Thursday, January 12, 2017

Why the Torture? Why?

It's that time of year again... changes with insurance.

When we get a new patient, we add them in to the computer. We ask for their insurance, and they fork over a card. Or if it is a regular patient, we ask to see the new card. "Nope," we hear, "Same as last year."  

But if the insurance is expired, why can't they say, "my insurance is expired," "I'm in-between insurance," or "this is a cash pay"? Why the pretension that the old information will somehow magically work?

Why do patients feel the need to go ahead and let us spend the time typing it in then let us try to bill it? It costs us money every time we send off an adjudication whether it is a paid claim or not. And it wastes time we could be filling their script or helping other people.

What's worse, a significant number of people will insist that they have coverage even when it comes back as expired or invalid ID or whatever. So we get on the phone, spend countless minutes yelling "PHARMACIST" or "REPRESENTATIVE" to try and get to talk to a live person ONLY to find out that the computer is correct, THEY DON'T HAVE CURRENT COVERAGE.

Why do they do this? Please, explain it to me.


5 comments:

Bob Culp said...

As St. Tommy Lee Jones tells us, "A person is smart. People are stupid."

Anonymous said...

Every. Single. Godforsaken. Year.

You would think that the number of times these idiots switch plans or have cards mailed to them that somehow in some miraculous way they would realize that, 'Hey, maybe I should let all my healthcare providers know that my information has changed?'

Nah, ain't nobody got time fo' dat.

Shoot me now.

The Evil Receptionist said...

They don't just do it to you, they do it to the PCPs, too. Except in that case, they ask to be billed. And then they get mad when they get a bill for the entire visit because the "office girl" didn't "send it right". Because I'm supposed to already know insurance info on EVERYONE....

Anonymous said...

Because they hope their old insurance doesn't know they were fired/quit/lapsed in payment and will just pay out anyway. AKA fraud.

Anonymous said...

My company doesn't give us cards for our prescription plan. This is a nightmare for all of us and all our pharmacists. At least I knew enough to call the company and get all the info the pharmacy would need, but how many people even know it isn't all stored in their pharmacy's computer? Most people are woefully ignorant of anything about health care, and think all their information is available "on the computer" regardless of the fact that the doctor's office, hospital, pharmacy, and insurance companies are all on separate systems that have nothing to do with each other.