Red Tape? or Stupidity?
Ok.. I don't think I mentioned it before. But I work in the medical field. Today, a patient who said that we have too much red tape yelled at me, stating that patients have to jump through so many loops before they can be seen. Let’s see exactly what my department requires before you can be seen.
1) Referral from a doctor. Look, I understand that you have symptoms this and that, and from your expertise in medicine (from watching countless hours of ER and House) qualifies you to believe that you have so and so. We don’t believe you. Go see a doctor, get a diagnosis and get it in writing.
2) See a local “specialist”. Please understand, we are a specialty clinic. Not just that, we are a very specialized specialty clinic. Which means, if you are diagnosed with something “common,” go and see a common practitioner. If they cannot help you, then you should be referred to us. In this case, Read step 1
3) Clinical notes and lab results. Look, so your doctor tells you that you have so and so. He must have ran a battery of tests, dictated countless notes. Get a copy of all of it (you should have copies of medical notes handy anyways). Keep reading.
4) Listen, we live in a world where it’s ran by the mighty dollar, none of the doctor is willing to see you Pro Bono. So you either have to pay it out of your own pocket, or from the pocket of your insurance company. Now with a PPO or and indemnity plan, it is like you have gotten prior permission from the insurance company for you to use their money. If you have a HMO, you must get permission, AKA an authorization
So, let’s recap. You need to see your Primary Care, who diagnoses you with so and so. Then you should see a specialist in your area. Who will probably run a series of tests on your and write a bunch of clinical notes, obtain all of these. And finally, a method of payment.
5) So we have the referral, the notes, the test results and prove that you can pay.. you need to fax all of that to us. Why fax? Because it is the lesser of two evils. If you fax something to us, you would still have a copy, and when it gets lost, (stay tune for my rant on faxes), you can fax it to us again. When you mail something, chances are you won’t make a photocopy of it. And when it gets to our medical center, which composes of like 30 buildings in like 5 different locations, guess what. It gets lost. So just fax it to us..
6) Now.. when you get things to be faxed to us. Fax it all in 1 package.. I really don’t need you to fax me your insurance card. While your Primary Care Physician faxes me your referral. Your specialist faxes your clinical notes. The lab faxes your test results. While this makes it easier on you. Please remember, I get around 50 referrals a day. On top of that, we get refill request, personal faxes, additional clinical notes for established patients, and Spam faxes (No. I don’t want to buy penny stocks or go to Cancun for 99 bucks). We use like 4 reams of paper daily on that fax machine. Multiple pieces of faxes will get lost, I can guarantee it.
7) After I receive all the information, process it, the appropriate doctor reviews it, either approve it or deny the request (Don’t ask my why they are denying it. I have no idea. *In a William Hung Voice* I have no profession medical training) and then an appointment can be made or you can seek help elsewhere.
Average day for a patient who sends everything I need in to be approved (or deny), 4 days, 3 of which is sitting around, waiting for a physician to review.
Average day for a patient who doesn’t send everything I need, like MONTHS. (I just received insurance information for a patient, who’s record was send to us on April… 2004!)
It is really very simple. Learn the rules, follow the rule.
BTW.. include a number we can reach you at or leave confidental information on. There is this thing call HIPAA (Health Insurance Portability and Accountability Act of 1996) which we have to follow. if we can't reach you or know that your message service is secure.. we can't leave you an message to call us to schedule an appointment.. all your work (and my work) goes down the drain
Next up.. FUCKIN FAX MACHINES!
1) Referral from a doctor. Look, I understand that you have symptoms this and that, and from your expertise in medicine (from watching countless hours of ER and House) qualifies you to believe that you have so and so. We don’t believe you. Go see a doctor, get a diagnosis and get it in writing.
2) See a local “specialist”. Please understand, we are a specialty clinic. Not just that, we are a very specialized specialty clinic. Which means, if you are diagnosed with something “common,” go and see a common practitioner. If they cannot help you, then you should be referred to us. In this case, Read step 1
3) Clinical notes and lab results. Look, so your doctor tells you that you have so and so. He must have ran a battery of tests, dictated countless notes. Get a copy of all of it (you should have copies of medical notes handy anyways). Keep reading.
4) Listen, we live in a world where it’s ran by the mighty dollar, none of the doctor is willing to see you Pro Bono. So you either have to pay it out of your own pocket, or from the pocket of your insurance company. Now with a PPO or and indemnity plan, it is like you have gotten prior permission from the insurance company for you to use their money. If you have a HMO, you must get permission, AKA an authorization
So, let’s recap. You need to see your Primary Care, who diagnoses you with so and so. Then you should see a specialist in your area. Who will probably run a series of tests on your and write a bunch of clinical notes, obtain all of these. And finally, a method of payment.
5) So we have the referral, the notes, the test results and prove that you can pay.. you need to fax all of that to us. Why fax? Because it is the lesser of two evils. If you fax something to us, you would still have a copy, and when it gets lost, (stay tune for my rant on faxes), you can fax it to us again. When you mail something, chances are you won’t make a photocopy of it. And when it gets to our medical center, which composes of like 30 buildings in like 5 different locations, guess what. It gets lost. So just fax it to us..
6) Now.. when you get things to be faxed to us. Fax it all in 1 package.. I really don’t need you to fax me your insurance card. While your Primary Care Physician faxes me your referral. Your specialist faxes your clinical notes. The lab faxes your test results. While this makes it easier on you. Please remember, I get around 50 referrals a day. On top of that, we get refill request, personal faxes, additional clinical notes for established patients, and Spam faxes (No. I don’t want to buy penny stocks or go to Cancun for 99 bucks). We use like 4 reams of paper daily on that fax machine. Multiple pieces of faxes will get lost, I can guarantee it.
7) After I receive all the information, process it, the appropriate doctor reviews it, either approve it or deny the request (Don’t ask my why they are denying it. I have no idea. *In a William Hung Voice* I have no profession medical training) and then an appointment can be made or you can seek help elsewhere.
Average day for a patient who sends everything I need in to be approved (or deny), 4 days, 3 of which is sitting around, waiting for a physician to review.
Average day for a patient who doesn’t send everything I need, like MONTHS. (I just received insurance information for a patient, who’s record was send to us on April… 2004!)
It is really very simple. Learn the rules, follow the rule.
BTW.. include a number we can reach you at or leave confidental information on. There is this thing call HIPAA (Health Insurance Portability and Accountability Act of 1996) which we have to follow. if we can't reach you or know that your message service is secure.. we can't leave you an message to call us to schedule an appointment.. all your work (and my work) goes down the drain
Next up.. FUCKIN FAX MACHINES!
posted by The World Against Me at 9:58 AM
1 Comments:
Don't you just love people who assume that they are your only client, that you have nothing but time because they are your only client, and because they are your only client that they should be the exception to every rule and/or state or federal law?
My shrink told me that I should stop hanging around stupid people because they piss me off so much...I'd be unemployable.
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