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Jaylen Brown scores 29 points before Celtics beat Timberwolves 107-105 with late defensive standOLED monitors and TVs could get cheaper soon thanks to TCL's inkjet breakthroughArgentina's Racing wins its first Copa Sudamericana championship by beating Brazil's Cruzeiro 3-1Renuka Rayasam | (TNS) KFF Health News In April, just 12 weeks into her pregnancy, Kathleen Clark was standing at the receptionist window of her OB-GYN’s office when she was asked to pay $960, the total the office estimated she would owe after she delivered. Clark, 39, was shocked that she was asked to pay that amount during this second prenatal visit. Normally, patients receive the bill after insurance has paid its part, and for pregnant women that’s usually only when the pregnancy ends. It would be months before the office filed the claim with her health insurer. Clark said she felt stuck. The Cleveland, Tennessee, obstetrics practice was affiliated with a birthing center where she wanted to deliver. Plus, she and her husband had been wanting to have a baby for a long time. And Clark was emotional, because just weeks earlier her mother had died. “You’re standing there at the window, and there’s people all around, and you’re trying to be really nice,” recalled Clark, through tears. “So, I paid it.” On online baby message boards and other social media forums , pregnant women say they are being asked by their providers to pay out-of-pocket fees earlier than expected. The practice is legal, but patient advocacy groups call it unethical. Medical providers argue that asking for payment up front ensures they get compensated for their services. How frequently this happens is hard to track because it is considered a private transaction between the provider and the patient. Therefore, the payments are not recorded in insurance claims data and are not studied by researchers. Patients, medical billing experts, and patient advocates say the billing practice causes unexpected anxiety at a time of already heightened stress and financial pressure. Estimates can sometimes be higher than what a patient might ultimately owe and force people to fight for refunds if they miscarry or the amount paid was higher than the final bill. Up-front payments also create hurdles for women who may want to switch providers if they are unhappy with their care. In some cases, they may cause women to forgo prenatal care altogether, especially in places where few other maternity care options exist. It’s “holding their treatment hostage,” said Caitlin Donovan, a senior director at the Patient Advocate Foundation . Medical billing and women’s health experts believe OB-GYN offices adopted the practice to manage the high cost of maternity care and the way it is billed for in the U.S. When a pregnancy ends, OB-GYNs typically file a single insurance claim for routine prenatal care, labor, delivery, and, often, postpartum care. That practice of bundling all maternity care into one billing code began three decades ago, said Lisa Satterfield, senior director of health and payment policy at the American College of Obstetricians and Gynecologists . But such bundled billing has become outdated, she said. Previously, pregnant patients had been subject to copayments for each prenatal visit, which might lead them to skip crucial appointments to save money. But the Affordable Care Act now requires all commercial insurers to fully cover certain prenatal services. Plus, it’s become more common for pregnant women to switch providers, or have different providers handle prenatal care, labor, and delivery — especially in rural areas where patient transfers are common. Some providers say prepayments allow them to spread out one-time payments over the course of the pregnancy to ensure that they are compensated for the care they do provide, even if they don’t ultimately deliver the baby. “You have people who, unfortunately, are not getting paid for the work that they do,” said Pamela Boatner, who works as a midwife in a Georgia hospital. While she believes women should receive pregnancy care regardless of their ability to pay, she also understands that some providers want to make sure their bill isn’t ignored after the baby is delivered. New parents might be overloaded with hospital bills and the costs of caring for a new child, and they may lack income if a parent isn’t working, Boatner said. In the U.S., having a baby can be expensive. People who obtain health insurance through large employers pay an average of nearly $3,000 out-of-pocket for pregnancy, childbirth, and postpartum care, according to the Peterson-KFF Health System Tracker . In addition, many people are opting for high-deductible health insurance plans, leaving them to shoulder a larger share of the costs. Of the 100 million U.S. people with health care debt, 12% attribute at least some of it to maternity care, according to a 2022 KFF poll . Families need time to save money for the high costs of pregnancy, childbirth, and child care, especially if they lack paid maternity leave, said Joy Burkhard , CEO of the Policy Center for Maternal Mental Health, a Los Angeles-based policy think tank. Asking them to prepay “is another gut punch,” she said. “What if you don’t have the money? Do you put it on credit cards and hope your credit card goes through?” Calculating the final costs of childbirth depends on multiple factors, such as the timing of the pregnancy , plan benefits, and health complications, said Erin Duffy , a health policy researcher at the University of Southern California’s Schaeffer Center for Health Policy and Economics. The final bill for the patient is unclear until a health plan decides how much of the claim it will cover, she said. But sometimes the option to wait for the insurer is taken away. During Jamie Daw’s first pregnancy in 2020, her OB-GYN accepted her refusal to pay in advance because Daw wanted to see the final bill. But in 2023, during her second pregnancy, a private midwifery practice in New York told her that since she had a high-deductible plan, it was mandatory to pay $2,000 spread out with monthly payments. Daw, a health policy researcher at Columbia University, delivered in September 2023 and got a refund check that November for $640 to cover the difference between the estimate and the final bill. “I study health insurance,” she said. “But, as most of us know, it’s so complicated when you’re really living it.” While the Affordable Care Act requires insurers to cover some prenatal services, it doesn’t prohibit providers from sending their final bill to patients early. It would be a challenge politically and practically for state and federal governments to attempt to regulate the timing of the payment request, said Sabrina Corlette , a co-director of the Center on Health Insurance Reforms at Georgetown University. Medical lobbying groups are powerful and contracts between insurers and medical providers are proprietary. Because of the legal gray area, Lacy Marshall , an insurance broker at Rapha Health and Life in Texas, advises clients to ask their insurer if they can refuse to prepay their deductible. Some insurance plans prohibit providers in their network from requiring payment up front. If the insurer says they can refuse to pay up front, Marshall said, she tells clients to get established with a practice before declining to pay, so that the provider can’t refuse treatment. Related Articles Health | Which health insurance plan may be right for you? Health | Your cool black kitchenware could be slowly poisoning you, study says. Here’s what to do Health | Does fluoride cause cancer, IQ loss, and more? Fact-checking Robert F. Kennedy Jr.’s claims Health | US towns plunge into debates about fluoride in water Health | Vallejo City Council passes smoking ordinance Clark said she met her insurance deductible after paying for genetic testing, extra ultrasounds, and other services out of her health care flexible spending account. Then she called her OB-GYN’s office and asked for a refund. “I got my spine back,” said Clark, who had previously worked at a health insurer and a medical office. She got an initial check for about half the $960 she originally paid. In August, Clark was sent to the hospital after her blood pressure spiked. A high-risk pregnancy specialist — not her original OB-GYN practice — delivered her son, Peter, prematurely via emergency cesarean section at 30 weeks. It was only after she resolved most of the bills from the delivery that she received the rest of her refund from the other OB-GYN practice. This final check came in October, just days after Clark brought Peter home from the hospital, and after multiple calls to the office. She said it all added stress to an already stressful period. “Why am I having to pay the price as a patient?” she said. “I’m just trying to have a baby.” ©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.
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The Gross Law Firm Reminds Visa Inc. Investors of the Pending Class Action Lawsuit with a Lead Plaintiff Deadline of January 21, 2025 – VThings to watch this week in the Big 12 Conference: No. 14 BYU (9-1, 6-1 Big 12, No. 14 CFP) at No. 21 Arizona State (8-2, 5-2, No. 21), Saturday, 3:30 p.m. ET (ESPN) League newcomer Arizona State has a three-game winning streak and BYU is coming off its first loss. The Cougars, after losing at home to Kansas, still control their own destiny in making the Big 12 championship game. They can clinch a spot in that Dec. 7 game as early as Saturday, if they win and instate rival Utah wins at home against No. 22 Iowa State. Arizona State was picked at the bottom of the 16-team league in the preseason media poll, but already has a five-win improvement in coach Kenny Dillingham's second season. No. 16 Colorado (8-2, 6-1, No. 16 CFP) at Kansas (4-6, 3-4), Saturday, 3:30 p.m. ET (Fox) Coach Deion Sanders and the Buffaloes are in prime position to make the Big 12 title game in their return to the league after 13 seasons in the Pac-12. If BYU and Utah win, Colorado would be able to claim the other title game spot with a win over Kansas. The Buffs have a four-game winning streak. The Jayhawks need another November win over a ranked Big 12 contender while trying to get bowl eligible for the third season in a row. Kansas has won consecutive games over Top 25 teams for the first time in school history, knocking off Iowa State before BYU. Iowa State quarterback Rocco Becht has thrown a touchdown in a school-record 14 consecutive games, while receivers Jayden Higgins and Jaylin Noel both have more than 800 yards receiving. San Jose State is the only other FBS team with a pair of 800-yard receivers. Becht has 2,628 yards and 17 touchdowns passing for the Cyclones (8-2, 5-2), who are still in Big 12 contention. Oklahoma State goes into its home finale against Texas Tech with a seven-game losing streak, its longest since a nine-game skid from 1977-78. The only longer winless streak since was an 0-10-1 season in 1991. This is Mike Gundy's 20th season as head coach, and his longest losing streak before now was five in a row in 2005, his first season and the last time the Cowboys didn't make a bowl game. ... Baylor plays at Houston for the first time since 1995, the final Southwest Conference season. The Cougars won last year in the only meeting since to even the series 14-14-1. ... Eight Big 12 teams are bowl eligible. As many as six more teams could reach six wins. The Big 12 already has four 1,000-yard rushers, including three who did it last season. UCF's RJ Harvey is the league's top rusher (1,328 yards) and top scorer with 21 touchdowns (19 rushing/two receiving). The others with consecutive 1,000-yard seasons are Texas Tech career rushing leader Tahj Brooks (1,184 yards) and Kansas State's DJ Giddens (1,128 yards). Cam Skattebo with league newcomer Arizona State has 1,074 yards. Devin Neal, the career rushing leader at his hometown university, is 74 yards shy of being the first Kansas player with three 1,000-yard seasons. Cincinnati's Corey Kiner needs 97 yards to reach 1,000 again. Get local news delivered to your inbox!Yadah yesterday cam e out guns blazing, claiming midfielder Tanaka Shandirwa is not for sale, just 24 hours after it had emerged the player was angling for a move to Harare giants CAPS United. Shandirwa, who is approaching the end of a two-year loan deal at Dynamos, apparently signed a pre-contract with Makepekepe on Monday, with a move to the Green Machine scheduled for next season. But his parent club Yadah and rivals Dynamos were not amused. Yadah released a statement yesterday expressing their displeasure with the development. "We have noted with concern the pictures of CAPS United owner, Farai Jere, CAPS United coach, Lloyd Chitembwe, and Tanaka Shandirwa which have gone viral on social media, misleading the general public and the football fraternity that Tanaka Shandirwa has joined CAPS United," said the Yadah statement. "The Yadah administration wishes to inform the public that Tanaka Shandirwa has a running contract with Yadah FC. Further to that, Yadah FC wishes to inform the concerned football fraternity that no club has made formal engagement about Shandirwa's deal." Dynamos also wanted clarity on the matter and yesterday wrote to the Miracle Boys, who were equally incensed that Makepekepe went on to confirm their pre-contract agreement with Shandirwa on their social media platforms without first engaging them on the status of the midfielder. The Walter Magaya-owned club revealed they have plans with the midfielder, despite his terrible time in his second season with Dynamos. His loan spell at DeMbare is set to expire in December, after which he will revert to being a Yadah player. The extent of the length of Shandirwa's contract with Yadah could not established. The midfielder joined Yadah in 2019 after passing a trial. "Shandirwa is a Yadah FC player who is currently on loan to Dynamos and his contract with Yadah FC still subsists. Yadah FC wishes to debunk the notion that Shandirwa is on sale. "Shandirwa will be an important cog for Yadah FC next season. Yadah FC is not willing to invite any prospective suitor to the negotiation table," said the statement from Yadah. Yadah did just enough to survive relegation this season, but they could end in the top 10 if results favour them in the last round of matches this weekend. The Miracle Boys currently sit in 11th position. They round off the campaign away in Bulawayo where they face giants Highlanders in their last match of the season. Close Sign up for free AllAfrica Newsletters Get the latest in African news delivered straight to your inbox Top Headlines Zimbabwe Soccer Submit By submitting above, you agree to our privacy policy . Success! Almost finished... We need to confirm your email address. To complete the process, please follow the instructions in the email we just sent you. Error! Error! There was a problem processing your submission. Please try again later. _ready.push(function($) {if ( ! loadjs.isDefined( 'newsletter-signup-assets' ) ) { loadjs( ["https://cdn01.allafrica.com/static/js/jquery/jquery.serialize-object.min.js?v=2024110900","https://cdn05.allafrica.com/static/js/newsletter-signup.min.js?v=2024110900","https://cdn05.allafrica.com/static/css/newsletter-signup.min.css?v=2024110900"], 'newsletter-signup-assets', { async: true, });} // the newsletter widget calls storageAllowed(), which is imported with // the cmp bundle. passing an array of bundle names to loadjs triggers // the callback only after all of the listed bundles have fired. loadjs.ready( [ 'cmp', 'js-cookie', 'events', 'newsletter-signup-assets' ], function() { $('.newsletter-signup.inread.collapse.w-background.w-background-color.blue').newsletterInRead({ maxShowCount: 10, maxCloseCount: 3, maxSuccessCount: 1, alternateCallback: function() { activateAdSenseSlots( [ 'responsive-aans-view-c-container' ] ); }, }); }); }); The move by Shandirwa to engage in talks with CAPS United has also dragged giants Dynamos into the equation. The Harare giants accused their crosstown rivals CAPS United of "unethical conduct". DeMbare chairman Moses Maunganidze yesterday wrote to Yadah chairman Everson Chatambudza seeking clarity on Shandirwa's position. "Dynamos Football Club hereby requests your esteemed office and person to confirm the following in respect of the following for player Tanaka Shandirwa: Release of the player to CAPS United FC on loan for 2025. Conclusion of pre-contract between CAPS United and the player. "It has come to our attention that CAPS United FC unveiled player Tanaka Shandirwa today as their latest acquisition. In the premises and the absence of your confirmation of the above we believe CAPS United have demonstrated unethical conduct," wrote Maunganidze. Fixtures: Saturday: Bikita Minerals v Hwange (Wadzanayi), GreenFuel v Dynamos (GreenFuel Arena), Manica Diamonds v Bulawayo Chiefs (Sakubva), ZPC Kariba v Simba Bhora (Nyamhunga), FC Platinum v TelOne (Mandava), Arenel v Chegutu Pirates (Luveve), Herentals v Chicken Inn (Rufaro) Sunday: Highlanders v Yadah (Barbourfields), CAPS Utd v Ngezi Platinum Stars (Rufaro) Read the original article on The Herald .
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