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American healthcare...be afraid (sorta long)

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  • American healthcare...be afraid (sorta long)

    I don't have to deal with the usual sorts of customers that most of you do, but as mentioned earlier, I have done my time in retail, and the customers that I deal with, being human, can be every bit as daffy/rude/??? as the retail or food service sort.

    I work in medical billing for a clinical laboratory. I must obtain information from clients (doctors' offices, hospitals, etc.) for the purposes of billing the patients' insurance that in most cases, the clients should have supplied us with at the time the tests were ordered. Most of the time, my job chugs along fairly smoothly. But I regularly run into people that, were I a patient at that clinic, I would be feeling very afraid about my health information being in their hands.

    1) "We don't have time for that." I run into this one pretty often, and although I deal with about 300 different clients on a regular basis, I'm pretty good about remembering who gives over with the info and who's a pain in the butt about it. I make notes about those clients. I make sure to call them at off-peak times or even fax them the requests if they get snitty with me. Therefore, it's always a nasty surprise when I get my head chewed off through the phone because they're too busy to even take a message and get back with me.

    2) "I can't give you that information." I am very, very aware of HIPAA policy. I am requesting this information because the company for which I work is not in the habit of doing free labwork. You like to get paid, don't you? I promise I am not going to go out and start signing up for credit cards with patients' Social Security numbers and birth dates. I have a very good reason for asking for this info.


    3) "You want what?" I first ran into the concept of ICD-9 (International Classification of Diseases) coding nearly 20 years ago, when I worked for a doctor's office. It has apparently taken the rest of the medical world a while to catch up. I have spoken to an actual RN before who kept telling me, "I'm an RN. I don't know what those are." She was telling me in the spirit of "I'm too busy to be bothered with this trivial spittle," but I was astounded that she had no idea what I was talking about.

    4) "Yes, I pulled this government-mandated form out of my nether regions just to bother you because I have nothing better to do with my time." Medicare regulations are strict. Very strict. Healthcare providers are required to tell Medicare patients EACH time certain tests are performed that Medicare may not pay for those tests (based on diagnoses, frequency of tests performed, etc.) There is a mandatory form that MUST be signed by the patient, acknowledging that she or he has been told that. We are actually saving the clients unwanted scrutiny from Medicare by performing the courtesy of calling them about these tests and are there any added diagnoses (did you really give Mr. Jones a prostate specific antigen test with just a diagnosis of diabetes? Are you sure you want to give Mrs. Smith a prostate test?) Yet you wouldn't believe how many clients I run across who think this is something we made up just to be whimsical.

    5) Crystal Ball Not Included: When you tell us that the patient is to be billed, it would be helpful if you gave us an ADDRESS.

    6) "Oh my goodness. We screwed up. I'm so sorry. Let me get that for you right away." By far the rarest sort of response.

    It doesn't help matters that our salespeople really push the point to clients: "Oh, it's OK, don't worry about including that information, our billing department will take care of it," without adding that the way we will take care of it is by...contacting the client. Salespeople live in their own little world, one in which they get to drive really nice company cars.
    He loves the world...except for all the people.
    --Men at Work

  • #2
    I got some of these when I worked in title insurance, where we worked with lawyers and banks instead of doctors and hospitals.

    Quoth Noelegy View Post
    1) "We don't have time for that."
    Well, I don't have time to chase you down and get this information that I can't proceed without. Maybe if you had some professional pride and took ten seconds to check over your work before sending this binder to me, we wouldn't be having this conversation.

    3) "You want what?" I first ran into the concept of ICD-9 (International Classification of Diseases) coding nearly 20 years ago, when I worked for a doctor's office. It has apparently taken the rest of the medical world a while to catch up. I have spoken to an actual RN before who kept telling me, "I'm an RN. I don't know what those are." She was telling me in the spirit of "I'm too busy to be bothered with this trivial spittle," but I was astounded that she had no idea what I was talking about.
    Mine was more along the lines of: "What do you mean I need an attorney? You're a title company! Why can't you do the work?" Because it's the law. One that can cost you a lot of money if you violate it.

    "Well, I've been in real estate for twenty years and I've never heard of this!" Well, this company has been in business for almost thirty years, and we've never done title work without a title attorney involved. Apparently, you've never done real estate work in North Carolina.
    A smile is just a grimace that's been edited for public consumption. -- Tony Cochran

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    • #3
      The ICD-9 response, I got quite often when I worked (briefly) as a CSR for a Health Insurance company. It was always from a Nurse...or a Doctor. They acted as though I were the moron in the conversation. "A WHAT?? What is that??"


      And yes, I was shocked they didn't know what it was. My sister and my mother are nurses, (sister being an RN, my mother being a FNP) They always got a kick out of the "WTF is an ICD-9"
      Oh, "Blah blah blah 'Your Needs'!"

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