Ms. Auth: "Major Illness Insurance."
Dr. Grumpy: "This is Dr. Grumpy. I'm calling to get a medication authorized on a patient."
Ms. Auth: "Okay, what is their 10 digit ID number"
Dr. Grumpy: "It's... The only number on her card is 7-digits, 8675309."
Ms. Auth: "No, I need the 10 digit one"
Dr. Grumpy: "There isn't another number on here."
Ms. Auth: "Well, I can only work with the 10 digit one."
Dr. Grumpy: "What about her name and birthday? Or Social Security number?"
Ms. Auth: "We don't use those. The only thing I can work with is her 10 digit number."
Dr. Grumpy: "How do I get that?"
Ms. Auth: "Call back and press option 5. Then enter her 10 digit number in order to get it."
Dr. Grumpy: "But I don't have the 10 digit number!"
Ms. Auth: "Then we can't help you, can we? Have a nice day."
How did you keep yourself from saying, "BITE ME" to Jenny!
ReplyDeleteYou should have just said "0001234567"
ReplyDeleteThank God those awful government bureaucrats aren't allowed near our health care!
ReplyDelete"Ibee's not here."
ReplyDeleteW.T.F!!!
ReplyDeleteadd zeros to the front..
ReplyDeleteAnd once you finally get the 10 digit number and give it to Ms. Auth, you'll still be required to give the patient's full name, date of birth, address, SSN, employer, astrological sign, favorite Spice Girl, et. al. and THEN they'll finally be able to "pull them up" in the system.
ReplyDeleteSounds about right for an insurance company. Always ready to take your money, premiums, but never want to pay claims
ReplyDeleteBut what if you're already at ten digits and you need that extra bit of authorization?
ReplyDeleteWork bought me a nice new tablet, which comes with a data plan. Like a smartphone, you can use it to do Intertubes stuff when there's no WiFi, using the cellphone wireless.
ReplyDeleteI went to set up the cellphone account on the tablet. Vendor's app said, "OK, to confirm this is you, we'll send you a text message."
After 10 minutes I found that for the tablet to receive text messages I have to use a specific app -- which comes pre-installed! Yay!
I fire up the app and it says, "ok, now we must register you for the app. To do this, we've sent you a text message."
tl;drTerry Gilliam had it right.
I have been trying to fax a prior auth request for therapy to Big Bozo Insurance for a set of twins. Twin A's form was received and the processing process began right away. (Processing evidently takes 3 weeks but that's a whole 'nother post!) Twin B's form was "not received" according to the Big Bozo rep. He stated that they may have just thrown it away because the name looked similar to Twin A. Or...and this is my favorite...if there is some sort of error on the form (ie dates written in non-approved format, font size not to their liking, too many spaces between state and zip code, etc) they simply throw away the form and pretend they never got it. So when you call to confirm receipt of the request, they look in their computer and say they never got it. Then when you fax the form in again, they find the same "error" and throw it away again. I am on fax number 3 for twin B. One of the reps I talked to said he would call me when he received it and would let me know if there was something wrong with it (instead of just throwing it away). He never called and my follow up voicemail to him went unanswered. I suspect they fired him.
ReplyDeleteThey probably promoted him.
DeleteWhen I was working in psyche, as an RN, we had to call the insurance companies of each client, to get approval for their continued stay. Their condition had to warrant it, and we had to give details of their condition, to get the all important approval, so the client could get treatment.
ReplyDeleteIt just used to tick me off so badly, to have to explain to some agent who didn't have a clue, that someone was still at risk, on the basis of their behaviors.
One day, in complete disgust, I said to one of them asking for more information, or something " I don't know,they don't teach insurance 101 in nursing school!"
"I suspect they fired him."
ReplyDeleteNo, they promoted him.
I remember when my son was born premature
ReplyDeleteHe spent time in the NICU. The insurance company denied the bill from the neonatologist twice because "We don't cover well-baby care"
Well that is fine and all, but you paid the NICU bill. Babies in the NICU are not "well-babies" by definition
The Doctor's office apparently was used to this treatment from insurance companies. They were able to get it straightened quickly.
This was over 20 years ago, I am sure the problems have gotten worse.
I firmly believe that there is someone at every insurance carrier whose sole job is to figure out how *not* to pay for things.
ReplyDeleteOk, the pt name is Jenny, and you must be Cpt. John Yossarian.
ReplyDeleteSo, what else in new? Did you ever find the 10-digit magic number (An 8-ball might help )?
How awful.
ReplyDeleteFor several years we had about half my daughter's claims denied if we filed using her first name instead of her middle name.
ReplyDeleteIt turned out that when we registered her with Tricare (they lost her October 1st 9 months after she was born) they hadn't really lost her, they'd just lost the first name on the original registration. So apparently for several years they thought I had twins (with the same social?), one a little girl and the other a little boy named Elisabeth.
At least once we figured out the problem they were able to merge her files.
When we had her tonsils out they refused to pay the hospital as it didn't have an authorization number.
Me: Why won't you pay the hospital?
Ins: They weren't pre-approved.
Me: But you paid the surgeon?
Ins: Yes
Me: And the preapproval for the surgeon is the same one as for the surgical facility?
Ins: Yes.
Me: So why is the surgeon preapproved but not the facility?
Ins: Because he has an authorization number.
Me: Wouldn't that same number cover both the hospital and the surgeon?
Ins: Yes.
Me: So why haven't you paid them?
Ins: Because they don't have an authorization number.
I gave up at that point.