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Archive for June 25th, 2011

WebMD – Why Some Smokers Have a Harder Time Quitting

Posted by 4love2love on June 25, 2011

Study Shows Variation in Brain May Give Some Smokers More Pleasure From Nicotine
By Denise Mann
WebMD Health News
Reviewed by Laura J. Martin, MD

smoker and double helix overlay

May 16, 2011 — Quitting smoking is never easy, but some smokers have an even harder time kicking the habit, and now new research suggests that they may derive more pleasure form nicotine.

The new study, which appears in the Proceedings of the National Academy of Sciences, may also help foster the development of more effective quitting strategies for certain smokers.

Researchers used PET scans to capture images of the number of “mu-opioid receptors” in the brains of smokers. Smokers with greater numbers of these receptors seem to derive more pleasure from nicotine, and as a result may have a harder time quitting.

“The brain’s opioid system plays a role in smoking rewards, and quitting smoking and some of the variability in our ability to quit among smokers is attributable to genetic factors,” says study researcher Caryn Lerman, PhD, director of Tobacco Use Research Center at the University of Pennsylvania in Philadelphia.

“The ability to quit smoking is influenced by a number of psychological, social, and environmental factors, but also genetic factors,” she says. “For some people, genetic variations may make it more difficult to quit than for someone else who smokes the same amount for same amount of time,” Lerman says.

The study findings are more applicable to quitting smoking than becoming addicted in the first place, she says.

New Quitting Strategies/Tools Needed

There may be a role for personalized medicine when it comes to smoking cessation, Lerman says.  Personalized medicine takes the trial and error out of matching treatments by making decisions based on genetic profiles.

“Based on a person’s genetic background, we can select the optimal treatment,” she says. “It is a two-pronged approach of developing new medications and being able to make the best choice for a particular person based on existing options.”

Importantly, even diehard smokers should not take these findings to mean they can’t quit, she says.

“Don’t become fatalistic,” she says. “You may need particular approaches tailored to you,” she says. Going forward, “we hope to study this pathway in more detail to understand whether examining genetic background and the numbers of brain receptors can help us choose the right treatments for the right individual.”

Raymond S. Niaura, PhD, an associate director for science at the Schroeder Institute of the American Legacy Foundation, an antismoking group based in Washington, D.C., says that “there are genetic influences involved in becoming addicted to nicotine and tobacco and on how hard it is to quit smoking.”

The new findings provide “a peek into the genetic and underlying brain processes responsible for nicotine addiction,” he says.

Daniel Seidman, PhD, assistant clinical professor of medical psychology and the director of Smoking Cessation Services at Columbia University Medical Center in New York City, agrees.“There are a lot of smokers and everybody gets lumped together, but there are a lot of patterns like with other types of addiction.”

This paper “points to a biological or genetic substrate which predisposes some people to have a hard time,” he says. Quitting smoking can be emotionally charged, he says. Symptoms typically include irritability, anger, and sad mood. “Some people are able to rally more and some may not bounce back as well because they have a harder time finding alternative sources of pleasure,” he says.

Agreeing with Niaura, Seidman says that some smokers seem to need nicotine replacement for longer periods of time. “When they come off nicotine patches or gum, it doesn’t feel right and it may be related to this subtype,” he says. “This is not a problem because nicotine replacement doesn’t cause cancer or go into yourlungs.”

People with this particular genetic variation may benefit from extended treatment, he says. “They may have a certain kind of sensitivity to nicotine, which could explain why they became addicted in the first place and why they may need to use nicotine replacement for a longer time than others.”

 

© 2011 WebMD, LLC.

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WebMD – Sunscreen: Are You Really Covered?

Posted by 4love2love on June 25, 2011

Our experts debunk sunscreen myths — plus a top dermatologist reveals her favorite sunscreens.
By Ayren Jackson-Cannady
WebMD the Magazine – Feature
Reviewed by Karyn Grossman, MD

Now that summer’s in full swing, it’s time to make sure you’re fully protected from sun. But what kind of sunscreen should you buy? How long should you keep it? And just what are the factors for skin cancer anyway? In this special feature, we answer the top myths about sunscreen, bring you a top dermatologist’s sunscreen recommendations, and offer a quick way for you to assess your own chances of getting skin cancer.

Top Sunscreen Myths

1. The higher the SPF, the better the protection.

FALSE. It sounds right — a sun protection factor of 100 should be twice as protective as SPF 50. But it’s only a few percentage points more effective. An SPF of 15 screens 93% of the sun’s rays and an SPF of 30 screens 97%. “But the number becomes irrelevant if you aren’t applying enough in the first place,” says Mona Gohara, MD, a dermatologist in Danbury, Conn., and an assistant clinical professor at Yale University Department of Dermatology. Studies show the average person slaps on one-seventh to one-tenth of the amount of SPF needed to reach the number that’s on the bottle.

“For better protection apply 1 to 2 ounces (the size of a Ping-Pong ball) of sunscreen on your body 30 minutes before going outdoors [so your skin can absorb it completely], and every two hours to any exposed skin after that,” Gohara says. For your face, apply a dollop the size of a silver dollar every day, no matter what the weather. Note, too, that SPF refers to protection from UVB (the burning rays) only, not UVA (the aging rays). You need to guard against both, since both can lead to skin cancer.

2. It’s OK to use last year’s bottle of SPF.

TRUE. Most sunscreens have a shelf life of about two years, says Jordana Gilman, MD, a New York City dermatologist. If you are using sunscreen properly, however, you shouldn’t have any left, since it takes about 1 to 2 ounces of sunscreen to cover the entire body, so a 4-ounce bottle should last for only four applications.

3. Sunscreen only needs to be applied to exposed skin.

FALSE. The average T-shirt offers an SPF of about 7, notes Gilman. Darker fabrics and tighter weaves provide more protection, but it is much safer to apply sunscreen to your entire body before you get dressed. Or better yet, wear clothing made of UV protective fabrics. These have been specially treated with colorless UV-absorbing dyes, and most offer an ultraviolet protection factor (UPF) of 50, which blocks both UVA and UVB.

Don’t want to invest in a whole new summer wardrobe? Spike your detergent with a wash-in SPF product you can toss in with your laundry.

4. Using makeup with SPF is just like wearing regular facial sunscreen.

FALSE. Certainly, applying makeup that contains SPF is better than skipping it altogether, but it’s not as effective as wearing a facial lotion with sunscreen underneath. Generally, most makeup cracks on skin, allowing UV rays through. “For makeup to provide adequate ultraviolet protection, it would need to be applied in a really thick layer, which most women do not do,” Gilman says. So unless you plan to spackle on your foundation, smooth on a layer of lotion with sunscreen first, and then apply your makeup.

5. Sunscreen can cause cancer.

FALSE. The only way sunscreen could be hazardous to your health is if it is absorbed into the body, which does not happen, says Amy Wechsler, MD, dermatologist and author of The Mind-Beauty Connection: 9 Days to Reverse Stress Aging and Reveal More Youthful, Beautiful Skin. “UV rays break down the chemical molecules in some sunscreens relatively quickly, long before they can seep into skin.”

Still concerned? Use a sunscreen containing physical blocking ingredients such as zinc oxide and titanium oxide, which stay on the surface of the skin as a protective barrier. Don’t be tempted to use babies’ or children’s sunscreens, which don’t necessarily contain physical blocks. And make sure to check the “active ingredients” section on the label to see what the bottle contains. Even the same product can vary from year to year. Some dermatologists believe people should wear physical blocks only. They might be safer than a mix but are harder to find and not as easy to wear since they tend to be thicker and goopier products. Try a few to find one you like.

6. “Waterproof” sunscreen doesn’t need to be reapplied after swimming.

FALSE. It’s no surprise researchers at the Colorado School of Public Health recently found that vacations near the water were associated with a 5% increase in small skin moles, which in turn boosts a person’s risk of melanoma. While the FDA recognizes the term “water resistant” (which means a sunscreen offers SPF protection after 40 minutes of exposure to water), it does not acknowledge the term “waterproof.” “No sunscreen is truly waterproof,” Wechsler confirms. Sunscreen should be reapplied every two to three hours — and every time you get out of the water if you’re doing laps in the pool or splashing around in the ocean.

7. Wearing sunscreen can lead to vitamin D deficiency.

FALSE. There’s no denying that our bodies need vitamin D (which can be obtained though sun exposure) to function — without it, the body can’t use calcium or phosphorus (minerals necessary for healthy bones). And according to a study published in Archives of Internal Medicine, three-quarters of Americans are deficient in the crucial vitamin. But that doesn’t give you a no-SPF pass. “You still get enough sun to make plenty of vitamin D through the sunscreen,” says Brett Coldiron, MD, a dermatologist at the University of Cincinnati. If you’re worried about vitamin D deficiency leading to brittle bones, Wechsler says, ask your doctor about taking a supplement. The Institute of Medicine’s recently revised guidelines recommend most adults get 600 international units of vitamin D a day; some people may need more.

8. Sunscreen with antioxidants provides better UVA/UVB protection.

TRUE. While they aren’t necessarily active sunscreen ingredients, antioxidants are great SPF supplements. Sunscreen alone does not block all of the damaging rays from the sun — even an SPF of 50 blocks out only 98% of UV rays. “Antioxidants are a good way to catch the UV radiation that ‘sneaks’ past the sunscreen,” Gohara says. Sunscreens infused with antioxidants such as skin-loving green tea extract or polyphenols from tomatoes and berries are proven to reduce the formation of free radicals (small chemical particles that wreak havoc on skin and can cause skin cancer) in the presence of UV light.

To read entire post, please go to Sunscreen : Are you really covered?

© 2011 WebMD, LLC.

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WebMD – 10 Best Low-Carb Snacks

Posted by 4love2love on June 25, 2011

By Elaine Magee, MPH, RD
WebMD Expert Column

Chips, cookies, ice cream, candy bars, crackers, and microwave popcorn are some of America’s most popular snack foods. But they’re often packed with fats and carbs, with little nutritional value.

What are your options if you are looking for a smart low-carb snack?

You could choose foods that are higher in fiber and/or important nutrients, feature carbohydrates with lower glycemic indexes, are balanced with some protein, and contain some of the more heart-healthy fats.

That’s exactly what the following 10 low-carb snacks are all about.

My Top 10 Low-Carb Snacks

1. Turkey and Cheese Roll-Ups

Cut one part-skim mozzarella cheese stick in half lengthwise. Roll about 1 ounce of sliced roasted turkey breast around half of a part skim mozzarella cheese stick and repeat with the remaining cheese and turkey to make a total of two roll-ups.

Each serving contains: 3.5 grams carbohydrate, 0.3 gram fiber, 144 calories, 17 grams protein, 6.6 grams fat, 3.8 grams saturated fat

2. Side Salad Topped with a Hard-Boiled Egg or Avocado

Top a typical side salad with a hard-boiled egg or 1/4 chopped avocado, drizzle with a teaspoon of extra virgin olive oil and 1-2 teaspoons of balsamic vinegar or 1 tablespoon of balsamic vinaigrette.

Each serving (with egg) contains: 3 grams carbohydrate, 1 gram fiber, 146 calories, 11 grams protein, 10 grams fat, 3 grams saturated fat

Each serving (with avocado) contains: 6 grams carbohydrate, 4.4 grams fiber, 120 calories, 4 grams protein, 9 grams fat, 2 grams saturated fat

3. Large Artichoke

Cut artichoke in half (from the stem to the tip) and cut out the inedible thistle part of the center of the artichoke. Place in microwave-safe, covered container with 1/2 cup water and cook on high until tender throughout (about 6 minutes for one artichoke or 10 minutes for two). Enjoy with lemon juice or 2 teaspoons of canola oil or olive oil mayonnaise.

Each serving (with lemon juice) contains: 17 grams carbohydrate, 9 grams fiber, 76 calories, 5.5 grams protein, .2 gram fat, .01 gram saturated fat

Each serving (with mayonnaise) contains: 17 grams carbohydrate, 9 grams fiber, 106 calories, 5.5 grams protein, 3 grams fat, 0.1 gram saturated fat

4. Avocado and Shrimp Cocktail

Toss 2 ounces of cooked thawed shrimp with 1/4 avocado (chopped) and a tablespoon of cocktail sauce.

Each serving contains: 8.5 grams carbohydrate, 3.4 grams fiber, 161 calories, 13 grams protein, 7.6 grams fat, 1.2 grams saturated fat

5. Typical fast-food Caesar salad with grilled chicken (no dressing)

Each serving contains: 12 grams carbohydrate, 3 grams fiber, 220 calories, 30 grams protein, 6 grams fat, 3 grams saturated fat

6. Peanut Butter & Celery Sticks

Serve 3 celery stalks with 2 tablespoons of natural peanut butter.

Each serving contains: 8.5 grams carbohydrate, 3 grams fiber, 208 calories, 7 grams protein, 16 grams fat, 2 grams saturated fat

7. A Handful of Nuts

A handful, depending on the size of the hand, can be the ideal snack portion: a quarter cup. You can keep roasted, unsalted mixed nuts on hand or choose any variation of nuts.

Each serving (1/4 cup roasted almonds) contains: 6.7 grams carbohydrate, 4 grams fiber, 205 calories, 9.5 grams protein, 18 grams fat, 1.4 grams saturated fat

8. Edamame Bowl

A super-convenient way to enjoy high protein soybeans as a snack is to put 3/4 cup of frozen, shelled edamame into a microwave-safe bowl and micro-cook them for a few minutes or until nice and hot. Sprinkle with pepper and 1/2 teaspoon extra virgin olive oil, if desired.

Each serving contains: 8 grams carbohydrate, 4.3 grams fiber, 97 calories, 9 grams protein, 4 grams fat, 0 grams saturated fat

9. Carrot Sticks and Hummus

Cut one large carrot into sticks or coins and serve with 1/4-cup hummus.

Each serving contains: 15.8 grams carbohydrate, 5.8 grams fiber, 133 calories, 6 grams protein, 6 grams fat, 0.9 grams saturated fat

10. Soy Latte (iced or hot)

Blend a cup of light soymilk with a shot or two (1/8 to 1/4 cup) of espresso or triple-strength coffee (decaf if you’re sensitive to caffeine). Serve over or blend with 3/4 cup crushed ice for an iced soy latte.

Each serving contains: 8.5 grams carbohydrate, 1 gram fiber, 73 calories, 6 grams protein, 1.9 grams fat, 0 gram saturated fat

Elaine Magee, MPH, RD, is the “Recipe Doctor” for WebMD and the author of numerous books on nutrition and health. Her opinions and conclusions are her own.

© 2010 WebMD, LLC.

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Techland – Do Domain Names Even Matter Any More?

Posted by 4love2love on June 25, 2011

By  on June 24, 2011

Do Domain Names Even Matter Any More?REUTERS

Evan Williams, the man (seen above) who brought us Blogger and Twitter, and therefore reasonably described as a dude who knows where his internet towel is, has something to say on the subject of domain names: they really don’t matter any more.

The people at ICANN who recently voted to allow the registration of .anything-you-want for the sum of $185,000 a pop might disagree, but Williams has a compelling argument.

(MORE: Custom Domain Suffixes Coming: Here’s What You Need To Know)

For one thing, domains don’t matter because Google knows where everything is, and it doesn’t care about domains. Google doesn’t care if your website lives inside a sub-sub-sub directory on an obscure sub-domain sitting in a neglected corner of an old server rack kept in a barn in Oregon.

As long as the stuff the sites contains has a high enough pagerank, Google will be happy to index it and present it as a search result. Or to put it another way: as long as it matters, people will be able to find it.

And that’s just one reason why domains are losing importance. Williams has a whole list of others.

People used to think that having a single-word .com domain was the only way to ensure success, but that’s simply no longer the case. People are still finding their way to what they want, with or without a “good” domain name attached to it.

Does this mean an end to domain name speculation, and to people paying huge fees for great one-worders? No, it probably doesn’t. There’s one thing still in a good domain’s favor, and that’s for word-of-mouth.

People are still much happier to say “Where did I get these shoes? I bought them at someamazingonlineshoestore.com.” They won’t say “I faved a Tweet by some guy that linked to a saved search that took me to some site I can’t remember. But thanks for asking.”

Read more: http://techland.time.com/2011/06/24/do-domain-names-even-matter-any-more/#ixzz1QGoCCOeB

 

© 2011 Time Inc.

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Time – Does Housework Make Women Less Productive?

Posted by 4love2love on June 25, 2011

Posted by  Friday, June 24, 2011 at 3:01 pm
Anna Peisl / Getty

These days, it’s hard to get through a week that doesn’t include headlines about a guy getting slammed for saying, doing, or tweeting something dumb about women. The slip-up du jour comes from a New Zealand businessman who claimed women get paid less because they take time off for babies and period pain. Oh yes he did.

Alasdair Thompson, chief executive of New Zealand’s Employers & Manufacturers’ Association, was on a radio show talking about the 12% pay gap between men and women, which he said was due to the fact that women take more sick leave:

“Why? Because once a month they have sick problems,” he said.

“Not all of them, but some do.

“They have children that they have to take time off to go home and take leave of. Therefore, it’s their productivity. It’s not their fault.”

Not to get on the female soap box, but I think there are a few data points missing from this equation.

First, it’s true that women work less than men (41 minutes fewer per day in the U.S., according to Bureau of Labor Statistics’ Time Use survey for 2010). However, women also report spending five fewer hours per week on leisure than men. Why? Because they do more housework than men: 49% of women from the Time Use survey report doing housework on the average day, versus only 20% for men.

(LIST: Five Questions for Top Women Executives)

While women may get pulled away from bean-counting in the office more than their male counterparts, they’re less likely to be headed home to watch the boob tube. Rather, they’re tending to chores and family. And that’s not something standard measures of productivity — measured as economic output per hour worked — take into account. The hours women spend outside the office may not contribute to their companies’ bottom line, but research suggests those hours indirectly contribute to economic output in society, because women who tend to the home rear more productive children bound for the workforce. A quote from Tipper and Al Gore in a paper by political economist Nancy Folbre makes this point nicely:

“At any given moment when the decision between work and family must be made, the workplace has a much stronger ability to quantify and express the immediate cost of neglecting work.”

Women also tend to take more sick days than men because they have to care for sick children. Research by the Kaiser Family Foundation found that 4 in 5 mothers are primarily responsible for selecting their children’s doctors and accompanying them to appointments.

(LIST: Top 10 Things We Miss about the Mad Men Era)

The question is whether their high productivity at home deserves higher compensation in the office. Should companies have to pay women who tend to their home as much as the men who stay at work? A paper by Stanford economist Kathryn Shaw offers some suggestions:

One possibility is to reduce the monetary rewards for market work or to increase the monetary rewards for work at home. For example, policies such as income subsidies and maternity leave lower the cost of taking time out of the labor force and increase the amount of time that parents have to spend with their children. However, these policies are clearly expensive for taxpayers and firms, so that the benefits must be weighed
against the costs. Moreover, the costs are also borne by women; for example, firms in European countries are thought to avoid hiring young women due to the high costs of maternity leave.

Ultimately, says Shaw, women may actually be more productive in the office that companies acknowledge. In that sense, the solution to women’s wage woes may have to come from technology, which offers better ways to measure productivity. Instead of measuring by hours worked, for instance, some firms haven taken on more sophisticated systems that pinpoint talent. Those can target the more obscure, and arguably more important, worker contributions like team-building, an area in which women tend to do particularly well.

Read more: http://curiouscapitalist.blogs.time.com/2011/06/24/does-housework-make-women-less-productive/#ixzz1QGhNAJlJ

 

© 2011 Time Inc.

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Channel 13 CF News – Casey Anthony’s defense plans to rest next week

Posted by 4love2love on June 25, 2011

By Jacqueline Fell, Reporter
Last Updated: Friday, June 24, 2011 6:00 PM
ORLANDO — Jose Baez said Casey Anthony’s defense could rest in a matter of days.

When prompted by Judge Belvin Perry for an estimate Friday afternoon, Baez said he expected to wrap up his case by Wednesday or Thursday, June 29 or 30.

The murder trial against Casey would be in the middle of its sixth week by then. Judge Perry had told jurors he expected the trial to last six to eight weeks.

After the defense rests, the prosecution will have a chance to call more witnesses for rebuttal. Assistant state attorney Linda Drane Burdick told the judge she expected that to take no longer than one to two days.

Judge Perry then asked lawyers on both sides how long they needed for closing arguments.

The state said it would need a half-day for theirs, about the same amount of time as Burdick’s opening statement.

The judge said he would give an order governing closing arguments later. The defense had requested the possibility of each attorney giving a closing argument.

THE CASE AGAINST CASEY – LATEST HEADLINES

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Reuters – New ban on popular cribs to take effect next week

Posted by 4love2love on June 25, 2011

Reuters10:30 a.m. EDT, June 23, 2011

WASHINGTON (Reuters) – New safety rules take effect in the United States next week that will ban the manufacture and sale of traditional drop-side rail cribs.

The U.S. Consumer Product Safety Commission ordered the ban on the popular cribs late last year amid growing evidence they had played a role in the suffocation or strangulation deaths of dozens of infants over the past decade.

But hotels, motels and day care centers in the country can continue to use drop-side rail cribs for another 18 months. After December 28, 2012, those businesses must switch to cribs that comply with the tougher new federal standards.

The new rules, the first change in U.S. crib standards in 30 years, also require manufacturers to make mattress supports and hardware used in cribs stronger and more durable and to subject their products to more rigorous safety testing.

 

Copyright © 2011, Reuters

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Kaiser News – Health insurance claim denied? Appeal, appeal, appeal

Posted by 4love2love on June 25, 2011

By Michelle Andrews, Kaiser News Service7:47 p.m. EDT, June 23, 2011

Nobody wants to get into a fight with a health insurer, but it may be worth your while. A recent Government Accountability Office report found that more claims problems stemmed from annoying but often straightforward billing and eligibility issues than from disagreements over whether care was medically appropriate. What’s more, the odds are about 50/50 that if you appeal an insurer’s decision, you’ll win.

When Natasha Friedus’s son, Nofi, was born almost two years ago, her insurer refused to pay $1,500 of Friedus’s $7,500 hospital bill because she hadn’t gotten prior authorization for the hospital stay near her home in Seattle. The plan also sent a $600 bill to Nofi, because he’d neglected to inform the insurer that he’d be in the hospital for a few days. “Apparently he was supposed to call before being born,” Friedus says.

The new mother spent hours on the phone trying to sort out the problem, but she got nowhere. Finally, someone suggested appealing the decision to the insurer and asking for retroactive approval for her hospital stay. That did the trick, says Friedus, even though the insurer had never informed her that she could appeal the bills.

Under the 2010 health law, the situation should improve. Health plans will be required to inform members that they can appeal disputed claims internally within the health plan as well as to an independent review organization not affiliated with the health plan.

Coding is everything

As anyone who has tried to decipher a health plan’s “Explanation of Benefits” knows, coding is everything. That’s where many errors occur, experts agree. If the CPT (Current Procedural Terminology) code that describes the medical service or test you received doesn’t correspond to the ICD (International Statistical Classifications of Diseases) code that describes your diagnosis, your claim may well be denied, a decision that will probably be communicated via a “reason code” on your EOB.

Medical services aren’t the only thing that must be in sync with the diagnosis: “The CPT code needs to correlate with age and sex and place of service as well,” says Candice Butcher, head of Medical Billing Advocates of America, which helps consumers resolve medical billing problems. In other words, if the CPT code is for a routine physical for an adult, but the patient is a 10-year-old child, the claim will be denied, says Butcher.

Sometimes claims that appear to be denied because the treatment isn’t appropriate — a particular service isn’t considered “medically necessary,” for example, or is deemed “experimental or investigational” — are actually coding errors, say experts, because the diagnosis code is wrong, for example.

You can’t prevent providers from miscoding your care or insurers from misinterpreting your plan or eligibility, but you can ask your doctor or insurer to cross-reference the treatment with the diagnosis and make sure the two are in sync, says Nancy Davenport-Ennis, chief executive of the Patient Advocate Foundation, which works to resolve these and other problems with health insurance claims.

Phone calls didn’t work

Sometimes even seemingly straightforward billing problems take months to resolve. When Janet Wolfe was hospitalized in central Georgia following a diagnosis of lymphoma a few years ago, she received a $1,600 bill from the insurer because she had stayed in a private room, which their insurer would pay for only if there were no other options. The hospital had only private rooms, but despite numerous phone calls by her husband, Andrew, to try to sort out the problem, the insurer eventually sent the bill to a collection agency.

When the letter from the collection agency arrived, Andrew took it and drove to the hospital. He demanded to see someone who could address the issue. Eventually, with the help of the hospital’s chief financial officer, the insurer removed the charges. “No one was taking responsibility for fixing the problem,” he says.

Getting assistance

Such experiences illustrate the difficulty that people with serious illnesses may face when trying to manage their medical bills, says Stephen Finan, senior director of policy at the American Cancer Society’s Cancer Action Network. Having a family member or someone else to backstop the process is essential. “If [patients] get lost or overwhelmed, there’s someone else who can help them with this critical process,” he says.

Organizations such as the Patient Advocate Foundation are not the only sources of assistance: The new health law provided $30 million for state-based consumer assistance programs to help people appeal health plan decisions.

Claim denial rates vary significantly by insurer, according to the GAO report. In California, for example, the denial rate for six managed care insurers ranged from 6 percent to 40 percent in 2009. Whether you’re insured by a plan that kicks out many claims or only a few, it may pay to appeal. The study found that consumers were successful in appeals filed with insurers in 39 percent to 59 percent of cases. When they appealed to an independent reviewer, consumers prevailed roughly 40 percent of the time.

Before you file an appeal, talk with your insurer to understand why your claim was denied, says Cheryl Fish-Parcham, deputy director of health policy at Families USA, a patient advocacy organization. “The biggest mistake people make is that they write an appeal that doesn’t really address the reason for the denial,” she says.

Have questions for Michelle Andrews? Write to her at khnquestions@kff.org.

Andrews writes for Kaiser Health News an editorially independent news service and a program of the Kaiser Family Foundation, a nonpartisan healthcare policy research organization. Neither Kaiser Health News nor the foundation is affiliated with Kaiser Permanente.

Copyright © 2011, Los Angeles Times

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