, including 15 in California.The news of Newsomâs Nov.
6 dinner at the French Laundry in Yountville only strengthened Aguilarâs resolve. ÂYes, we all make mistakes, but his apology was pathetic,â Aguilar said. ÂHe told us he was outdoors, but then the photos surfaced.
He can attend in-person gatherings, but we canât?. Thereâs absolutely no trust there.â Email Sign-Up Subscribe to KHNâs free Morning Briefing. New hair loss treatment cases and hospitalizations have surged at an alarming rate in California, with a seven-day average of over 11,500 cases Saturday, more than triple the number of a month earlier.
Hospitalizations have doubled over the same period, according to the Los Angeles Times, part of a national trend that has pushed total hair loss treatment s in the U.S. Above 12 million.In most California counties, restaurants, fitness clubs, yoga studios, churches, movie theaters and museums that have already been through two previous shutdowns and reopenings since March are once again required to cease indoor operations â just as winter hits. Some are laying off workers for the third time this year.Add to that the failure of Congress to pass another stimulus package and, in many cases, a preexisting mistrust of government mandates.
It all amounts to more disgruntled entrepreneurs.Larry McNamer, owner of Majorâs Diner in the tiny San Diego County community of Pine Valley, said he is continuing to serve people indoors, even though the county closed indoor dining on Nov. 14 in accordance with state regulations. He doesnât believe the government has the right to impose such an ordinance on him.
And, he said, Newsomâs dinner fiasco helped him make his decision to stay open.âWeâre having to deal with all of the lying, the hypocrisy â youâve got a governor thatâs running around ignoring his own mandates,â McNamer said.McNamer knows the propecia is real, he said. He is seating only a quarter of his normal indoor capacity and has added distance between tables. But after closing the restaurant from March 15 to May 23, laying off half his employees and falling $200,000 behind on rent and other bills, McNamer isnât sure how much more his business can take.Last Wednesday, he was hit with a cease-and-desist order from the county, threatening him with a fine of $1,000 for each offense.
San Diego County law enforcement officers are aggressively pursuing violations of public health orders, and the county has issued at least 83 citations to businesses since Nov. 16.In many other counties, including Riverside, Orange, San Bernardino and Placer, sheriffs and police departments have rejected the hair loss treatment ordinances or expressed reluctance to enforce them.Last week, Newsom announced that 41 of Californiaâs 58 counties â representing 94% of the population â were in the stateâs âpurpleâ tier â the most severe of four color-coded risk levels that impose increasingly restrictive limits on business activities. That was up from 13 purple counties the week before.A few days later, the governor ordered a curfew, requiring people in the purple counties to stay at home between 10 p.m.
And 5 a.m. Unless theyâre performing essential activities, including certain jobs, grocery shopping or going to the doctor.Los Angeles County went a step further Sunday, banning outdoor dining for at least three weeks. Unlike earlier in the year when that measure was ordered, now no federal financial aid is available to restaurants or their employees.
Indoor dining has been shut down in the county for months.Despite plunging revenue, mounting debt and the frustrating uncertainty of shifting goal posts, many small-business owners are not defying the latest public health restrictions, either out of a sense of responsibility or fear of enforcement actions â or of contracting the propecia themselves.Those who do flout public health ordinances are doing so for a variety of reasons, with economics topping the list.âThere are people who are protecting their employment, protecting their income,â said Vickie Mays, a clinical psychologist and professor of health policy and management at UCLAâs Fielding School of Public Health. ÂThere are no stimulus checks coming. Thereâs no alternative.âMany people who own their own businesses âhave taken other risks in their lives, and the risks they have taken have paid off, so thereâs a belief that despite this risk, youâre not going to get infected,â Mays said.Many business owners, whether they comply with the health orders or not, believe their industries are being unfairly targeted and that the risk of viral spread in their establishments is not as great as officials say.Scott Slater, who owns two restaurants in San Diegoâs seaside community of La Jolla, said he was frustrated by the public health focus on restaurants when a lot of hair loss treatment transmission is happening in private home gatherings.âWeâre a perfect scapegoat,â Slater said.
ÂThey can control us, but they canât control someoneâs own home.â He called Newsomâs dinner âa slap in the faceâ but said he and his wife are complying with the new restrictions, scraping by on catering, takeout and delivery â though he estimates they are $200,000 behind on rent.Francesca Schuler, CEO of Stockton, California-based In-Shape Health Clubs, which has more than 60 fitness centers and just laid off most of its staff for the third time this year, said gyms should be viewed as part of the solution, not the problem.âI look at people who are dying of hair loss treatment, and itâs people who are overweight, who have high blood pressure or diabetes,â said Schuler, who is respecting the closure orders despite her objection to them. ÂThere are a lot of people who are trying to exercise to stay healthy, yet they shut down gyms while people can still go to tattoo parlors, to McDonaldâs and to liquor stores. I just donât get it.âMays, however, said gyms are considered high-risk because âpeople are breathing hard.
They are expelling air further.âAnd there are multiple ways people can stay fit without going to a gym, though outdoor exercise can be difficult sometimes because of heat and wildfire smoke, or in high-crime areas.In many cases, the propecia restrictions are crushing enterprises small-business owners have struggled to build over a lifetime. Theyâve invested their savings, time, sweat and dreams in building something from the ground up, and now itâs threatened.Aguilar, who owns the training facility company, said he comes from a broken family, was homeless and penniless at age 16 and later got his start giving physical training lessons out of his garage. From that, he built his coast-to-coast chain.âAt this point,â he said, âif Iâm going to lose it all, I might as well go down fighting.â This KHN story first published on California Healthline, a service of the California Health Care Foundation.
Bernard J. Wolfson. bwolfson@kff.org, @bjwolfson Anna Almendrala.
aalmendrala@kff.org, @annaalmendrala Related Topics Public Health hair loss treatmentJournalists from KHN and the Guardian have identified 1,413 workers who reportedly died of complications from hair loss treatment they contracted on the job. Reporters are working to confirm the cause of death and workplace conditions in each case. They are also writing about the people behind the statistics â their personalities, passions and quirks â and telling the story of every life lost.Explore the new interactive tool tracking those health worker deaths.
More From This Series. Related Topics Health Industry hair loss treatment Doctors Investigation Lost On The Frontline Nursing HomesThis story is part of a partnership that includes KCUR, NPR and Kaiser Health News. This story can be republished for free (details). Registered nurse Pascaline Muhindura has spent the past eight months treating hair loss treatment patients at Research Medical Center in Kansas City, Missouri.But when she returns home to her small town of Spring Hill, Kansas, sheâs often stunned by what she sees, like on a recent stop for carryout food.âNo one in the entire restaurant was wearing a mask,â Muhindura said.
ÂAnd thereâs no social distancing. I had to get out, because I almost had a panic attack. I was like, âWhat is going on with people?.
Why are we still doing this?. 'âMany rural communities across the U.S. Have resisted masks and calls for social distancing during the hair loss propecia, but now rural counties are experiencing record-high and death rates.Critically ill rural patients are often sent to city hospitals for high-level treatment and, as their numbers grow, some urban hospitals are buckling under the added strain.
Kansas City has a mask mandate, but in many smaller communities nearby, masks arenât required â or masking orders are routinely ignored. In the past few months, rural counties in both Kansas and Missouri have seen some of the highest rates of hair loss treatment in the country.At the same time, according to an analysis by KHN, about 3 in 4 counties in Kansas and Missouri donât have a single intensive care unit bed, so when people from these places get critically ill, theyâre sent to city hospitals.A recent patient count at St. Lukeâs Health System in Kansas City showed a quarter of hair loss treatment patients had come from outside the metro area.Two-thirds of the patients coming from rural areas need intensive care and stay in the hospital for an average of two weeks, said Dr.
Marc Larsen, who leads hair loss treatment at St. Lukeâs.âNot only are we seeing an uptick in those patients in our hospital from the rural community, they are sicker when we get them because [doctors in smaller communities] are able to handle the less sick patients,â said Larsen. ÂWe get the sickest of the sick.â Email Sign-Up Subscribe to KHNâs free Morning Briefing.
Dr. Rex Archer, head of Kansas Cityâs health department, warns that capacity at the cityâs 33 hospitals is being put at risk by the influx of rural patients.âWeâve had this huge swing thatâs occurred because theyâre not wearing masks, and yes, thatâs putting pressure on our hospitals, which is unfair to our residents that might be denied an ICU bed,â Archer said.A study newly released by the Centers for Disease Control and Prevention showed that Kansas counties that mandated masks in early July saw decreases in new hair loss treatment cases, while counties without mask mandates recorded increases.Hospital leaders have continued to plead with Missouri Republican Gov. Mike Parson, and with Kansasâ conservative legislature, to implement stringent, statewide mask requirements but without success.Parson won the Missouri gubernatorial election on Nov.
3 by nearly 17 percentage points. Two days later at a hair loss treatment briefing, he accused critics of âmaking the mask a political issue.â He said county leaders should decide whether to close businesses or mandate masks.âWeâre going to encourage them to take some sort of action,â Parson said Thursday. ÂThe holidays are coming and I, as governor of the state of Missouri, am not going to mandate who goes in your front door.âIn an email, Dave Dillon, a spokesperson for the Missouri Hospital Association, agreed that rural patients might be contributing to hospital crowding in cities but argued that the strain on hospitals is a statewide problem.The reasons for the rural hair loss treatment crisis involve far more than the refusal to mandate or wear masks, according to health care experts.Both Kansas and Missouri have seen rural hospitals close year after year, and public health spending in both states, as in many largely rural states, is far below national averages.Rural populations also tend to be older and to suffer from higher rates of chronic health conditions, including heart disease, obesity and diabetes.
Those conditions can make them more susceptible to severe illness when they contract hair loss treatment.Rural areas have been grappling with health problems for a long time, but the hair loss has been a sort of tipping point, and those rural health issues are now spilling over into cities, explained Shannon Monnat, a rural health researcher at Syracuse University.âItâs not just the rural health care infrastructure that becomes overwhelmed when there arenât enough hospital beds, itâs also the surrounding neighborhoods, the suburbs, the urban hospital infrastructure starts to become overwhelmed as well,â Monnat said.Unlike many parts of the U.S., where hair loss treatment trend lines have risen and fallen over the course of the year, Kansas, Missouri and several other Midwestern states never significantly bent their statewide curve.Individual cities, such as Kansas City and St. Louis, have managed to slow cases, but the continual emergence of rural hot spots across Missouri has driven a slow and steady increase in overall new case numbers â and put an unrelenting strain on the statesâ hospital systems.The months of slow but continuous growth in cases created a high baseline of cases as autumn began, which then set the stage for the sudden escalation of numbers in the recent surge.âItâs sort of the nature of epidemics that things often look like theyâre relatively under control, and then very quickly ramp up to seem that they are out of hand,â said Justin Lessler, an epidemiologist at Johns Hopkins Bloomberg School of Public Health.Now, a recent local case spike in the Kansas City metro area is adding to the statewide surge in Missouri, with an average of 190 hair loss treatment patients per day being admitted to the metro regionâs hospitals. The number of people hospitalized throughout Missouri increased by more than 50% in the past two weeks.Some Kansas City hospitals have had to divert patients for periods of time, and some are now delaying elective procedures, according to the University of Kansas Health systemâs chief medical officer, Dr.
Steven Stites.But bed space isnât the only hospital resource thatâs running out. Half of the hospitals in the Kansas City area are now reporting âcriticalâ staffing shortages. Pascaline Muhindura, the nurse who works in Kansas City, said that hospital workers are struggling with anxiety and depression.âThe hospitals are not fine, because people taking care of patients are on the brink,â Muhindura said.
ÂWe are tired.âThis story is from a reporting partnership that includes KCUR, NPR and KHN. Alex Smith, KCUR. @AlexSmithKCUR Related Topics Health Industry Multimedia Public Health States Audio hair loss treatment Hospitals Kansas Missouri Rural Medicine.
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