Catch-22

File this one under the most ridiculous insurance policy to date. I got a call from my insurance broker yesterday to discuss my dental claims. Turns out, the dentist used "dental codes" to file the claims with Blue Cross. Silly people - don't they know that you need to use "medical codes" in order for the medical insurance to pay?

The broker asked me to have the dentist resubmit all the claims with the medical codes, and then he would be able to work on getting Blue Cross to pay the claim. Easy enough, right? Here's the catch: my dentist doesn't have the medical codes. Sounds simple enough, right? I asked the broker for the medical codes. Here's about how the conversation went:

me: My dentist doesn't have medical codes.

broker: Can they ask around and get them?

me: Um, can't you just give them to the dentist?

broker: Oh, I don't have the codes and Blue Cross won't give them to me.

me: Huh? Why's that?

broker: If I had the codes, then I would give them out and dentists would file under medical policies. Then Blue Cross would have to pay.


Ah, yes. Another one of the insurance companies methods for avoiding payouts. "Yeah, it's covered if you file the claim properly, but we're not going to tell you or anyone how to do that, sohaveanicedaybye!"

Implant Complete

I went to the dentist yesterday - I figured I would start my long weekend with a bit of pain. The worst part, by far, was getting the Novocaine injection into the roof of my mouth. After getting completely numbed up, the actual placement of the implant was completely pain free. Definitely heard some weird sounds, but none of the pain you would normally associate with crunching bone.

So, now i have a screw in my mouth that needs to fuse with the bone over the next 6 months. Very uneventful, just the way I like it. No more dental appointments until March... woo hoo!

Blockbuster Vs. Netflix

I've been a long time user of Netflix - since I got my first DVD player back in 1999 - back when Netflix was a pure rental model, not a subscription service. When they switched to their subscription model, I hated the "End of Late Fees" advertising, because, after all, you were constantly paying - late fee, subscription fee, whatever.

Anyway, eventually they got the pricing model(s) right, and I've enjoyed the service they offer for many years. The one thing that was missing was the ability to walk in to a store and exchange a movie on a whim. That's where Blockbuster could have a killer advantage. Recently, I decided to give Blockbuster Total Access a try. I hunted around the net until I found a 4 week trial of the 3 at a time Total Access Program. Here was my experience:

1. Sign up (thumbs up)
VERY easy. Up and running very quickly, first movie on its way within 1 business day.

2. In-store game rental coupon (thumbs up)
Big selling point for me. They give you 1 free in-store game rental per month with the total access 3 at a time account. That's an $8 value. Nice.

3. Selection (thumbs up)
They have both HD-DVD and Blue Ray titles available, and I found everything I was looking for.

that's where the good stuff ends.

I took my new coupon down to my local blockbuster, picked out Metroid Prime 3 for the Wii and tried to get it for free. I was asked if I had a store account, I said I have Total Access and was told the store and the internet program are 2 completely different entities. Huh?

Why in the world would they do that? What does "Total Access" mean???

4. In store Account Sign-up (BIG thumbs down)

If you are not an existing blockbuster store member, they now charge $10/year to use the store...err, excuse me, to join their non-optional rewards program. Uh, I DON'T NEED the store rewards, i get plenty of rewards from Total Access. I had never paid a fee in the past to be a "store member," but they conveniently dropped my account because it hadn't been used for 90 days or more.

I ended up leaving the store, going home, finding my old blockbuster card, and re-enabling my store account for free. What a hassle.

5. Movie Returns Via the Mail (thumbs down)

My first rentals showed up within 2 business days. I quickly watched and returned 2 of them. Then waited. It took 4 days to show up as returned before the next 2 shipped (Netflix is usually a 1 day turnaround for me). Turns out, 4 days was FAST. The next round took 10 days to show up, and even then, I had to mnaully tell the website I had returned my movies. Then I waited.

After nearly 3 weeks of using the trial service, I have received a total of 5 DVDs. That's with a queue of 15 movies and returning within 24 hours of receiving. That's just plain SLOW.

6. Customer Service (neutral)

I wrote to customer service to let them know how bad their service was and how slow things were... here's the response to my e-mail:

"I sincerely apologize for the inconvenience this has caused. I've reviewed your account and see that you are waiting for three DVDs to be shipped. Here's an explanation of why this happened. If a movie at the top of your priority list is not available at a distribution center near you, the system automatically searches for the movie at other centers. If that movie falls outside of an acceptable shipping window, the system automatically searches for a movie lower in your queue that can get to you quicker. This process looks for "Available" titles 30-40 deep within your queue. We do this so your shipping times will be faster. On occasion, if your top selections are not available at a center near you and you have fewer than 30-40 "Available" movies in queue, a shipment may be skipped.

It appears this is exactly what's happening with your account. Based on the process I mentioned above, I would recommend keeping more than 30-40 "Available" titles in queue at all times. Once you take a few moments to do so, I'm certain you'll see something shipped by the end of the next business day after your queue meets our recommendations. Please let me know if there's anything else I can help with."

Huh???
So, they would rather not ship anything because it would take too long to ship? That's the dumbest thing I've ever heard. I don't want 30 - 40 items in my queue. I had about 10 movies I wanted to see. I don't want to fill my queue with CRAP just so I can get something quickly.

So, I've given up on Blockbuster and moved back to Netflix 2 at a time for $14 per month. Even the Netflix 1 at a time unlimited was better than my Blockbuster Total Access trial.

On paper, Blockbuster could have a killer service. Unfortunately, they are trying to figure out how to nickle and dime you. It feels like they're trying to figure out just how far they can push you with fees and restrictions instead of making it a friendly, all inclusive service.

Take it from me - stick to Netflix - no hidden fees, great selection of HD movies, fast, easy service to use and excellent customer service. Why was I even thinking of leaving in the first place?

Rejected - Round 2

Got a response back from BCBS yesterday from my second grievance letter. I'll summarize:

Dear Mr. Seifer,

We already wrote and told you that we aren't going to cover you.
I've enclosed that letter in case you forgot.
Stop bothering us.

BCBS

So, now I am trying to get the insurance broker involved.
And the saga continues.

Kitchen Remodel

We now find ourselves on the slippery slope of remodeling. You know how it starts - "Yeah, I'd really like to fix up the fireplace" which leads to "and the kitchen could use new appliances" followed by "we should gut the kitchen" and next thing you know "it would be great to do the kitchen AND the bathroom AND the family room."

I guess we should set a budget, eh?

Fireplace Remodel

Now that my summer is over, it's time to start thinking about the colder weather moving in. My favorite room in my house is my Family Room / Home Theater. Problem is, it has 3 exterior walls, a non-working fireplace and a large OLD sliding glass door with no insulating properties to speak of. It gets chilly in there. It would be great to replace the fireplace with a gas insert and use it as a zone of heat. I also HATE the way my fireplace looks.

It's very plain, just look:



After playing around in photoshop for an hour or so, and digging out some pictures of fireplaces, fireplace surrounds and bookshelves, i mocked up a picture of what I'm thinking of doing:



What do you think?

Speaker Grills Should Match!

How To Paint Your In-Wall Speaker Grills

One of the projects I had completed when we moved into our house, was installing a home theater that could be experienced, but not seen - you know, in wall speakers, all of the components in the basement, flat panel TV - the whole nine yards. Apart from a few problems with the plasma (which were handled nicely by NEC BTW), the home theater has been amazing. Great video and outstanding sound, easily controlled with a Logitech Harmony 880 Universal remote.

The speakers I chose for my in-walls are from the Triad line of speakers (InWall Silver line). While they don't sound quite as good as a non-in-wall speaker, they do sound pretty darn good. Unfortunately, at the time I bought the speakers, the grills and brackets came in white, and it cost extra to match the paint of the room. They have since changed their policy and now include the cost of custom grills in the cost of the speakers - smart move if you ask me. Unfortunately, my speakers still stood out with their white faces on my desert tan walls. Triad offered to send me new matching grills - at $100 each! $600 for grills... I did consider it, but figured I'd see if I could paint them myself before spending any real dough.

I started by pulling the grills off the speakers, leaving the brackets/frames in place. I taped up the outside edge of the frames to keep my walls clean and proceeded to put 2 coats of Benjamin Moore Desert Tan paint on all of the frames. I did this with a 1" paint brush and 2 pretty thin coats of paint. The results were excellent - the frames blended right into the wall - ok, easy part done.

Now for the hard part. Painting the grills with a brush would just look like complete crap! The little holes in the grills that let the sound pass through would clog with paint, making them look and sound MUCH worse. However, I did find that if i painted the grill with a thin coat of paint, then used a compressed air can to spray the grill, the holes all opened up nicely and they started to look good. However, I then thought of a better way to paint these - using an air-brush. Since I didn't own an air-brush, I needed to find an inexpensive model (less than $50 for sure) that could do the job, otherwise, the time & expense of the project would be more than just ordering the grills from Triad.

I called around to a few arts & crafts stores and found that Michaels Arts & Crafts had just what I was looking for. They carry a basic Badger air-brush for $24.99. Add in a can of "propel" (compressed air) for $12.99 and it was well within my budget. After a quick trip to Michaels, I was armed with my new tool.

After assembling the air-brush (2 minutes), I experimented with the paint flow a bit. I ended up mixing water into the latex based paint to thin it down to the consistency of milk. This proved to spray very nicely and evenly. I experimented on one of the grills and voila! perfect. The paint coated the grill without clogging any of the holes.

I then spent the next hour spraying a thin layer of paint on all of my grills, trying to be as even as possible in the coverage (did one pass horizontally and one pass vertically). I did use a bit too much paint in spots, which resulted in clogged pours. This was easily remedied by wiping the excess paint from the back of the grills, then using my compressed air can to blow out the clogged holes.

I let all of the grills dry for an hour or so, then sprayed a second coat on, repeating exactly as I did with the first pass. After letting them dry for about an hour, the results were outstanding!!!
I reinstalled the grills and they look like they came from the factory painted to match my walls. Of course due to the nature of a grill cover, they appear a bit darker than the wall, but now they are MUCH less visible and no longer attract any attention when you enter the room.

Here is a picture:

Smile!

Got some new (temporary) teeth yesterday... it went like this...

Step 1: Get the teeth filed down (YIKES!)



Step 2: Add metal post to tooth nub



Step 3: Add 4 piece bridge



While it obviously looks better than having missing teeth, it's still not as good as it once was :(
Fortunately, these are plastic teeth and we'll work to make them look more natural before making the final teeth.

Here's what they used to look like:


The two teeth next to the front teeth used to be smaller and my front teeth where more rounded. Hopefully, we'll get them looking like that again!

Grievances

How crazy is it when an insurance company has 4 levels of grievances? It works like this - file your grievance, watch it get rejected. File a 2nd grievance. Watch it get rejected. Rinse and repeat. I'm on my second grievance attempt now. i've got 3 doctors notes all saying that my condition is medical. I've written another detailed letter to BCBS. Now, the insurance broker who works for my company will also follow up with BCBS. Maybe this will have some impact?

I don't know.

What I do know is that the process is obviously setup to discourage people from taking action. Put up enough barriers and most people will just say "screw it" and give up. Is this how insurance is supposed to work?

Time to Research

I used the time I had to start researching my options. I sent an e-mail out to the USCF-NE list to see what folks would say there. I got lots of good advice, offers from dentists around the area to check me out, but ultimately, nobody had the silver bullet.

I started talking to the dentists to see what they recommended. I made evaluation appointments at a few places and went in to get checked out. As a low cost alternative, I went to Tufts Dental School to get an evaluation, but ultimately did not feel comfortable there. Penny wise & pound foolish.

A good friend of mine's wife (Kathi) used to work for the "denying" side of the insurance industry. She gave me lots of great advice, plus a good dental contact. I went to see the folks over at the Dentist's Collaborative (http://www.superdental.com) and boy was I impressed. I got an extremely thorough exam, no jumping to conclusions on treatment until a complete evaluation by 3 separate specialists was completed. I knew I had found the place to do my work.

Now it was just going to be a question of how to PAY for all the work. My initial grievance with Blue Cross Blue Shield was denied (sorry, you're not covered). I was pretty angry by this point with BCBS - but Kathi had warned me nothing would come easy. Here I was, with full medical and dental coverage, plus race insurance and I was looking at $14k out of pocket. HOW COULD THIS BE!

I got a phone call from BCBS around this time - a customer satisfaction type of call. I was so pissed. "How's everything going?" SCREW YOU. I let 'em have it, told them they should be ashamed of themselves, blah blah blah. The insurance industry is so bad. They are fine for small stuff, but boy, when you need 'em for something big, poof - they hide behind their contracts and fine print. Complete BS. Start jumping through hoops and be persistent...

Insurance Companies Are More Dangerous

I was healing quickly and back at the office within a week. All along I had assumed I only had to focus on getting better, not the money for my treatment. I called Blue Cross to confirm my assumption. My conversation went something like:

me: "Will my dental work be covered"

them: "Yes, under your dental plan"

me: "But my dental plan has a $1000 max"

them: "Yes, that's where it's covered"

me: "But it's $10,000 worth of dental work"

them: "It's covered under your dental plan"

me: "No it's not, you're only give me $1k on $10k worth of work"

them: "That's due to your plan"

Turns out, no dental plan in the country offers more than $2000 per year, so, there was no way my dental reconstruction was going to be covered under ANY dental plan. So, I call back.

me: "My accident should be covered under my medical insurance"

them: "No, it's dental"

lots of arguing back and forth.

me: "Do you think I need my teeth medically?"

them: "They are dental"

me: "What if I didn't have dental insurance at all? What if I only had medical?"

them: "But you do have dental"

me: "Do you think my teeth are medically necessary?"

them: "..."

me: "I need them for eating, breathing, talking, quality of life, right?"

them: "Yes"

me: "So they are medically necessary?"

them: "Yes, and they are covered under your dental plan"

Ahhhhhh! So, I wrote up a grievance and talked to my dentist about how to go about getting medical coverage. He said, "good luck." He was totally not interested in helping me fight the insurance company. Damn.

I realized then that I was in for a fight, and that I needed as much information as possible. The good thing was, I had plenty of time to start my research. With a broken jaw, i couldn't even start to get my teeth fixed.

So, my research started...

Before and After

Just a couple of pics to show the wires on my broken jaw. The "old" me was taken in Dec. 2006... the new me was taken 2 weeks after the accident - still a bit swolen, but most of cuts had healed. FYI - those wires on my teeth were a real PITA!

Before:

After:

Staying at Home is not Dangerous

I was released from the hospital the following day - feeling much better, but looking back on it now, far worse than I thought I felt. I was sent home with some pretty good painkillers, but I tried my best not to take them (I think I took a total of 2).

Fortunately, I had recently started a new job which afforded me some sick time (I was previously consulting for Syrinx Consulting which would have meant no $ for me while I was laying in bed). After 3 days of lying around watching TV, I was dying to get back to work.

I still looked pretty horrific (although, according to some friends, it was an improvement), so when I told my boss I would be coming in to pick up some stuff so I could work from home, he graciously offered to swing by and drop it off for me.

I spent the week at home, healing as fast as possible. By Monday of the following week, I was healthy enough to go into the office, at least part time. It was also around that time that I started thinking about the cost of the accident and how the insurance company would handle the bills. I had (and still have) Blue Cross Blue Shield of Massachusetts coverage for both medical and dental. In addition, I had race coverage provided by the USA Cycling. I was well covered, so surely I would only have to worry about getting better, not the cash for treatment.

Boy, was I wrong...

Bike Racing is Dangerous

One of the things I love doing is riding my bike. I ride a lot and up until Father's Day of this year, race a lot.

I was in a local race in Newton, MA on June 17, 2007 when some sketchy rider in front of me fell and I managed to endo over him and hit the pavement with my face. Hitting the pavement with your face while traveling 32 MPH leads to problems.

I was knocked out, broke my upper jaw, lost 2 teeth completely, cracked another 2, split my face open vertically and basically cut my lips off - oh, and wound up with tons of road rash.

Yuck.

All this to get a little speed work in a week before the Fitchburg Longsjo Stage Race, which I was training very hard for.

Yuck.

I wound up at Beth Israel Hospital in Boston where they performed just about every test on me to make sure nothing was seriously wrong. Fortunately, I did not have a head or neck injury. My wife showed up in the ER before any of the injuries were treated. I could tell I looked pretty bad based on a couple of things: 1. The lack of any reflective surfaces in my vicinity and 2. My wife turning completely pale when she realized the bloody lump on the stretcher was me (she only knew it was me by looking at my wedding ring).

Three hours of plastic surgery and countless stitches (and shots of Lidocaine) later, my face was back together. I had to keep asking for an Oral Surgeon to come in to look at my teeth. If I didn't insist, they wouldn't have done anything - oh my.

The Oral Surgeon came in and shot my mouth up with some more Lidocaine (including a VERY unpleasant shot into the roof of my mouth) and proceeded to wire my upper jaw with an Arch Bar. She managed to save a tooth that had come most of the way out, but unfortunately, one tooth was completely missing and nowhere to be found.

Once the work had been completed, I was wheeled to a room, so I could spend the night. I wasn't able to sleep much that night, but by the morning I was feeling much better. I even took a picture of myself using my cell phone:


Isn't that pretty? Take it from me... it wasn't fun.

Upgraded to XP Pro

I spent this weekend upgrading my new Thinkpad T60p laptop to Windows XP SP2. At least that's how it felt.

When I started my new job at CoreStreet, I insisted on building a machine that could fully handle the full weight of Vista. We're talking about a laptop equipped with a Dual Core 2.33 Ghz 3GB RAM 100 GB hard drive and 512 MB ATI Fire GL graphics adapter. If there's a laptop out there that's Vista ready, this is it.

Let me start by saying, that I am a Microsoft developer to the core. I've been developing solutions using Microsoft tools since 1990. I am currently a MCT and a MCSD .NET. I drank the Kool-Aid a long long time ago. So, when a good friend of mine at Microsoft told me he got nearly the identical laptop, and that HE was running Vista and it was "awesome," I just had to have it. I had read a lot about Vista and seen plenty of demos. I primarily use my Operating System as a launching point for my Virtual Machines. I don't put the full stress of development on the base OS - that happens on my development images - typically Windows 2003 Server. I use VMWare Workstation 6.0 for my virtual tasks - due to Microsoft's lack of USB support in Virtual PC. I figured the people having problems with Vista, were the same people that try to run every new piece of software on the market and fill their system tray with tons and tons of utilities - that's a recipe for disaster and one that I don't follow.

When I arrived at CoreStreet, our IT manager handed me the laptop, kind of chuckled and said - well, it's already bluescreened 2 times on me. Heh... umm... not good, but who knows what he was doing. I was anxious to get started with Vista, booted it up and waited. And waited. And waited. Wow. Brand new laptop and the boot time was much longer than my 3 year old desktop running XP. Now, I can't blame all of the boot time on Vista. IBM certainly is to blame as well. They put every piece of management software known to man on the machine. How annoying.

Speaking of annoying - the user account control feature of Vista has got to be one of the most annoying "features" ever. I quickly googled how to shut it off, and within a few minutes, it was gone.

As annoying as all the IBM pre-installed junkware was, it wasn't a showstopper. I could live with it. I then proceeded to install the few bits of software that I needed - VMWare Workstation and the Cisco VPN client. Uh oh... strike one. The company only owned version 5.5 of VMWare Workstation. Not Vista compatible. A trip to VMWare's website informed me that version 6 had just been released and it was compatible with Vista. Time to pull out the old credit card. No big deal, installed the new version of VMWare Workstation, upgraded my virtual machines and I was up and running.

Next step, the Cisco VPN. Again, same deal. New version of the VPN client was available, compatible with Vista. Installed. No luck. Ugh. Since I was new at the company, I really didn't need the VPN immediately, so I left it to our IT guy to look into the problem.

I also had problems with two other pieces of software that really need to reside on the host OS - Easy Media Creator and TheaterTek DVD.

I managed to get up and running fairly quickly. I could read docs and e-mail, which is all that mattered on my first day. That night, I brought the laptop home and connected to my home wireless network. Cool, seemed to work OK. After about 10 minutes, the wireless network disconnected. Within 10 seconds it reconnected. Hmm... no big deal, probably just some interference. Ten minutes later, same thing. Ugh. All night I dealt with it going offline/online.

I began my hunt for updated drivers and found that the laptop was completely out of date with its drivers. Funny, here was a brand new laptop and there were new versions of pretty much every driver. I began the process of downloading every new driver and methodically updating all my drivers and testing after each update.

Once I had the drivers updated, things seemed to get better. I believe the new power management driver along with the new wireless driver fixed my problem. I was then able to connect to the wireless network without interruption, well, almost. Occasionally, my wireless connection would drop out and the only way to reconnect would be to disable and re-enable the wireless adapter.

My big shock with Vista came the next day when I went to copy a fairly large file from a server on the company network. It was a 4 GB file. Should have taken a few minutes. Vista took forever to get going with the file and then calculated that it would take over 2 hours! WHAT??? Surely, this must be a bug? I did some googling around and found some fixes to make the copies start faster, but the actual network copies NEVER got better. I tried the same file on a Windows XP virtual machine running under VMWare - under 10 minutes.

I could go on with my Vista experience, but it doesn't get any better. Blue screens when docking/undocking; extremely slow standby/wakeup; flashing video when docked; incompatible devices; constant hunting for new drivers (often beta). You get the picture. All this for an OS with a really cool looking interface. umm. ok, great. But, could I run anything new? Could I run anything that I couldn't run under XP? Since I'm not a PC gamer, DirectX 10 didn't matter at all, so the answer was, no.

All these hassles were for more glitz and Windows Sidebar. Wow. So, after 3 months of living (suffering) with Vista, I gave up. I tried. I really tried to like Vista. In the end it feels like Windows ME all over again. I formatted my drive, installed XP and now my machine is fast, stable and runs everything I need.

Take it from me, if you are a business user and need to be productive with your computer, stick with XP.