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or why medical personnel are testy.

8 November 2002

The next time you put in a call to a medical office and the person on the other end of the line is a little less than cheery, try to be compassionate. This is what I did today.

Dr. G has ordered a sleep study for a patient who is having terrible insomnia.

The sleep clinic will only take her if I get preauthorization from her insurance company.

So I look at her insurance card.

My options are:

- hospital precertification (this is not a hospital study)
- verify eligibility and benefits
- prescription drug verification
- mental health precertification

This does not come under any of those categories, but I figure that since it's affecting her mental health, I should start there. So I call.

The person who answers has never heard of a sleep study. She asked if this is a mental health procedure. I tell her I'm not sure, but mental health seemed to be a good place to call. She asks for the patient's ID number. I give it. She tells me she has no bills outstanding for that ID number.

I tell her that I'm not calling about a bill, I'm calling for PRE authorization. She tells me she can't help me and asks me to call the insurance company. I tell her that number is not on the card.

She gives me another number to call. I wait on hold. The next number tells me I've called the wrong department and they can't help me either, so she gives me a third number to call.

The third number has also never heard of a sleep study but can help me with surgical pre-authorization. I explain that this has nothing to do with surgery.

She tells me that in order to get this preauthorization I need to call another number. I check and it's the same number I called the first time.

So here I sit with a patient who can't sleep, a doctor who wants a sleep study, an insurance company that has never heard of a sleep study and can only authorize it after it has taken place (apparently), and a doctor's office who won't see the patient until they know that the insurance company has authorized it.

Add to that the frustration of trying to do anything or get hold of anybody on the phone these days. Is "customer service" something about which our grandchildren will have absolutely no concept? I also tried to get an IUD for a patient who was coming in. I started this about 3 weeks before. I did what I was supposed to do--I called our OrthoMcNeil rep and, since of course you can never get a real person on the first--or tenth--try, I left a message. When the patient showed up the first time, we had no IUD. I called the rep back again. This time his message said that he no longer worked for OrthoMcNeil and left a number to call. I called that number, and after going through voice mail hell, got to a spot where I was put on terminal hold. Then after about 10 minutes of elevator music, the person (I refuse to call it a "rep") told me I had the wrong number and that there was a special line for ordering IUDs.

Back to voice mail hell and terminal hold and finally a grumpy person who wanted absolutely nothing to do with helping me. I tried to explain that we needed this in timely fashion, and she said that until we filled out an application form for an account, we couldn't order anything and that she'd send me a form. I explained that if she sent me the form there would be NO WAY we could get an IUD by Thursday. I asked if she could fax it. She kvetched, but made the grand concession and agreed to fax it.

Did she?

Of course not.

Which meant that the papers didn't arrive until three days before the patient's appointment, when I had to go through voice mail hell again (only this time at least I started with the IUD number). This time I got a person who faxed me the forms, but they had to be signed by Dr. G personally, and he was not in the office that day (he works at a hospital on weekends), he couldn't sign until the next day. What were the odds of getting this IUD in time? Not a snowball's chance in hell.

Try to call Health Net and before you can even get into voice mail hell, you have to listen to a 3 minute spiel about how it's much better if you use their internet site. Even if you know the bypass code for actually getting to elevator music, you can't use it until the "commercial" has finished.

Today we received a note from the lab that a specimen we sent in for analysis had a problem and we needed to contact their office within 3 working days to let them know what we wanted them to do. I couldn't (of course) get anything but an answering machine asking me to leave my name, phone number, the patient's name, and the pertinent information. I left a message saying they had wanted me to call, and to please return the call.

Did they?

Of course not.

I also had to call a pharmacy and the phone rang a good 10 minutes before I had to hang up and go help with a patient exam. That place didn't even have an answering machine or voice mail hell. Just ringing and ringing and ringing.

This is, unfortunately, a VERY typical day in a doctor's office. If there is any consolation at all, it's that I got a raise this afternoon. It doesn't make the frustrations any less, but I didn't seem to mind as much.

Quote of the Day

Never doubt that a small group of thoughtful, committed citizens can change the world: indeed, it's the only thing that ever has.

-- Margaret Mead, Anthropologist

Photo of the Day

TheBirds.JPG (36109 bytes)

At dusk, the skies near my office are filled with literally hundreds of birds getting ready to settle down in the nearby trees for the night.  Kinda makes you want to look around for Alfred Hitchcock!


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