#what is prior authorization
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deimosatellite · 8 months ago
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bsd tumblr listen to me. steinbeck/fyodor power couple
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backmarkerr · 18 days ago
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I came across this article of a guy meeting Michael at a dinner party, and I'm seriously losing it
Schumacher was dressed casually in his jeans, plaid shirt and brown suede jacket, and I was trying to figure out a cool way to walk over and strike up a conversation. Then I saw that he was smoking a cigar and drinking a glass of red wine. "[...]so what do you think about this wine? Schumacher was drinking a glass of 2000 Sette Ponte Crongolo, a Tuscan red made of Sangiovese and Merlot. My neighbor, the party's host, makes it. "I like it," I said rather timidly. "It's a good, elegant Tuscany red." "Seems sort of thin to me," Schumacher said, looking at his glass of wine as if there was a hole in it. "I prefer a wine with more body, like a Australian Shiraz." [...] With that, I thought to myself, "Michael Schumacher cannot drink a thin wine. I must find something he likes." "Let me find something with a bit more body for you, Michael," I said, taking his glass and dumping the wine into a nearby flowerpot. I quickly dashed into my friend's cellar in hopes of finding something more to the liking of the grande pilota. There I was in a Tuscan's wine cellar, and the chances of find a jammy fruit bomb from Australia were about as likely as finding buried treasure in the same place. I settled for a bottle of Tuscan Merlot from Fattoria di Petrolo. The cork of the wine was quickly pulled and a glass was served to Schumacher. "What do you think of that?" I asked. "It's better, but it's not an Australian Shiraz," he said. The winemaker of the Merlot was standing next to me, and I was sure that he was going to slit his wrists on the spot. He is a hard-core Ferrarista (his 1978 308 GTO spends most of its life in the garage in some state of disrepair) and he kept on repeating in Italian, "Oh my God, Michael Schumacher doesn't like my wine. Oh my God, Michael Schumacher doesn't like my wine."
and as if giving a winemaker an existential crisis wasn't enough...
After the first course of pasta with mushrooms, Schumacher began to relight his Davidoff. "Michael, if you wait, I will give you a Cuban Davidoff," I said, now clearly under the influence of numerous glasses of non-Australian Shiraz. "Have you ever had one?" "No. I didn't think you could find them anymore," he said, looking slightly suspicious. "I would like to try one, though." I stole the keys of my neighbor's All-Road Audi and sped down the dirt road towards my house, About halfway there, I began dreaming what it would be like if Schumacher was hot on my backside trying to pass as he always does on one of the tracks in Italy, such as Imola or Monza. 
honestly I get it
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wolvertooth · 10 months ago
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au/fix where the sabretooth that gets sent down to the pit and does the sabretooth war stuff is uhmmm just a clone. its the clone plot again. for the 3rd time.
i mean im kinda torn on this since sabretooth 2022 + sabretooth and the exiles did have some good moments. its just the ending and everything that happened after that was. weird. and off.
so maybe before the pit, the clone was doing some Evil clone stuff, but being in the pit triggered some genuine memories for the clone, allowing for it to have a brief period of victors actual self. then, by the end of sabretooth and the exiles, that wore off, and he reverted back to normal Evil clone. that would also give a good reason for the brief moments in sabretooth war that felt ‘real’ being at the same time he was remembering things, his actual self slipping through again. fuck now im feeling kinda bad for this hypothetical sabretooth clone…..
meanwhile, the real sabretooth(inverted) is chilling at home, watching this go down from the outside. cuz like, lets be real, his friends wouldnt just leave him in that reverted state at the end of weapon x 2017. they would absolutely kick some ass in order to get him back to normal. and i bet it was weird for him to hear about the graydon thing too, seeing as hes now got a solid relationship with his own graydon.
oh. and ben percys wolverine is totally a clone too. cuz he just seems so different from the wolverine in infinity watch.
and the real ones are definitely living together.
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anyway, extra -> tbh the whole percy run feels like an au to me. mostly due to the way both of their memories are handled, wolverines especially, as shown in x lives / x deaths. its a mashup of a bunch of different wolverine runs, but with the authors own spin on them.
its kinda representative how every new wolverine run is like their own au, each author taking bits and pieces of canon as needed, but also slightly rewriting them to fit their personal take. bit like a game of telephone, plot points getting forgotten over time as new authors dont bring them along, and other authors ideas getting remixed. especially in the earlier days, when runs were way longer, plot points getting abandoned in their own run.
a good example of this comes from return of wolverine and infinity watch, which are both considered ‘canon’, but due to their length are never referenced again. and even though infinity watch is an immediate sequel to return of wolverine, the concept introduced in that run where wolverine has all the different versions and variants of wolverine in his head wasnt ever mentioned.
its like the previous stories set up new plots only for the future ones to drop them. like how weapon x 2017s ending of sabretooth being reverted back to a ‘feral’ state never gets elaborated on later, despite seeming like something that would lead into a new arc.
all different stories, all somehow labeled as canon.
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trothplighted · 3 months ago
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I saw a series of tags on another post that contained a derisive comment about “(current or former) HP fans who refuse to see that the books share the views of the author” (paraphrased, because I don’t want to call out one specific person), and I guess I wanted to talk about it, because… yes and no
in an earlier post I talked about how I don’t trust JKR’s ability to accurately identify good and evil, and how I work around her thumb on the scale when it comes to how I’m supposed to think of a character (so, for example, every good character suddenly deciding Sirius is a bad and dangerous person for Harry to be around in OotP is not an indication that this is true, it’s because they’re homophobic either implicitly or explicitly or if they’re gay they’re being influenced by a homophobic society to judge him more intensely. another example would be James’s bullying - I make the conscious choice to integrate both his early characterization as a good and principled and noble and morally sound person and his tendency for violence, and I look at the normalized culture of violence at Hogwarts and the pranks that good characters play and the dismissal of harassment or abuse or stalking from teachers and the administration, and I examine the accuracy and limitations of Pensieve memories and how the Worst Memory differs from others we’ve seen, and I ask myself about Snape’s motivations in the moment and his cultural background and personal prejudices, and somewhere in all of that is the truth about how bad James was objectively + how bad James was in the context of Wizarding Britain school culture. those things are two different things) and I guess I’m mostly annoyed that there’s a lot of people on this site who seem to think that no one who likes these books has ever been critical of Joanne, that no one who spends time in this world is unaware of how fucked up it is, etc.
and yet her path to radicalization is well-documented! we know when she pivoted to TERFdom. we can see her early attempts to diversify HP and make it more global and try and appeal to a progressive crowd in the early/mid 2010s to stay relevant, and we can see how after the progressive part of fandom pretty firmly rejected and mocked her (for both valid AND invalid reasons; I do think that there were a lot of trolls and assholes in between the real serious criticism) she went running to the right wing for validation and support, and they sucked her in. she’s a largely-failed author whose non-HP books do not manage to live up to HP’s legacy, and who will be forever associated with this project that ended 18 years ago, and she’s been desperate to remain relevant rather than content to rest on her laurels. (Or to write again intermittently when inspiration strikes, like Suzanne Collins has done)
so - there IS a lot of fucked up stuff in the books, ideologically, in how the characters act. it’s just stuff that was fucked up before she turned into a TERF, and as a result it’s a lot less obviously evil and more ideologically thorny. ignoring her declarations of who is or isn’t Good will reveal a whole cast of morally grey people trying to figure out what the right moves are, and living in a horribly fucked up world that nonetheless deserves to be saved. and I think that seeing her flaws as they are preserved in ink and paper, and arguing against them, and finding reasons to oppose them - this is the backbone of the more analytical parts of what’s left of the fandom.
(I’d argue going further to interpret her prejudices against “Evil” characters Watsonianly as in-universe prejudices against deviation from the norm has brought me to an observation of a sort of four-sided debate on the subject of how to run the world (authoritarian right/Voldemort, authoritarian left/Grindelwald, libertarian-ish right/the Ministry, libertarian-ish left/Dumbledore) where all sides kind of have at least a few good points and the real measure of how bad a movement or system is is “how many real people are helped or hurt by this? how protected are vulnerable innocents?”) but that’s the subject of another post. I’ll spread the “the greatest evil is fascism” agenda elsewhere.)
In an ideal world, HP would have faded into relative obscurity fairly quickly. The books were never perfect but the engagement with those flaws has been ongoing forever; there’s much less hero-worship of Joanne in serious fan spaces than in casual ones, and her issues are ones we’ve been wrestling with for decades. but they weren’t TERFery, and I think that’s important to remember, because we can criticize her for things that she’s done wrong 18 years ago and 22 years ago and not have to bend over backwards excoriating ourselves because she metamorphosed into something worse than she already was. she’s a writer. no more, no less. and she’s one of many who’ve written some great art with some horrible bigotries underneath. I don’t apologize for liking Shakespeare, and he’s a way better writer who was much more explicit in his prejudices than she was in 2003 or 1998 or 2007. The woman who exists now grew out of the woman who wrote all this, frustratingly so, but they aren’t identical.
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alliswyattonthewesternfront · 3 months ago
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i'm reading a paper from 1936 on soda jerk slang, and it's wild how many of these terms are still around, unchanged, as widely used slang terms in america, or else evolved into similar sounding contemporary slang. the paper is pretty narrow in scope, too, focusing solely on soda fountains in nyc that were independently owned. once again, you gotta hand it to new york city.
not to say the soda jerks invented all of the slang they were using (though part of getting the job was the ability to create clever euphemisms on the fly), more so that their social position of being the local neighborhood Cool Dude made the preservation and proliferation of slang terms easy to track. who knows if we'd still be calling it a "cup of mud" or "cup of joe" if not for the humble soda jerk
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qazastra · 1 month ago
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this country is a joke for countless reasons but what do you mean i just won’t be getting my medication (that ive already been taking for months) until my insurance decides they want to press a button in a few weeks. Cool. set tge world on fire <3
#1) request refill at pharmacy 2) request refill again because it didnt get filled 3) get told i should contact doctors office4) i do that#5) i need ‘prior authorization’ (bullshit that translates to ‘your insurance wants to make you suffer for profit’)#6) check back with doctors office. they say yeah we sent that request to insurance 7) pharmacy says we still dont have it 8) doctor says#THAT IT WILL TAKE A FEW *WEEKS. * W E E K S. As in multiple weeks. MULTIPLE WEEKS.#WHEN I HAVE BEEN OUT OF THOS MEDICATION FOR A MONTH ALREADY DOING THIS BULLSHIT WHERE I CONTACT TWO DIFFERENT INSTITUTIONS SO THAT THEY CAN#CONTACT A THIRD WHO DOESNT CARE WHAT HAPPENS TO ME#all the while my doctors office is like hey have you found a psych yet? NO I HAVENT. FUNNY HOW HAVING ADHD MAKES IT HARDER TO DO THAT#and add to that. not everywhere takes my insurance in the first place#i would really prefer to not go to some big practice so that narrows my options#and one that looked promising would mean i have to stOP SEEING MY THERAPIST BECAUSE INSURANCE WOULDNT COVER BOTH#are you out of your goddamn MIND#another that looked promising didnt call me back a third said Actually i Dont take your insurance even though i said i did but uou can do#sliding scale and then submit the claim to insurance!#girl i will not be doing that i dont trust my insurance as far as i can uuh. nudge a boulder with my pinky toe#another one might need me to get a Big Big Evaluation for adhd and those usually have long waitlists and cost $$$#so i wonder why more americans dont want free universal healthcare.#m
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yeah-thats-probably-it · 8 months ago
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i hate this vyvanse shortage i’m so sick of it wishing every pharmaceutical executive a personal go to hell. also wishing every insurance company executive a personal go to hell. and to whoever invented the us healthcare system sending you an extra special fahr zur hölle if you would be so kind bitte
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morgenlich · 14 days ago
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not many seem to know this but as a tech i can’t answer why your insurance does or doesn’t cover certain things or why they changed your copay you are unfortunately going to have to go to them about it
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medicalxbilling · 3 months ago
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battywitch · 29 days ago
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Fingers crossed my insurance does approve my migraine prescription this week, finally
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deepseasoliloquy · 1 year ago
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i think it's really funny how people just go on the internet and tell lies
#this post is about nightheart#i went into every book following river horrified that theyd ruin him#but man im just#not#seeing it#at all#nightheart is a misogynist? nope! thats the writers#nightheart doesnt respect sunbeam's boundaries? wrong! nightheart has done nothing but respect her boundaries#nightheart undermines frostpaw's problems by comparing them to his? wrong! hes empathizing with her#its to the point im wondering if im reading the same book as you all. how did you get this impression of this dude.#i think the last one in particular stems from nightheart's conflicts not being taken seriously. yes#its dumb#this was never a prior issue for any of firestar's kin#but it is happening#and that shit is so damaging let me tell you#and also#calling him a misogynist is just gross im gonna be so fr#the AUTHORS are misogynistic. we know this. this is not our first rodeo.#that fact just seems to be projected on to nightheart instead of pointing the finger at the erins#it is misogynistic that these characters are being conveyed the way they are. but the fact remains is that its whats on the page#and nightheart has every damn right to be upset about it#AORRY I AM LIKE. PASSIONATE. ABOUT THIS. i like nightheart a lot and see myself in him#i dont think its bad if people dislike him#but a lot of the reasons ive seen arent even valid reasons because they arent accurate representations of his character#tldr; stop blaming the authors' shitty writing decisions on nightheart pleaseee 😇#nightheart#warrior cats#i would not blame anyone if u said i aint rwading allat tbh this was not meant to get so out of hand
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chuellas · 2 months ago
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Walmart Pharmacy in my area, you better count your days :)
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clowndensation · 1 year ago
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insurance is literally the dumbest shit in the world btw.
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seilon · 5 months ago
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If i don’t get an update soon on my god damn top surgery insurance negotiation im going to lose my fucking mind
#it’s been just. a fucking absurd amount of time#mostly not their fault in that my dad fucked everything up last year by dropping me from his insurance without prior notification#and i had to go through authorization + LOA negotiations all over again with my new plan once i FINALLY got said plan#and now im at that LOA part again which is almost entirely out of my hands (negotiation of coverage between the clinic and my insurance#cause the clinic is out of network and blah blah blah)#so I don’t really know what’s going on and I just have to wait indefinitely until they contact me. it’s been 3 weeks since I last messaged#them begging for an update. it’s been much longer than that since the LOA thing started#funny that this is Still preferable to if I went with the in-network location I was originally referred to. which I called in January 2024#just to be told the soonest CONSULTATION appointment would be in late January of 2026#again just for the consultation. god knows when the actual surgery would be#so. all things considered I think i chose the best option I could here but ghrgsggsgghh im still losing my mind#I hate having no timeline and no idea what’s going on and I just have to wait and pray#I can’t even start planning or anything re: money + booking a hotel + etc#beyond like. just generally saving money. which I certainly have been trying to (with moderate success)#actually pretty decent success if things keep going the way they currently are + I get my financial aid money throughout the year#does not help though that I have literally no decent point of reference for what my insurance might have me pay out of pocket#like taking a shot in the dark (+ some reddit posts that Might apply)….maybe 4-7K out of pocket?#but I don’t know man. I really do not know#im just hoping going through all this is worthwhile and I don’t waste all this time just to be given an estimate that’s not even that#different from the totally out of pocket cost#at least I have like three different ways of getting massive hotel discounts that’s a godsend#sigh#kibumblabs
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salsa-ishida · 5 months ago
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you're back!! it's been so long!! I missed you <3 <3
ahhhh I missed you too!! Life has been insistent on grinding me to a paste but we perservere
#life has been so so so hard <3#i've never fully recovered from long covid so an average workday was leaving me absolutely drained#and on top of that i had an incident where i was trying to look into a prior auth for a patient#the kid was trans and cried on the phone because he was afraid his insurance wouldn't cover his testosterone now that trump had won#his doctor was at her wit's end because she had been assured on three separate occasions that the authorization was all set#so since it was literally a dead day at work anyway i spent about half an hour playing phone tag with the insurance#trying to find out what their mcfucking issue was#only to eventually be told they wouldn't speak to a representative from the pharmacy about it and that the prescriber had to make the call#so i did let the prescriber know and found a goodrx coupon that made the price like $20#patient was thrilled and very grateful for the effort#(this was like. the day before christmas and his last chance to get his medicine before he had to travel.)#pharmacist however immediately jumped my shit when i hung up for ''wasting time''#despite the fact that there was??? literally no other work to do???#we had three other techs on and i was keeping up with the data entry as things came in while i was on the phone.#tried to defuse the situation by apologizing but she was literally top-of-her-lungs screaming at me#in front of my coworkers and the like 2 customers nearby. so loud that one person could hear her clearly from the bathroom#had worked with this woman for 5+ years and she was the reason i went to this particular pharmacy in the first place#left and texted my boss what happened and told her that this gets fixed or i'm out. had a meeting with the store manager and everything#told them i would have a conversation with her to see if we could move past this. and she refused to speak to me#so i quit and my bestie quit in solidarity and we have been job hunting except that we both also got sick as FUCK the next day#like vomiting shaking massive headache unable to function sick#his fever was like 104.7 at one point? it was ungood#i'm finally about 85% better and back on the job hunt but like. yeah#thought i had something lined up that would free me from the shackles of customer service but unfortunately the guy changed his mind#and the one pharmacy interview i had they wanted to pay me $10/hr 💀 homie that's a $9/hr pay decrease#so yeah life is a prison etc etc BUT not having a full time job anymore DOES mean#that i have the time and energy to tungl again without all the chronic exhaustion#silver linings!!!
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esleep · 1 year ago
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HELP. i somehow ended up in a relatively casual "book club" composed of some irl friends, most of whom have VERY different taste in books from me. we have a narrow space of overlap thanks to the relatively recent popular acceptance of "fantasy romance" as a genre that adults are allowed to enjoy, so now i can read about elves and dragons without being immediately ridiculed as a Weird Nerd as long as there's at least one sex scene, but it just occurred to me that at some point soon i am going to be required to pick the next book in our rotation and i have NO IDEA what to force these people to read. which means i have the potential do the funniest thing of all time (to me and only me) and force all these romance enjoyers to read Dune. i need someone to talk me out of that and give me some better suggestions before i am forcibly evicted from the friend group.
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