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Avoid being scammed! “What You Should Know About Health Insurance Before Buying”

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For many of us, finding the right health insurance plan, can be a tedious task. When selecting a plan, you might need a psychic. COAST Surgery Center of Huntington Beach, CA explains why. We tend to pick a plan that fits our needs for today, but those needs change. So unless you have a psychic to tell you how your health, your family situation, or if your financial situation will be in the future, how will you really know what plan is best for you?

Most of us are clueless as to how insurance plans work and insurance companies don’t make it any easier to understand. There are tools to help us purchase a plan but it almost seems like we would need a PhD just to understand them. Once we have decided on an HMO or PPO, we may soon realize we have picked the wrong plan because many of us don’t really know what our policy covers until we need surgery and then we’re told it’s not covered or our co-insurance is super high. That’s when we realize our plan has too many restrictions and conditions.

“Wasn’t that the whole reason for purchasing the PPO plan and be able to see any physician we want?”

Those who work in medical billing have experienced how insurance companies use tactics that many of us don’t know about. We are deceived into buying a PPO plan without clearly understanding how they work. When we purchase a PPO plan, it’s mainly so we are able to see any doctor without having to be tied to a network or require a referral from a Primary Care Physician (PCP). After paying a higher premium for months or even years, something happens to you and you need a specialist. After carefully selecting the best specialist to treat you, the insurance calls to ask why you have selected that specialist. Here’s where the tactic begins. Although, they shouldn’t be contacting you, naturally, you respond that this doctor is experienced and has a good reputation. The insurance representative would then inform you that since you are using an out-of-network specialist, they will not cover the procedure as much as their in-network specialists and then hint that you should switch to their in-network specialist.

Most out-of-network doctors and facilities usually get paid Medicare rate, meaning very little. Therefore, patients may get hit with the responsibility of what the insurance doesn’t pay and they never tell us that. Insurance companies know our fear of having to pay more out of pocket if they don’t cover as much. So do we then switch to an in-network doctor or pay more out of pocket? We chose our physician for a good reason and we cannot risk our health to just any doctor. Wasn’t that the whole reason for purchasing the PPO plan and be able to see any physician we want?

Insurance companies should not use tactics to scare us when we are in a stressful situation. They are taking advantage of our vulnerability to coerce us into making an irrational decision. If we are out-of-network, they are not supposed to suggest that we go in-network when verifying coverage. Insurance companies will continue to make money, while patients, physicians, and facilities providers lose. Health plans are constantly changing and premiums are increasing each year, while coverage is getting reduced. So before you buy, make sure you get the right information for not only your needs today, but for when you do actually use the coverage.

If you feel that you have been scammed or mislead into purchasing a plan that isn’t right for you, you can file a complaint with the Department of Insurance at 800-927-4357 or with the Department of Managed Healthcare at 916-324-8176.

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NAVIGATING THE AESTHETIC JOURNEY AND KNOWING THE RISKS OF LOCAL ANESTHESIA

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Cosmetic surgeries have become increasingly popular in recent years, offering individuals the opportunity to enhance their physical appearance and boost their confidence. Embarking on the path to aesthetic enhancement through cosmetic surgery is a significant decision that warrants careful consideration. Two key factors that can make or break the success of your transformation are the choice of a cosmetic surgeon and knowing your options when it comes to anesthesia. Researching and selecting the right surgeon can be a transformative step toward achieving the desired results and ensuring a safe and satisfying surgical experience.

Before entrusting someone with your appearance, it’s essential to verify the credentials of potential cosmetic surgeons. Look for board certification, which signifies that the surgeon has undergone rigorous training and adheres to high professional standards. Additionally, check for memberships in reputable medical societies related to cosmetic or plastic surgery and check with the medical board for any citations, history of death, or any criminal records that the surgeon may have.

Different cosmetic surgeons have varying areas of expertise. Research surgeons who specialize in the specific procedure you’re considering. An experienced surgeon in a particular field is more likely to deliver optimal results and handle any potential complications with skill and confidence. Be aware of general surgeons advertising themselves as cosmetic surgeons. Schedule consultations with potential surgeons to discuss your goals, express concerns, and assess the surgeon’s communication style. Pay attention to how well the surgeon listens, explains procedures, and addresses your questions. A positive and open doctor-patient relationship is crucial for a successful cosmetic surgery journey. Ensure that the surgical facility where the procedure will take place is accredited. Accreditation indicates that the facility adheres to stringent safety and hygiene standards. Your safety during the surgical process is paramount, and choosing a well-equipped and accredited facility is a fundamental part of that commitment. Surgeries are only safe when performed by a surgeon at a surgery center. It would be unsafe or potentially cause the patient’s death if the surgery is performed at a medical office.

One other crucial decision lies in the choice of anesthesia—local or general. While local anesthesia may seem like a less invasive option and more affordable, it’s essential to understand the associated risks and why general anesthesia may be a safer choice for certain cosmetic surgeries.

Local anesthesia involves numbing a specific area of the body, rendering it insensitive to pain during a surgical procedure. For minor cosmetic interventions like injectables or minor facial enhancements, local anesthesia may seem like a convenient choice. However, the temptation of consciousness during a more extensive surgery may come with its own set of risks. Under local anesthesia, patients remain conscious during the procedure, potentially causing anxiety and discomfort. Watching a surgery in progress, even if pain-free, can be mentally distressing for some individuals. Local anesthesia may not provide adequate pain control for more invasive procedures. This could lead to discomfort or even pain during the surgery, impacting both the patient’s experience and the surgeon’s ability to perform optimally. Achieving complete anesthesia in a specific area can be challenging. Factors like individual pain tolerance, variations in anatomy, and unforeseen complications may result in inadequate numbing, leading to unexpected pain during the procedure.

In contrast, general anesthesia induces a state of unconsciousness, ensuring a painless and controlled environment allowing the patient to remain completely unaware and pain-free throughout the surgery. While it may seem like a more invasive option, general anesthesia offers several advantages that contribute to a safer and more controlled surgical environment. General anesthesia ensures the patient is entirely unconscious, eliminating any potential discomfort or psychological distress associated with being aware during surgery. This is particularly beneficial for complex and lengthy cosmetic procedures. With general anesthesia, pain management is more effective as it targets the entire body. This is crucial for minimizing post-operative pain and ensuring a smoother recovery process. Surgeons can perform cosmetic surgeries with greater precision and focus when the patient is under general anesthesia. This is especially important for intricate procedures that require meticulous attention to detail.

If the surgery is performed at a surgery center, the specialized team of anesthesiologists, nurses and surgical technicians will have the authority to force the surgeon to immediately stop the surgery if the surgeon becomes negligent or left out an important step. But if this surgery is performed in the surgeon’s medical office under local anesthesia, no one will have the authority to stop the surgeon from performing the surgery. Simply put, when performing surgery under local anesthesia, the surgeon will perform and make all the decisions without the opinions and professional witnesses of the team of anesthesiologists, nursing staff, surgical technicians.

Embarking on a cosmetic surgery journey is a personal and transformative experience, and choosing the right surgeon is a critical step in ensuring a positive outcome. By investing time in thorough research, checking credentials, reading reviews, and attending consultations, you empower yourself with the knowledge needed to make an informed decision. The right cosmetic surgeon will not only possess the technical skills required for your chosen procedure but also share a commitment to your safety, well-being, and overall satisfaction.

While local anesthesia may seem like an appealing option for its perceived simplicity and lower cost, the risks associated with inadequate pain control, patient discomfort, and the potential for incomplete anesthesia cannot be ignored. General anesthesia, on the other hand, offers a more comprehensive approach, ensuring patients are completely unconscious, and pain-free, allowing surgeons the precision required for intricate cosmetic procedures.

Ultimately, the choice between local and general anesthesia depends on the type and complexity of the cosmetic surgery. It is crucial for patients to engage in open and thorough discussions with their surgeons to determine the most appropriate anesthesia option, taking into account both the nature of the procedure and individual health considerations. Prioritizing safety and comfort will contribute to a positive cosmetic surgery experience and a smoother recovery journey.

Remember, your aesthetic journey is unique, and selecting a surgeon who aligns with your goals is key to achieving the confidence and satisfaction you desire.

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FBI INVESTIGATORS ARE CREATING CRIMINALS

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Dr. Robert Joseph, a podiatrist in California, who was indicted by the United States District Court for the Central District of California for the illegal practice of colluding with pharmaceutical marketers for writing prescriptions of compounding drugs, is now working undercover for the FBI. In exchange for a lower sentence due to his indictment in 2018, Dr. Robert Joseph is now working undercover to deceive medical facilities and doctors by intentionally offering illegal deals.

This article is to help warn medical facilities and doctors of the devious practice that the FBI is taking to catch them in the act. It is one thing to investigate incidences due to patient complaints or whistleblowers but to intentionally embed a mole to create a problem when there is no problem, this is how the FBI works. If Adam is tempted by the apple because it was offered is that the same as if he had already bit the apple without the temptation created by Eve? In this case, the FBI is going fishing in hopes of finding something.

A medical facility in Huntington Beach, CA was a victim of Dr. Robert Joseph and the FBI. Dr. Joseph came into the facility wearing a concealed camera and had the intention of catching them by offering an illegal deal. Fortunately, this medical facility did not take the bait but wanted to share their experience with the public so that other medical offices and doctors will be aware of Dr. Robert Joseph.

As the public, we want doctors to care about us and to do what’s best for us and not be greedy. That is the oath they take when they become doctors. There are doctors who are tempted to sway but being tempted versus actually acting on greed is not the same. What the FBI is doing is turning the tempted into greedy criminals. 

Ref: https://www.justice.gov/file/1076086/download

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$150 CÓ ĐÁNG VỚI RỦI RO LÀM HẠI GƯƠNG MẶT CỦA BẠN KHÔNG?

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 Các phương pháp điều trị da bất hợp pháp đang được cung cấp trong các nơi chăm sóc da mặt và tiệm cắt tóc như được phát hiện bởi các cuộc điều tra bí mật gần đây về các nơi chăm sóc da mặt và tiệm cắt tóc ở Nam California. Đàn ông và phụ nữ đang trả 150 đô la cho mỗi lần khám cho các phương pháp điều trị bằng tế bào gốc, vi kim và collagen của các chuyên gia thẩm mỹ không được cấp phép hành nghề y tế. Tất cả những nơi chăm sóc da mặt và tiệm cắt tóc nói rằng họ có y tá và bác sĩ trong đội ngũ nhân viên nhưng các quy trình thực sự được thực hiện bởi các chuyên gia thẩm mỹ không có bằng hành nghề y này. Họ quảng cáo cung cấp tế bào gốc, collagen, vi kim để tiêm Vitamin C, PRP (Platelet-Rich Plasma) injections và phương pháp điều trị bằng laser IPL cũng như các quy trình làm đầy, botox, dùng kim để nặn mụn và mài da siêu nhỏ. Tất cả các quy trình này đều đi dưới bề mặt da và xâm lấn, vì vậy chúng cần có giấy phép hành nghề y tế và phải được y tá hoặc bác sĩ thực hiện. Hội đồng Nghề Làm tóc & Thẩm mỹ Tiểu bang không cho phép các chuyên viên thẩm mỹ và chuyên gia thẩm mỹ tham gia vào bất kỳ thủ thuật xâm lấn nào. Chúng chỉ được phép hoạt động trên bề mặt da. 

Khách hàng thường nhầm lẫn các dịch vụ thẩm mỹ xâm lấn này với các dịch vụ hoặc sản phẩm chăm sóc da mặt và biểu bì. Ví dụ, một loại kem dưỡng da có thể quảng cáo rằng nó làm mịn và đẹp da của bạn (dùng trong mỹ phẩm), tuy nhiên, nếu nó quảng cáo rằng nó sẽ chữa khỏi hoặc điều trị mụn trứng cá, thì đó có thể được coi là hành nghề y. Một chiếc máy có thể quảng cáo rằng nó hỗ trợ thẩm thấu các chất dưỡng ẩm, dưỡng ẩm để làm đẹp làn da của bạn (dùng trong mỹ phẩm), tuy nhiên, nếu nó tuyên bố sẽ giảm cellulite hoặc kiểm soát cơn đau, thì đây được coi là một phương pháp hành nghề y. Một chất lột da có thể quảng cáo rằng việc sử dụng nó sẽ loại bỏ các tế bào da chết không mong muốn và thúc đẩy làn da sáng, đầy sức sống (dùng trong mỹ phẩm), tuy nhiên, nếu chất lột da tuyên bố loại bỏ các đốm nâu hoặc sẹo, thì đó có thể được coi là hành nghề y học. Người tiêu dùng cũng nên biết ai đang thực hiện các thủ tục này. Ngay cả khi họ có treo giấy phép của y tá hoặc bác sĩ tại doanh nghiệp, hãy yêu cầu cá nhân thực hiện dịch vụ trình ra giấy phép hành nghề y của họ và đảm bảo rằng đó là giấy phép được cấp bởi Bộ y tế chứ không chỉ là Giấy phép của Hội đồng Nghề làm tóc & Thẩm mỹ của Tiểu bang. 

Với $150, khách hàng đang tự đặt mình vào rủi ro và các quy trình hoặc sản phẩm này sẽ gây ra tổn thương vĩnh viễn nếu không được thực hiện bởi những người hành nghề y được cấp phép bởi Bộ y tế. Nếu người tiêu dùng phát hiện ra rằng một hành vi bất hợp pháp đang diễn ra, hãy báo cáo các hoạt động này cho Hội đồng Nghề Làm tóc & Thẩm mỹ Tiểu bang tại www.breeze.ca.gov


IS $150 WORTH THE RISK OF DAMAGING YOUR FACE?

 Illegal skin treatments are being offered in beauty salons as discovered by recent undercover investigations of salons in Southern California. Men and women are paying $150 per visit for stem cells,  micro-needling, and collagen treatments by estheticians and cosmetologists that are not medically licensed. These salons say they have nurses and physicians on staff but the procedures are actually done by estheticians and cosmetologists. They advertise offering stem cells, collagen,  micro-needling to inject Vitamin C, PRP (Platelet-Rich Plasma) injections, and IPL laser treatments as well as fillers, botox,  extractions, and microdermabrasion procedures. All of these procedures go below the surface of the skin and are invasive, so they require a medical license and must be administered by a nurse or physician.  The State Board of Barbering & Cosmetology does not allow cosmetologists and estheticians to engage in any invasive procedures. They are only allowed to work on the surface of the skin. 

Customers often mistake these invasive cosmetic services for facials and epidermal services or products. For example, a skin cream can advertise that it smooths and beautifies your skin (cosmetic use), however, if it advertises that it will cure or treat acne, it could be considered the practice of medicine. A machine could advertise that it assists in the penetration of hydrating moisturizers for the beautification of your skin (cosmetic use), however, if it claims to reduce cellulite or manage pain, this is considered a practice of medicine. A skin peeling agent could advertise that its use will remove unwanted dead skin cells and promote vibrant, glowing skin (cosmetic use), however, if the skin peeling agent claims to remove brown spots or scarring, it could be considered the practice of medicine. Consumers should be aware of who is performing these procedures as well. Even if they have a nurse or doctor’s license posted at the business, ask the individual performing the service for their license and make sure that it is a medical license and not just a State Board of Barbering & Cosmetology License. 

For $150, customers are putting themselves at risk and these procedures or products cause permanent damage if not done correctly by some with a medical license. If a consumer discovers that an illegal practice is taking place, report these activities to the State Board of Barbering & Cosmetology at  www.breeze.ca.gov 

Ref: https://www.barbercosmo.ca.gov/forms_pubs/publications/skin_device.pdf

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