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| Why are you getting so worked up? |
My office staff did an intervention on me the other day.
It all exploded when a clerk on the other end of the phone asked me for my NPI number, which, of course, I have never memorized. They could hear me shouting at this woman down the hall and they came down, three of them, to tell me the patients in the waiting room could hear me and it was disturbing everyone and they were never going to get me a caffeinated Cappacino at Dunkin Donuts again because they were sure it was the caffeine which had set me off.
It wasn't the caffeine.
It started with a "prior authorization" which is permission the insurance company gives you to order a test or a drug for a patient which is not automatically approved. For some things, you have to speak with some 18 year old clerk in Oklahoma City who is sitting in front of his computer with two buttons to push, "No" or "Yes."
This time, my assistant had run interference and she had been given the telephone number of an actual, bone fide physician at the insurance company who would discuss with me the reasons for this test. I expected this to be very short conversation, since the test was a no brainer: If the test proved negative, the patient would not have to undergo surgery, thus saving the insurance company a bundle; if it was positive, the surgeon could plan for a more extensive surgery than if he did not know it was positive, in which case he would have to go in once to make the diagnosis and return a second time, with a second general anesthesia for the patient, for the definitive procedure.
I had set aside 15 minutes for this phone call, between patients.
I dialed the number and got a phone tree: First you listen to a list of possible reasons the insurance company says you might have called. Press one if you want to do this in English. Then, if you are a patient calling about an emergency, hang up and dial 911. Then, if you are a patient, press 1 if this is about a bill you have received; press 2 if this is about a bill you expect to receive; press 3 if this is about a bill which you have lost; press 4 if you live in Massachusetts; press 5 if you are not an American citizen; press 6 if you want to kill the governor. And so on.
Fortunately, I had the option of pressing a number on my dial or speaking, so I just kept saying "Representative" and eventually the automatic voice said, "Did you say 'representative'?"
Five minutes deep into this I finally got a human being who asks me why I am bothering her and taxing the insurance's company's budget by insisting on speaking with a human being. I explain I have been given the name of a doctor, Dr. Whosit, and this number, and I am a physician calling about getting a "prior auth."
"Oh, that's a peer-to-peer."
"Whatever you want to call it. I want to speak with the doctor."
"I'll need your NPI number."
"Why?"
"Because I cannot forward your call without your NPI number."
"But why? You know who I am because you gave me this number and I know the name of the doctor I'm supposed to talk to and I can give you my address and office number and you can call me back there if you want to verify. What gives you the right to ask for my NPI number?"
"You don't know your NPI number do you doctor?"
"No. But that's not the point. The point is you could ask for my DEA number or my social security number or my password, and none of it is necessary and I draw the line at these stupid rules which do not protect anyone."
It went on like that for a while, which is when my office staff came in, three women and did the intervention.
"You have to be nicer," they told me.
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| Press 4 if you want to stomp the phone |
But I was like the bull in the arena. You know, they open the door and the bull runs out to face the bull fighter, but some bulls are not inclined to fight, so they have these banderillos guys who run up and stick metal tipped sticks called banderillas into the bull. Then there's a guy on a horse, I think he's the picador, who rides up and sticks the bull with a lance. So there is a long build up, during which they harass the bull and taunt the bull until he's so mad that when the guy with the red cape steps into the ring, the bull charges.
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| Bad Temper from Bad Treatment |
Spare me that.
Phantom,
ReplyDeleteHow interesting-all these years I'd assumed physicians pressed #1 and immediately spoke with a live body and had their issues addressed quickly--A VIP line for the doctors, like pressing the "EASY" button..Now I see the insurance companies are equal opportunity time wasters. I can empathize with your losing your temper-they drive you to it..Driving callers over the edge is part of the insurance company training and in their employee job descriptions..Your level of caffeine consumption for the day is immaterial-they will continue to poke with their inane requests and questions-their banderillas- until you snap..it's their job...
Maud
Maud,
ReplyDeleteOh, I hadn't looked at it that way. It's their job. Well, that explains it. I should have known. It's a corollary to the principle I have to explain to my patients: The insurance companies do not care about your health. Their mission is to generate profit for shareholders. I know you've seen the TV commercials which say they care about you, but they do not. They believe it's more profitable to deny today and let someone else pay the cost of that denial a year or two, when, hopefully, you'll be covered by some other insurance company.
The only exception to this is Medicare. They are stuck with you for life.
Phantom