Wednesday, April 10, 2013

I Don't Have Insurance!

Saturday, 9am. Lady presents with a prescription for generic Ambien. I see on her profile that we haven't filled for her for quite awhile.

"We haven't filled for you for awhile. Do you have new insurance?"

She looks at me, sternly, like I just killed her cat. "I don't have insurance. I have Mayflower."

Mayflower is a state-funded Medicaid program which is separate from our regular Medicaid program. They provide coverage (uh, that's INSURANCE) for psych meds.

I dismiss the comment about her telling me she doesn't have insurance. I just process the claim on the billing information we have on file. It processes for a $3.00 co-pay. A lot of Mayflower claims come back with a $3 co-pay, so I don't think anything is unusual. It's Saturday and my workflow is light, so I tell her it will be "just a few minutes."

She looks at me, sternly, like I just killed another cat. "Just HOW long is a FEW minutes? Ten, Twenty, what?"

When people play this game with me it pisses me off. They want an exact figure, so I give them one.

"3.5 minutes."

She wanders off.

Saturday passes. Sunday passes. What happened in 3.5 minutes that she couldn't make it back?

Monday about 11am she appears at the window. I tell her that her co-pay is $3.00.

She looks at me, sternly, like I just nuked an entire pet compound. "I don't have a co-pay. It's FREE. I have Mayflower! I told you that on Saturday."


So I tell her I ran the claim on what we had on file. Logically, if she didn't have insurance but I have a processed claim, in my mind that would have been what we had on file and I would naturally assume it was Mayflower. I call over the tech to handle it at this point because I don't want to get pissed off and say something rude. 

The tech gets her Mayflower information because it's actually NEW insurance for her and we didn't have on file. Badda bing, a paid claim, and a zero co-pay for the patient. And once again, we have a Medicaid patient that just assumed that we have some sort of miraculous computer than knows her insurance information automatically.

I hand her the prescription. She's looking at me, more sternly than ever this time, like I just killed all the furry little animals in north America. I tell her that now we have her Mayflower INSURANCE on file and that her co-pay for this medication is no cost to her. But she's mad because I processed it on her regular INSURANCE (which she said she didn't have) and that NOW her "insurance knows" she's on psych meds (yeah, Zolpidem, the big psych med). I try to tell her that with the reversed claim on her regular INSURANCE that there will be nothing about that information and not to worry about it. She's unimpressed and then tells me, "I told you it was FREE anyway!"

Well, as my readers know I'm a huge abuser of Medicaid patients, so I went ahead and abused this lady too. I told her the TRUTH! I said, "Just because it was NO cost to you doesn't mean it is FREE. Someone ELSE paid for it... taxpayers!"

Oh, the inhumanity of what I said! For shame! Sorry, Thumper.

3 comments:

Anonymous said...

"Just because it was NO cost to you doesn't mean it is FREE. Someone ELSE paid for it... taxpayers!"

Thanks for having the cojones to point that out to her. Some people just don't get it. There's no such thing as a free meal...SOMEONE is paying for it.

Anonymous said...

Although people on assistance deserve respect, they should know that assistance isn't magic. If they act like it is, they deserve to be called out for it.

Anonymous said...

Plus, it isn't like she gave you the Mayflower information.

Soo....you were supposed to run it through an "insurance" that she hadn't even provided to you, but you are the bad guy?

Seriously, if you want me to bill something/have it paid a certain way, you need to give me the information to do that or it cannot feasibly happen!