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["Lynda" <lurine AT com-pair.net>]

Drew, the folks you are talked to are really out of date or just plain
telling tall tales.  Ontario currently has a world class air ambulance
system.

(O.K., I knew you wouldn't take my word for it <g>, so I went digging on the 
net.  Perhaps you'll believe the Toronto newspaper 
http://www.healthzone.ca/health/article/609875)

As to Medicare/Medicaid.  I hate to break it to you but the same is true of
the insurance companies here in the U.S. AND you are more likely to run into
roadblocks from them than from the government run Medicare/Medicaid.

The newbee nurses, and worse, the burnt out nurses call the shots for
insurance companies, NOT Medicare/Medicaid.

As to Medicare/Medicaid DME situations.  Doesn't even take a nurse to do
that, so I don't see the problem.  *Someone* has to do the approvals.
Unfortunately, in this country at least, we have too many docs that are like
the boob that worked for MJ, anything for money!

BTW, helicopters or air ambulances or whatever the heck you want to call 
them are NOT the cure all in places like Ontario.  They can't fly 24/7/52! 
About 40% of any given year has weather that doesn't let them off the 
ground.  You need to bare that in mind also!

Lynda
The press corp is fact-adverse but very fable friendly.

----- Original Message ----- 
From: <DSanner106 AT aol.com>>

> Nope, they have lived with this situation and you and I have not, so the
> idea that we are better informed is rather silly. Idiots who don't want to
> live  with the pain for a year before treatment is rendered? I guess I
> might
> be an  idiot too, If I could drive 60 miles, get immediate treatment and
> end
> the pain.  The fact that Quebec since going to socialized medicine has not
> had any trauma  helicopter service, common in the entire US. because of
> the
> expense is  inexcusable. What other technology will they not use to save
> lives, in order to  cut costs? Will they ground them here as well once we
> switch > over?  When  actress Natasha Richardson died a few months ago
> from a head
> trauma, the doctors  in Montreal and NY said she quite possibly would be
> alive if the helicopter were  available rather than the 4 hour ambulance
> ride to
> Montreal. I doubt her family  is comforted with the knowledge that Quebec
> saved a few bucks
>
> The guidelines for treatment in Canada, as in the US for medicaid/medicare
> are written
> and approved by the government. In neither case can doctors do as they
> feel
> best and be
> assured of payment if they have to step outside the guidelines. Sure, they
> can order that
> MRI, but they may not get reimbursed for it. It is not doctors, but
> records
> nurses who
> generally determine what services you will get from our govt. or the
> Canadian govt. My wife
> has friends doing this today. Nurses from the govt. negotiate with nurses
> from the providers.
> Often they are nurses who go into this right out of college, without any
> or
> with very little practice
> time. See the job posting today for description: note, no hospital
> experience necessary, but lots of computer and communications skills are.
>
> Drew
>
>    Medicare DME Reconsideration  Nurse
> Categories: Healthcare  Specialists
>
> The Medicare DME Reconsideration Nurse oversees medical  necessity appeals
> of Durable Medical Equipment (DME) under Medicare Part  B.
> Responsibilities
> include: the organization and management of DME  appeals; researching
> Medicare determinations and policies, including but  not limited to to
> National
> Coverage Determinations, Local Coverage  Determinations, Jurisdiction
> Supplier
> Manuals, and Internet only manuals;  reviewing appeals and completing
> nurse
> reviews regarding medical  necessity, compliance with documentation
> requirements, and utilization;  and facilitating communication with our
> client.
>
> Requirements:
>
> Active RN license
> Two years experience  processing Medicare DME reconsiderations
> Bachelors degree or advanced  certifications preferred
> Strong written and verbal communication  skills.
> Ability to perform intensive research.
> Highly organized  with attention to detail and the ability to manage
> multiple priorities and  deadlines.
> Strong proficiency in MS Outlook, MS Word, and Internet  searches
> Medium proficiency in MS Excel
> Ability to read and  interpret medical documentation written in Spanish
> helpful
>
>
>
>
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