Stress at the Office

I want a vacation. I need a vacation.
But EVERYTIME I take a vacation, someone f*cks something up and *I* get blamed for it, even though I wasn't there and I knew nothing about what was going on.

Like today, for example... I get a note the other day, asking me about a patient.
"What happened to (Jane Doe)- She should weigh in! No charge for that, or $10 to see me!"

Today, my boss says, "What happened to (Jane Doe)?"
I say, "Good question. I thought she couldn't come in anymore due to money issues."
She replies, "Did you get the note I gave you? Did you call her?"
I say, "I haven't- I didn't know what I was calling her about, since I thought she wasn't coming in anymore due to not having the money to do so. I thought she was off the program."
My boss then says, "Give me the note. You know what, give me the note so I can give it to Ruth (the office consultant). I can't do this anymore. Ruth should be here either Monday or Tuesday."

HA HA!

So I look through the chart... I find the old superbills... I discover...
The patient was last at the office on my day off, October 3rd. My boss did NOT circle a "follow-up" appointment day for her, so whoever was at the front desk that day did not schedule the patient, not even for a weight check. However, in the chart, the patient had directions to follow-up in 4 weeks. If the patient gains more than 3 pounds since her last visit, she is supposed to come in sooner.

Hmm... is it just me or is this yet ANOTHER inconsistency in scheduling that IS NOT my fault?! Peg noted that the patient was supposed to come in, but didn't notify the staff that we were supposed to schedule her. Happens a lot. It's either that, or Peg tells me to schedule the patient for a 40 min. appointment one week and then the next week says the appointment should only be 20-30 min... and then blames me for scheduling it incorrectly and asks me for the superbills so she can attempt to prove me wrong. (When in reality, she proves herself wrong most of the time).

So now, I need to call this patient and schedule a follow-up visit... after Thanksgiving. LOL! Yeah, I bet she's going to gain at least 3 pounds before now and then! hehe


Another fun time earlier today...
My co-worker's friend called to make an appointment this week. I set him up for today at about 10:20am. He wasn't sure about his benefits so I said I'd check and get back to him. Earlier this week, I called and left him a message, saying that his deductible wasn't met and that he would have to pay for the visit in full... $235. And yes folks, that's with a 20% discount for paying in full at the time of service (cash discount). I had a feeling he wouldn't be coming in, especially not for that price, but ya never know.

Yesterday, at about 2pm, he called to cancel his appointment for today. He was just a few hours shy of his 24 hour requirement, and he's a friend of my co-worker, so I cut him some slack and didn't say anything about the cancellation fee (yet another $65). Not only that, but I don't expect a new patient to pay a cancellation fee. They've never been here before; I don't want to piss them off prematurely. What if he wants to come back, but then changes his mind after being charged $65? I wrote Peg a note and "fudged" the time a little bit... I put 11am on the note. His scheduled appointment time was 10:20. Big deal, 40 minutes.

Well, apparently, 40 minutes *IS* a big deal to Peg. She wanted me to charge him the $65 cancellation fee and then call him to re-schedule. Not only that, but she wanted me to try to get him to come in anyway, even if only for 15 minutes...

"Did you tell him that there's a cancellation fee?"
"No, but it is on his new patient paperwork."
"Well, you need to tell them. You need to enforce our cancellation policy."
"The last time I tried to enforce the cancellation policy with a new patient, I got yelled at and hung up on."
"Well, then, you need to know how to handle patients better then."
Me: (/rolleyes)
"Do you tell new patients how much we charge for an office visit?"
"Not unless they ask- especially insurance patients."
"Well, aren't you supposed to? Isn't it in the new patient dialogue?"
"I don't think so."
"You called him and told him his benefits, right?"
"Yes."
"Ok. So he thinks he's going to be paying $74 for this visit, since that's 30% of our insurance charges. So instead of him paying the $65 cancellation fee, why doesn't he come in and just pay the $74 to get some help- I'll keep it as brief as possible, 15 minutes even. Just enough to get him some advice for what he should do."
"But his deductible isn't met. He would have to pay the full $235."
"He would only have to pay $74."
"No, he would have to pay the full amount you're going to charge his insurance, since his deductible isn't met yet... THEN he has a 30% co-insurance."
"Well, isn't $74 better than $65? I'd rather him get some help for $74 than none at all for $65. Give me a copy of what you tell new patients. I think it needs to be revised. I'll give this to Ruth when she comes in next week."

At this point, I just gave up. It was like talking to a brick wall. She was NOT understanding that the patient's deductible HAD to be met in full before he was responsible for paying 30% of charges. Which means he would have to pay in full at the time of service, for two visits, before he paid his co-insurance. That's a horrible thing to do to a person. Tell them, "Yeah, you only have to pay $74!" and then a month later, when we get the EOB (explanation of benefits), it will say, "Patient is responsible for the full amount," and then we have to send the poor man a bill. That's awful... and poor practice in my opinion.

I just told her that I left the guy a message. My co-worker will back me up on that.
When in reality, I did no such thing... and neither did my co-worker. We both agreed to let this one drop... and we're hoping this doesn't get brought back up again and again and again.

/sigh
But we both know it will.


It's not everyday now, at least... Thank goodness. I'm thankful for my "salary" promotion... but I don't get my raise until "The Gunt" (the biller) is fired! Damnit! I guess I'll have to wait for a raise until next year... BOO!