Tuesday, January 28, 2014

How To Fix The New "My Yahoo" Following Failed Rollout

Yahoo is about to force all of its "My Yahoo" users to use a new version of the page. This new "My Yahoo" has serious flaws. But on January 31st, 2014, Yahoo fully intends to make it the only choice available.

"My Yahoo" is a user-designable home page that many people have set as the default home page on their computer. It provides quick links to the news, weather, horoscopes, finance, sports, entertainment, and so on. Yahoo apparently set out to design a new "My Yahoo" version that would work on mobile devices - phones, particularly - and it looks like they completely forgot about their laptop/desktop users.

If you check the weather in the new My Yahoo, you will find that you live in Sunnyvale, California. Sunnyvale is a nice town on the San Francisco peninsula, down near Mountain View and San Jose. Yahoo lives in Sunnyvale. So do you.

Some programmer hard-coded "Sunnyvale" as the default constant value for the weather location. Then he or she forgot to change it to a user-changeable variable value before submitting the project for quality assurance and the move to production. This assumes that Yahoo still has a quality assurance team. It may be that they simply took the programmer's word that this feature worked ok, and they moved it to production.

Apparently "Sunnyvale" looked ok to whoever was managing the process.  Nobody tested for other cities.

So if you don't mind living in Sunnyvale, then this new version of My Yahoo is just right for you. The town has great weather, so you are ahead of the game, there.

There are other flaws, mostly of omission. The current design of the My Yahoo page allows for a lot of subtle adjustments that are omitted from this new version. In the old version, for example, the stock portfolios show the totals; in the new one, they don't.

In the old version, I could have multiple horoscopes and could see what my friends might be going through on a given day. In the new one, I can have only one. After all, only one person is using my computer. Neither the quality control guy nor the programmer have any friends, so it must have seemed perfectly normal to them to allow only one horoscope. Also, they may not believe in the use of horoscopes.  

I found a suggestion for a work-around. Wish I had bookmarked it so I could credit the person who shared it. The solution is very simple:

Use the Canadian "My Yahoo" site. They haven't been converted yet.


                       http://ca.my.yahoo.com/

Doing that - at the moment - brings up a mix of my before and after. But I see all seven horoscopes.

In the current Canadian version, weather is an option on a small panel of subscreens that can be brought up. When I go to "Content" in this Canadian version, there are six choices for weather, including the weather channel.

In the defective new My Yahoo version, either Weather is a big block on the screen, or it is not there because I removed it. When I go to "Content" there is only one choice for weather.

The list of egregious failures goes on and on. The failure to retain existing functionality is ... remarkable. Surfaces were programmed. Not innards.

Whether someone at Yahoo wakes up and halts the forced conversion on January 31st, or whether all of Yahoo's "My Yahoo" customers will be forced out and sent to MSN or Google for their home pages is up for grabs.

If I were a mean sort and had more than $25,000 in my Ameritrade account so I could qualify for short-selling, I would short-sell Yahoo. Their stock price may not survive this dramatic, massive error.

So, if you find yourself converted by force or by personal error to the "New My Yahoo" and are not happy with what you see - try Canadian.  And if that stops working, perhaps on the Australian My Yahoo the weather can be set to look at US cities. And to list multiple horoscopes.

                       http://ca.my.yahoo.com/

Have a happy springtime.

Thursday, April 4, 2013

Spybot Versus Family Tree Maker

Spybot is a wonderful free anti-malware tool for your computer. Although Microsoft Security Essential handles email security and some browsing security, it doesn't protect against everything. Spybot helps deal with the rest.

My computer was invaded a couple of months ago by a trojan horse called "FunMoods" that invites itself in as a source of nifty icons with which you can dress up your email. I'm not sure how it got in. Suddenly my Google button was a Funmoods button.  Funmoods would do the Google search and bring back its recommended answers. I couldn't evict it.

The cure for Funmoods was the free Malwarebytes Anti-Malware program. It worked like a charm. It found 57 things to delete. Funmoods was gone. Yay.

And then Malwarebytes started harping about subscribing, and I remembered that long ago on a galaxy of machines far away, I had installed something called Spybot that intercepted malware. So I installed Spybot. See if it would do the job.

And then... the Family Tree Maker on my machine could no longer merge info from online into my family tree. An Ancestry.com support staffer suggested that perhaps an antivirus program was interfering with the process.

So I uninstalled Malwarebytes, a task I had put off. No luck. Could the problem be Spybot?
 
I had to google to find out how to turn Spybot off. Here is how you do it:

In Spybot, click the button that brings up the Advanced Tools list. Click on Settings.
  
In Settings, click on System Services. There are three switches for turning off different functions.  Turn off the top two switches.

And voila - turning off Spybot enables Family Tree Maker.

So... if you have Family Tree Maker and discover you have a virus or trojan that your regular anti-bad stuff program didn't intercept - - try MalwareBytes.

Malwarebytes works with Family Tree Maker.

Sunday, January 20, 2013

Microsoft Security Essentials Fails

I replaced McAfee Antivirus years ago due to its insistence on billing me for services on computers long dead. The replacement - Microsoft Security Essentials - has now failed.

Microsoft Security Essentials - MSE - is a free anti-virus for the Windows Operating System. It protects against viruses in the mail, on floppy disks and flash drives, on web pages, and apparently protects against viruses that attack the operating system directly, looking for an unused port that's been left open.

They missed a spot. My computer is now a "funmoods" computer. It has been invaded  by malware. I ran a full MSE scan against the computer, including all drives. It did not find "funmoods".

Until I get "funmoods" removed for sure, I should not use this machine for online banking or buying.

Immediate recourse: I bought a magazine with a DVD with the Ubuntu 12.10 operating system on it. Ubuntu is a Linux system, so it will be free from bugs naturally. I plan to reserve - partition - a separate space on the hard drive for this operating system. When I start the computer, I should be able to choose between Ubuntu and Windows.

It looks like Malwarebytes is the most recommended anti-"funmoods" program. Microsoft only gives hints on how to remove it - some of which don't work!  But perhaps that's because these suggestions come from users.

One wonders why Microsoft, in all its might and grandeur, cannot defeat such a simple little invader.

In one response, Microsoft instructs users to download and use the "Microsoft Security Scanner". When I follow the link to the page, though, the software's name is "Microsoft Safety Scanner".  This dual naming is so utterly unprofessional that I doubt that it comes from Microsoft. I think my computer is trying to spoof me, overlaying something else onto the web page. Time for Malwarebytes.
.....

Malwarebytes worked. It found 58 objects, about 53 of which were "funmoods" related. And it deleted them.  Bingo.

Why on earth Microsoft Security Essentials cannot do the same is a mystery.  Why should the Windows operating system maker's own protection device fail so publicly on something so simple? One commenter thinks that MSE leaves back doors open so that the US government can intrude at will. "Funmoods" found out about the back doors. But MSE still has to leave them open - they can't shut the government out. So they blithely let users put messages up about how to repair the damage, but they themselves do nothing to keep the damage from happening.

Does anyone have a better theory?

Friday, November 30, 2012

Composing for Surround Sound

My desktop computer, although bottom-of-the-line, came with six audio jacks on the back and two in front.  It can play surround sound.

$20 of mini-earphones from eBay and - see below - anyone can listen to surround sound. The possibilities for arranging music for surround seem seductive.


Here's what I've found so far...  

My desktop plays 8 channels at 32 bits definition, 192kbps - four stereo pairs. Most modern desktops apparently can do this.  I only needed to download and install a large set of codecs from CNet. These are supposed to work on XP as well as Windows 7, so the same package may work on your  machine. Here's the link:

1)  Download and install this set of codecs.  

It installed quickly for me. A reboot, and then, when I went to  "Control Panel / Sound / Playback / Speaker Properties / General" up pops a screen that shows four stereo outputs, as follows.

       L    R      Front panel (green)
     RL  RR      Rear panel (black)
     C    Sub    Rear panel (red)  (This is for the two monaural channels, "Center" and "Sub-bass.")
     SL   SR      Rear panel (blue)   (Not sure what the S stands for.) 

Cakewalk lists all four pairs of outputs, although it can only send to one stereo pair.

2)  Test your installation. Download this little .AC3 file.  It's an 8-channel audio file.  It sends audio through each channel, naming the channel as it goes. Play it with the Windows Media Player. You should hear each channel reporting in.

The .AC3 file is the filetype for surround sound files. AC3 files fulfill the "ATSC A/52" specification, a phrase which brings up a lot of data on google.
Both QuickTime and Windows Media Player can play the .AC3 file type.


3)  Audio output: 

   a) The interface choices.
      1)  eBay sells little USB stereo adapters for $3.19. They claim "5.1 support" but there appears to be only one stereo output. Four of these and a couple of USB splitters would give 8 physical channels of output for under $20.

      2) a full 8 channel 7.1 adapter costs $18.53.   (googled "usb audio adapters s/pdif")   This adaptor has 4 stereo output jacks.
   
  a)  Speakers: most computer stores - even our Office Depot - sell 5-speaker sets for 5.1 surround sound. To get the two extra channels for 7.1 sound, add a pair of powered speakers - old computer speakers, music studio monitors or even an old hifi with a couple of speakers. Then you will have 7.1 surround sound.

   b)  Headsets:  make your own surround sound headset for $8 - $23:    http://www.videojug.com/film/how-to-make-51-surround-sound-headphones

   c)  Headsets:  $75  buys a pair of 7.1 "surround sound" earphones.  $90 buys a wifi headset.

- - - - - -

How is a person to make the music?

Audio editors that can handle 8 channels of output cost $350 and up. Sound Forge and Adobe Audition are the best, and the Adobe has more features.  That's something for the future. Nice to know it's there.

For now, I can test out ideas by exporting 4 same-length stereo files from Cakewalk. They can fade from one to the other, moving music through the sound sphere.  FFmpeg can compress these files as a group into the AC3 format. There may be other tools that can do this, too. But I'll probably need to get Adobe Audition to do anything serious.

So that's what I've found. My headset (I ordered the wifi 7.1) will be showing up in a day or two. If you liked, you yourself could begin to play with the environment for $40 or less.

There are programs that convert ordinary stereo to 8-channel sound. I suspect that they split the incoming sound by frequency and give different acoustic effects to the different frequency ranges. But people like it. There is certainly nothing beyond 2 channels of information in stereo sound. Similarly truthful, there are cheap usb adapters on eBay that claim to provide "virtual 7.1" sound - that is to say, stereo. You can play artificially created surround sound through them and they produce stereo again.

Musical compositions that are intended directly for the surround sound environment may come as something new. With the technology in place in many homes but only used for games and re-processed stereo, even a so-so composer might be able to find a big market for his work.

Wednesday, September 5, 2012

Adobe is Force-Feeding Us McAfee

I took McAfee off all my systems a few years ago after they billed me for their services on a machine long dead. They do not check to see if their periodic virus signature updates have been successful before they bill you. I installed Microsoft Security Essentials, which is free, self-updating, and covers all my security needs. Unless I give permission for something else to happen. Which I did.

This morning, Adobe requested permission to update its Flash Player. It has been doing this about once a day, lately.

Violating my permission, they also downloaded and installed on my machine a copy of "McAfee Security Scan".  It is in my C:\Program Files (x86)\McAfee Security Scan folder.

This immediately came to life and invited me to get involved with McAfee. Sorry, honey, we broke up.  McAfee paid Adobe to put their software on my computer.

I have not restarted my computer.

Did it really install?  In the "McAfee Security Scan" folder there is an "Uninstall.exe".  But when I float the cursor over the name, I see "File Description: McAfee Security Scan Plus Installer."

Installer, not uninstaller. This could be risky. I don't think I'll click it.

Is McAfee now listed as a program on the computer?  I click the "Start" button and go to Control Panel. Select "Programs and Features". Yes, it is.  It has been installed.

Adobe has actually installed McAfee software on my computer without my permission. What a blow to their reputation!  They are monetizing their reputation.  Has Adobe been bought by Bain?

Can I uninstall the invader from the Control Panel?  I click on it, see an "uninstall", click again - and yes!  It is no longer on the list. Windows is happy that it is gone.

But the McAfee folder is still in the Program Files (x86) folder. The program is still there. It could waken again at any time.

How to get rid of the McAfee folder?  Right-click on it. Select "Delete". Click again to provide permission. And it's gone.

I think I need to wait a couple of weeks before allowing another Adobe upgrade. Maybe a couple of months. Until it starts crashing. These daily updates are just invasive things that it gets paid to do, and you don't know what it's doing.

Friday, April 6, 2012

An End To Varicosity?

At almost 70, a problem that I've been fighting in recent months and years is an increasing varicosity in my lower calves. A bit of blood seeps out and this has created a reddish brown rash. When I stand for several hours, the sag in the lower end of the circulatory system reduces blood pressure in the brain, and I lose some higher functions. The blood vessels have become stretched, and, now thinner, they have become leaky.

Solution: Put the legs up on the desk, when I sit at the computer, and put the keyboard on my knees. Putting just the feet up on the desk isn't good - it can strain the knees. But crossing my feet and resting my calves on the desk, with the keyboard on my knees, slid to the right four inches so it's centered and kept from sliding down to my tummy by a notebook - this has me feeling better than I have in ages.

This position may also help prevent carpal tunnel syndrome. I sit at a 60 degree angle to the desk. The right mid-forearm rests on the edge of the desk and the hand floats over the mouse.

No tension.


Sunday, September 11, 2011

Gazpacho

Gazpacho: a cold soup made entirely of blenderized vegetables. I use a one-quart thrift shop blender. Blend until its like catsup.

Put in: one small garlic clove or some garlic powder. Half an onion, a stick or two of celery, a green pepper. A tomato or a big squirt of catsup. Salt. Then blend. Takes three minutes to make.

Last night I pureed it very fine for the first time. Easier to digest. And this morning I feel reborn.

Tuesday, April 5, 2011

How To Turn Off A Computer

There are three ways of turning a Windows computer off. If you turn it off the wrong way - with the power switch - over and over again - that can screw it up. The power switch is there for emergencies. Use it only to turn your computer on, not off. To turn your computer off these days and times, you need to tell it to turn itself off.

Here's how to do that.

1) The "fast wakeup" shutdown.
Click the START button in the lower left corner. On the big menu that comes up, directly above the START button is a strip of text that says "Start Search". To the right of that is a circle with a line through the top.

Click that circle for a fast shutdown. Your next startup will be faster. This shutdown closes your files and saves an image of your workspace. Your computer will start very quickly again, because it knows what to do. But the computer must stay plugged in.

2) The "full shutdown".
Click the START button. To the right of the circle with a line in it, you see a lock and a triangle. Click the triangle. Select "Shut Down".

The full shutdown gets all the kids dressed in their jammies and put into bed before it turns out the light.

If you ever have a problem, you may be able to fix it by restarting the computer and going through a full shutdown. The full shutdown is a healer. Good to do before you unplug the computer.

3) The power switch.

Use this only when you lose control of the mouse and keyboard.

On a computer, the power switch is a rescue switch. Once you have used the power switch you will need to restart the computer and put it through a full shutdown to make it ok again.

For other equipment that you turn off, you just flip the power switch. The same switch that turns it on, turns it off. You would think that this would be true for a computer. But for a computer, this is an emergency turnoff. It leaves a lot of work undone. It doesn't 'put the computer to bed'. Any program in use is left half finished, with files open. Any data in memory that needs to be written to those files is lost when power is switched off. Files can be broken. Using this switch all the time can screw things up.

So use number 1 or number 2 above, and your problems may fade away.

Friday, November 26, 2010

Connecting The Archos 7 To The Internet

If you have gotten an Archos 7 tablet and have trouble connecting to the internet...

It could be your modem. Is your modem a 2WIRE modem? Perhaps from AT&T? This modem uses WEP authentication. WEP works well with other computers but the Archos 7 needs to see WPA2 authentication in order to connect to the internet.

Updating the modem:

On your regular computer, in the URL window at the top of your browser, enter the address of your modem - 192.168.1.254

This should take you to the modem's main page - this is within the modem. (You may need to be connected to the modem with an ethernet cable, rather than wifi.)

On the modem's main page, click on 'Home Network'.

Under 'Wireless Settings', click [EDIT SETTINGS].

Under 'Wireless Security', change WEP to WPA2. I just let it use the default password - this is the password on the label on the modem, the numbers that are in parentheses.

Exit the modem by closing the tab.


On the Archos, touch the four-striped menu bar in the upper right corner. This brings up a menu at the bottom of the screen. Touch the 'Settings' button at the far right of the menu.

In 'Settings', touch 'Wireless Controls'.

Touch 'WiFi' to turn on the wifi. Touch 'WiFi Settings' and look for your modem on the list of modems that wifi can see. If it is a 2WIRE, it will be listed as '2WIREnnn' where 'nnn' is the last three digits of the serial number on your modem label. If your modem label says 'SN: 380919070887', then look for '2WIRE887' on the list.

Touch the '2WIRE887' and you should see a place to type in the "Access point password' - this is the number in parentheses on the label on your modem - the default password. If you decided when you set the modem to WPA2 to use a simpler password, here is where you type it in.

Once this is done, go to your main menu, click on your browser globe icon, and you should be on the internet.

The Archos browser limits your web experience to sites that can be found through google searches. Fresh out of the box, my AppsLib keeps crashing. But the Archos is a real computer, and this is new technology. Because it is a real computer, its systems and software can be updated.

So my next step will be to check for operating system updates at the Archos site, http://www.archos.com/support/support_tech/updates.html?country=us&lang=en T

The operating system is current - "Home / Menubars / settings / 'About device' " says that the Archos' firmware version is 1.0.15. That's the same as on their website. The OS is current.

The same site has a link that will let me download an updated version of the AppsLib, so that should solve the crashing problem.

While the Archos 7 is able to smoothly play a full-screen video - it comes with a couple of impressive and very cute videos - the h.264 mp4 file of high-def video that I uploaded to YouTube appears haltingly, with micro-pauses. I need to re-render my videos in lower resolution if they are to work on mobile computers. Big discovery.

I hope to find a web-TV app like the "Fox-TV" for Firefox that will work on the Archos. That will turn it into a little TV set with global reach. Also, because it has speakers, I can use it to show my friends my videos without needing them to put on headphones.

Friday, September 11, 2009

Make Your Own Public Option?

If the health care bill passes without a public option, many of us on limited means will be making their own public options. Opt out of Blue Cross. Go to the county hospital emergency room if you need any help whatsoever.

An amazing number of increasingly poor people have no other choice.

Thursday, June 18, 2009

The Secret Ice Cream Hiding In Your Freezer Can Make You Young Again

In your freezer door, do you have a small, round, orange container? When you take the top off it, is the stuff inside also orange? You are in luck. This is a special kind of ice cream, sometimes called "Frozen Orange Juice".

Take a spoon and scrape off a bite. Put the lid back on.

Do this now and then, and you will lose about five years.

Saturday, March 14, 2009

Billed For Your Free PSA Test? What To Do.

(Updated 06/15/11)

News - - On January 1, 2011, some new improvements to Medicare went into effect. These include a free yearly physical exam for seniors age 65 and older.

The exam needs to be billed as a "Wellness visit". It is coded with CPT codes

"G0438 – Annual wellness visit; includes a personalized prevention plan of service (PPPS), first visit

G0439 – Annual wellness visit; includes a personalized prevention plan of service (PPPS); subsequent visit"

On the first visit, the doctor takes a family history, sets up a screening schedule ("Come back in a year!"), and may possibly be able to charge just a bit more. The second visit is as usual.

So, for a person just coming into Medicare, there is

- at age 65: The "Welcome to Medicare" exam. Google it. It's massive.
- at age 66: The first "Wellness Visit". A history is taken. CPT code G0438.
(The first "Wellness Visit" may get folded into the "Welcome to Medicare" exam.)
- at age 67 and beyond: The annual "Wellness Visit". CPT code G0439.

What has happened to the PSA test?
"Medicare covers 1 PSA test every year AND 1 DRE test every year for Medicare beneficiaries ages 50 and older. There is no coinsurance or Part B deductible for the PSA test, but they both apply to the DRE test."
Here's the whole story.

It looks like the PSA test should henceforth bill naturally within the context of the yearly "Wellness Visit". A full prostate exam includes both a PSA blood test and a digital rectal exam, 0r DRE. You can't bill the blood test to Medicare without billing a DRE as well. So the "Wellness Visit" should include a DRE. And a PSA blood test.

For those who are between 50 and 65 and are on Medicare, other rules may apply.

This year, I had my annual physical - my first "Wellness Visit" - on 2/10. The PSA test was billed correctly and no issues developed.


(- - updated 3/26/2009 - - )

...The collection letter arrived two weeks ago for the bill for my free yearly prostate cancer screening test. Once again, the clinic had screwed up the billing. This time, they used an obesity diagnosis code to justify my PSA screening test billing. "Not medically necessary" was Medicare's conclusion. Perfectly logical, given the diagnosis code.

So I blogged a screaming storm.

The Director for Patient Advocacy of the no-longer-to-be-named diagnostics company that sent the bill to Medicare telephoned today. He explained in better detail than I was given locally how medical billings work. I have updated this posting to reflect his new info, and have generalized the name of the-company-which-is-not-to-be-named to "diagnostic services".

Do you have an inscrutable diagnostic services bill? Let's look at it.

Do the titles of the tests appear in the left-most column? Is there a billing code next to each test in a column labeled "CPT Codes"? This billing code is provided by the diagnostic services.

Below the list of tests may be a line: "ICD-9 Codes:" and a list of codes. These are diagnosis codes provided by the clinic or your doctor. They have to agree with the billing codes, or Medicare rejects the billing.

My clinic's billing clerk selected the obesity diagnosis code - 278.00 - to justify my PSA test. Google the phrase "ICD-9 Codes" and your diagnosis numbers one by one, and you can find the flaws, folks. They can be thrilling.

The correct diagnosis code for PSA (full) screening is the ICD-9 diagnosis code of V76.44. When the diagnostic services sees this code they apply HCPCS billing code G0103 to the bill and send it to CMS (Medicare) for payment. So they tell me.

Here's the memo of August 22, 2003, saying that they should do this. The memo.

If somebody has their doctor put a V76.44 diagnosis code on a test billing and the diagnostics service fails to bill the test G0103, please comment below.

When the clinic sends a bad diagnosis code, that forces Medicare to reject the bill. Medicare's rejection tells Blue Cross not to pay the supplemental insurance. Then the diagnostic service that runs the test wants $97. For my free test. Two years in a row. For me and for many more?

Me and how many more?

Are there perhaps hundreds of other geezers who also get their yearly physical at this clinic (55th and Cottage Grove - you know who you are) who have also had to pay for their free PSA tests? This test has been around for 8 years. Each patient may have had a number of tests and spent many hundreds of dollars that they should not have had to spend.

That's at one clinic. How many clinics miscode these screenings?

How many different kinds of screening tests are forced into miscodings by bad data?

Who is then liable? Blue Cross? The diagnostics service? Medicare?

Tons of clinics miscode. Hundreds of sites advise wrong codes online. They advertise their own liability. At the same time, CMS and the College of Physicians post the correct codes. Is this a class action lawyer's heaven, or what?

Lawyers:
Google 84153 PSA screening to discover a list of 500 healthcare sites about 50% of which specify publicly the wrong 84153 billing code for screenings.
Google -> 84153 V76.44 - - to discover sites that recommend using the wrong billing code with the right screening diagnosis.

Google -> screening CPT - - to discover other instances where CPT treatment codes are used to bill screening tests. Where a CPT code is specified as being in use, further research may discover a HCPCS screening code that has replaced it.

Google -> screening ABN - - to discover which uses of the ABN form commit patients to pay the cost when a screening test is rejected by Medicare. The codes recommended for these other tests may similarly have been obsoleted by new HCPCS codes.

May the force be with you.

My clinic's diagnostics service has posted on their web site the CPT billing code 84153 as the only recommended code for the PSA (full) test. Despite their disclaimers of responsibility, it well may be seen and used by many coding clerks. It may be in their coding manual.

Their web site tells coders to use code 84153 for all PSA(total) billings. As of March 15, 2009, that's what's on their site. Print it out yourself. It's evidence that may save your job, coders.

As noted above, this code was retired from screening use on August 22, 2003. The 2005 manual from CMS tells coders on page 90 to use the HCPCS code G0103. It does not give PSA screening as a use for the 84153 CPT code.

We repeat...
The correct billing code for the screening PSA test is G0103, an HCPCS code, and it wants an ICD-9 diagnosis code of V76.44.
The wrong billing code is 84153, a Common Practice Treatment code, or CPT code. Unless there is a cancer-related diagnosis code, it is rejected.
V76.44 is not listed among the diagnosis codes that support 84153, and code 84153 is for use with case management only, so far as I have been able to determine. But 84153 is the only code that the diagnostics service recommends.

This may be to their detriment.


So I'm filing an appeal with CMS. I may also write a note to the legal department of the hospital that sponsors my clinic and another to the clinic director. They may want to assess their potential liabilities. I think they may be at risk.

-- -- --
Update: When I called Medicare about appealing, they told me to call the clinic and ask for a doctor's note to tell Medicare how to change the code. I did this, the clinic jumped into action to cover their tails, and the problem will be solved shortly, they say. We hope so. Details below.

Update: Sent an email to the President using the link at Whitehouse.gov. Until Sebelius gets sworn in as HHS Secretery, it may sit in her in-box. Also sent notes to local folk. Told all my friends, including the guy who advises on Medicare issues down at the Senior Center.

Update: The director for billing at the clinic really wants me to wait and see what happens with the latest coding update they sent in. That is the "elevated PSA" diagnosis code. We should know in 20 more days.

In the meantime, if I get another letter from the diagnostic service demanding payment, I will ask for a court date. I want to show a judge their bill. There is no extension of costs to the totals column, no indication that their total on the bill reflects the PSA billing for which I signed the ABN promise-to-pay. The reader must deduce any link. Then I will show judge the prior year's bill, which goes further, omitting any listing for the PSA test entirely, although that's what it was they billed me for. I have already scanned the billing and am waiting and ready for the chance for show-and-tell.

Of course, the pitch is that I should go ahead and pay the bill and then wait for the clinic to correct its errors. Or finally give up. I did that last year. It can't happen twice.

If Medicare rejects the billing once again, will the clinic break down and use G0103?
-- -- --

I may also write the AMA. The diagnostics service says on their bill and on their site that the codes are approved by the American Medical Association. Does the AMA know that their stamp of approval has been put on flawed data? One wonders what the AMA may assess as its own liability for this use of its stamp.


And now I have heard from the diagnostics service...

They place themselves in a hellish position by finally having to collect on all this.

They send clients bills with their company's name at the top, a list of the tests that were done and at the bottom of the bill, the amount finally due. How could they not themselves be the sinners?

The bill they send does not even look right. The column with the total to be paid at the bottom shows nothing above it in the column. The very bill is defective. The billing items are not properly extended over into the columns. To anybody who ever typed an invoice, this looks very strange, right from the start. Uniform Commercial Code and all. Smells like sinners, from the start. You cannot see which tests contributed to the total you are asked to pay. Smoke and mirrors. Smells like sinners.

Their local people say that they do not recommend billing codes to the clinics, and I believe them. But their corporate web site shows bad data. Note at the top of the page that it suggests using this test for BPH. Medicare has said that if you are going to use this test to check for BPH, you need to fold it into the yearly G0103 PSA screening. They won't pay otherwise. The service's web site does not show the G0103 screening billing code.

The service's site uses computer generated screens which rather obviously present data that comes from a database.

Link to the above, do a "View Source" in your browser and you will see none of the usual programmer acknowledgements, no larger references. This is computer generated - ColdFusion is running as a front end on Eclipsys, perhaps. So - Who - manages this database, and how else is it used? What other appearances does this bad data make? Their coding manual?

Could the database accept some updates? It might help the rest of their effort go more smoothly. In its present very visible form, this page really makes one wonder about the worth of a very good company. It frankly justifies bad billings. A mis-billed person would look at that page and give up. Some clients may have done so.

So the diagnostics service's billing department has to patiently explain over and over to the unbelieving patient that these bad codes came from the clinic, not from the service. The patient - whose eyes tell him otherwise - screams and moans.

If the design of their bill were to include descriptions for the codes used, errors would self-correct. If the bill explained that these codes were basically chosen by the clinic coder - and here's his phone number - this could greatly reduce their corporate emotional burden. It might also get their bills paid a lot more quickly.

Give patients what they need to correct the coders.

Miscoding the screenings - and charging the client - is so common on these PSA tests that the clinics require older male patients who are in for their annual physical exam to sign an "ABN form" promising to pay if Medicare rejects the clinic's choice of PSA billing codes.


So - here's how to keep it from happening to you. I checked this with my coder, and he's totally cool with the idea.

At your next physical, when the clinic asks you to sign the ABN for the free PSA screening test, just attach a note:

"Please use ICD-9 diagnosis code V76.44 to bill this PSA screening test. This is the code that Medicare requests."

... and it should be billed correctly. If you've not had eleven months or more between tests, it could be rejected. But not for a bad diagnosis code. Mention it to your doctor.

If you do ever get a miscoded billing, just call the clinic and tell the desk clerk that you are appealing a miscoded billing to Medicare. Medicare needs you to get a doctor's note asking them to change the billing to the correct code. The clinic will very much want to fix it themselves.

"Getting a note from doctor" sets fires.

A very complex system has been created by very intelligent people. They then left it to be run by the average Joes and Noras of the world, good souls who must struggle daily with its endless complexity. I have seen two men die young from trying to manage the programming of such systems. Programs are poorly documented, the updates and patches less so if at all, and systems departments run black box dinosaurs that produce dino dung.

Good people can make it all well again. Just get a note from doctor.

On the posting below, I list some healthcare sites that tell the world they use the correct coding.

Those Who Bill PSA Screening Correctly

As I mentioned in the posting above, a number of healthcare providers do appear to bill Medicare correctly for the free yearly PSA screening exam. Here is a list I found by googling "G0103 V76.44". ( The correct billing code pair is HPSPC screening code G0103 and ICD-9 diagnosis code V76.44.)

CMS itself - Quick Reference Chart

Hill and Associates - Coding Compliance Professionals - Chart

NHIC Corp., an ISO 9001:2000 Certified Quality Management System, is the official Medicare Part B contractor for Maine, Massachusetts, New Hampshire, and Vermont - Provider Education Chart.

Medscape, which offers specialists, primary care physicians, and other health professionals the Web's most robust and integrated medical information and educational tools - Tables.

The California Academy of Family Physicians shows the CMS chart same as CMS above.

Virginia Commonwealth University shows the CMS chart.

PBSI Medicare Services in Louisiana has a great chart.

Wheaton Partners / Codemap in Barrington, Illinois, a major publisher, posts a printable sheet.
Their "The 2009 CodeMap® Reimbursement Manual for Lab and Pathology provides all the information required to submit Medicare claims and minimize errors..."

The Alabama Practice-Based CME Network has a Guidlines For Providers with correct codes.

This is a work in progress... many more good ones to be listed.

Saturday, November 8, 2008

Comes a Time

Comes a time a person stops being who another person needs him to be - they are all gone - and is as he is.

Comes a time the baggage is all that is left. The history of my life. The archive of uncompleted projects, undigested books, unwashed dishes. Half done, they linger on, filling my residence with a sense of self and purpose.

Yet now I am more.

Begin the ending of the past.

A now-gone dear friend of almost 40 years loved to fill a home with empty spaces. The only purpose of things was to define spaces. Of such is beauty born.

My own life principle is that spaces need to be filled with things. Of such is function born. Even for an object just to sit there and be beautiful gives it a function. Space allows it.

So my home is overfull. Comes a time.

I wander from room to room looking in each for one thing to change, one thing to complete, one thing to throw away. Slowly the undone projects cluster together. In the kitchen on a shelf sits a book whose cover needs gluing, some sun-glasses which periodically come unglued, and the bottle of glue, all awaiting a moment.

All my things once had purpose. Now almost none of them do.

I try letting form follow function. Do my thing and let the past become the lumber from which the future takes its solidity. The past is, after all, all I have. So I turn old dead floor lamps into plant stands. Boxes of books and old clothes let me wall off a recording studio.

I have little boxes of pretty stones, picked up from the ground as souvenirs over the years, mementos of forgotten places and times. I did this as a child when we last went to the little church I grew up in, before the time of wanderings began. I took some stones from the gravel by the door. I would always have them, to have and to hold. I have seven or eight boxes.

When my mother died, I took her box of stones and emptied them from a bridge into a rocky creek in Massachusetts leading to the sea so they would eventually return to the source of it all. Her stones were in envelopes, carefully labelled.

But I have forgotten where mine came from. Now their worth is just that they are pretty stones. I have not figured out how to involve them in my ongoing life. Put them in the fish tank?

Comes a time to drop the traces.

Wednesday, July 2, 2008

Cheap Eats

Been baking bread - sourdough. Make a pound loaf for fifty cents. Easy to do, but it takes forever to rise.

Yesterday, there was some cottage cheese on sale for $2 a pound at a time when ordinary cheese costs $6 a pound. So I bought some, drained it in an old t-shirt, and now hope for mozzarella.

Progress reports as progress develops.

Thursday, December 20, 2007

An End To SADness

Seasonal Affective Disorder had me laying back this year, not packing Christmas presents, unmotivated, doing nothing as the latest possible shipping date drew closer and closer.

SAD snuck up so slowly and easily that I didn't realize it was there. Just that it was really hard to get out of bed in the morning. I didn't want to do anything, just vegetate.

Seasonal Affective Disorder. When the length of the day diminishes, the body shuts down. Hibernation. It can happen to the best of us, and to you and me, too.

The solution is simple, cheap, and very pleasant. I hold a little desk lamp up to my eyes, eyelids closed, and move it around, letting light come in from all angles. My inner puppy melts in the warmth. The more I do it, the more the eyes relax, the more they soak up the glow.

Remember what it is like to lay on the beach in the sun, soaking up the rays? Eyes closed, the mind fills with the glow. This is the experience I give myself.

A minute or so twice a day, and I am happily involved in the world again.

Wednesday, November 7, 2007

The Liquid Supper Diet

Eat supper earlier and earlier, until you're eating around five PM.

This lets the stomach do its business before you go to sleep and you will sleep better.

If you become hungry in the evening, drink a glass of skim milk, or two or three. No solids. As the diet progresses, you will find it easier and easier to get up in the night.

There will not be fat molecules wandering around in the blood at night looking for a home. The heart will work better. As the arteries serving the brain clear, the brain may start to think more clearly.

Drink a glass of skim milk for breakfast and you may not need food until lunch. The wish for breakfast may not appear until you are truly hungry.

The Romaine Lettuce Diet

Go to the grocery store and buy three large heads of Romaine lettuce.

Every day before you eat breakfast, eat three large leaves. Or four or five smaller ones.

There's no need to waste time making a salad. Rinse a leaf under the faucet, fold it and roll it until it looks like a Chinese egg roll, then eat it as finger food.

After you've lettuced, then eat breakfast.

That's all you have to do.

Cup Cakes

Cup cake. A late-night muffin you mix and nuke.

Fill a microwave cup 3/4 full of cake mix, muffin mix or cornbread mix.

Turn the water faucet on so that only the tiniest dribble is coming out. Pass the cup back and forth under the faucet and capture a tiny amount of water.

Stir the mix and water. As the mix eats up the water, add more. You want a final consistency somewhere between taffy and pancake batter. A harder consistency tends to rise less. If the dough is stiff, it can nuke at high temperatures, boil down the sugars, and come out like a candy bar. If the dough is more liquid, the result will be a cake or a pudding.

Put the cup on a saucer to catch overflow, nuke for two minutes, and you're done.

Instant muffin, fresh from the oven.


Variations -

- Egg muffin - Start with an egg and a tablespoon of water, add mix and stir. Comes out very spongy and springy. This is a great way to get some protein cooked quickly without the usual grease.

- Banana muffin - Start with a banana, perhaps a very old banana. Mush it down into a bowl until it becomes gooey. Add cinnamon and spice cake mix or bran muffin mix and stir it into the goo. As you stir more and more, the batter will become more and more liquid. Set the bowl on a plate to catch any overflow and nuke for three minutes.

- Candy bar - Start with a quarter cup of Alaga syrup and add water only if it's absolutely necessary. Alaga sugars up the mix so much that it will boil and make candy during the baking. After baking, stir and stir it as it cools, and it will become pliable. Turn it out onto an oiled place and shape it into Tootsie Rolls or miniature loaves which can be sliced.

- Candy bar with jelly beans. Stir them in. Slice like a fruitcake. Dip in chocolate.

Overcook it and you can pull out a filling. Be warned.

- Rich, cheesy muffin - Add a quarter cup of feta cheese to the mix. You won't know it's there, except for the amazing richness of the result.

- Rich, cheesy cornbread muffin - Add a quarter cup of strong cheddar cheese.

- Chopped fruit muffin - just what its name suggests.

- Veggie muffin - olives and onions in cornbread. Maybe some rehydrated dried tomato. Oregano, cumin, even a touch of curry powder could enhance it.

- Quadruple chocolate muffin - chocolate cake or muffin mix, a tsp or two of cocoa powder, some Hershey bar fragments, and chocolate Slim-Fast.


The recipes above are given as an adjoint to the Romaine Lettuce Diet and are not to be taken separately.

Christmas Coffee

I love coffee. The other night without thinking, I made decaf in a cup that had a bit of Sugar Plum Spice Holiday Herb Tea remaining in it.

Holy Maloney! It tasted wonderful. It may have something to do with all the spices in the tea, which include cinnamon, ginger, cardamom, natural plum, rosehips and hibiscus. Just a possibility.

So tonight I made a cup of the tea and put three teaspoons into a cup of coffee. Same effect.

Not sure what a teabag would do to a coffee urn. The tea is from Celestial Seasonings.

Monday, November 5, 2007

Savor Serenity

What goes around comes around, faster and faster these days.

In a cybernetic control system, the reduction in turnaround time reduces slack in the system and makes it more responsive.

In politics...

Savor serenity.

Friday, September 28, 2007

A Water Glass Keeps You Wet

Every now and then, it's nice to have just a sip of water. I fill two water glasses. Keep one on the kitchen stove, the other in the living room. An end to thirst is just a step away and doesn't require fixing anything.

Sunday, August 12, 2007

The Acid Never Hits The Stomach

If you love coffee, then you may live on the near edge of stomach distress. "Can I stand one more?" is the question you ask when you're about as acidic as you dare to be.

Rinse a small pop bottle and put a teaspoon of baking soda in it. Fill with water. Taste it. It should be just a little "salty".

Put a little glurp in your coffee before you drink it, and the acid will be gone before the coffee hits the stomach.

Three-In-One Oil Cures Toenail Fungus

It's true. Maybe fatal, but true. Try a drop or two today.

It took the oil about three months of weekly oilings to rid my big toe of the fungus that had detached half the nail. The fungus needed air, and the oil wouldn't allow it.

In a convenient dispenser. Olive oil may work just as well, but you don't get the cute dispenser.

Saturday, June 16, 2007

Reason For Being

This blog is to record things I notice as I get older that might be useful.