Here is an update (very late in coming) on the status of Dick, whose child’s operation was postponed by his insurance company (State employee plan of Delaware through Blue Cross/ Blue Shield) at or about 4:00 the day before his 8:00 operation.
The next morning it was determined that the insurance company did not receive a critical piece of paper from the Doctor. Yet the physician’s office claimed the paper had been sent weeks prior. The paper was re-retrieved by the office staff, and re-resent, and the operation went though at 3:00 causing family members to call off work for the evening.
How could that happen, just one business hour before the operation? Sinister motives?
Perhaps not. Here is the business day of one person who works in the medical insurance field.
“At 9:35 am a fax comes into my office (I work in the medical insurance field), from Hanover Hospital stating the physician had approved this specific procedure to be done. But at the top of the fax had jammed and the information of contacting had all run together. I had no idea of who the patient was, who the physician was, or which employee or private plan this incident concerned. Now we are a big insurance company with multiple offices, multiple floors in each office, and multiple cubicles on each floor. I have no idea where this approval is supposed to go.”
“My only option is to call the hospital, and see if they can find out who sent the fax, and from there find out which patient’s account the fax is for. So I spent most of my day tracing down this account and by 2:35, was finally able to route this information to the person responsible for that account. It was important; I felt I had to do it, even though it put my own accounts behind…”
“But I see how such a situation could happen.”
In such a scenario, both parties could be right. The Doctors office: “We sent the information weeks ago”; ….. Blue Cross/ Blue Shield: “We never received the required authorization from this persons physician“.
I’m thankful for this insight. Quick to bash the insurance company I was. Perhaps, maybe, perhaps not? Questions that could be solved by a national data pool that electronically handles all medical issues. Privacy could be jeopardized, but lives would not.
We can handle privacy issues by making the penalties for violating patient trust (such as an insurer telling a corporate entity about upcoming health issues of a certain employee), so severe, that the corporate entity would back off first, saying “don’t tell me… I don’t want to know”. Headlines like “State of Delaware Lawmaker Tony DeLuca Loses 65 million Lawsuit on Violating Insuree’s Privacy” would insure our privacy remains intact.
That is how you handle privacy issues.
And Dick extends his thanks to all who responded with support, caring, and offers of assistance. (All of which because of my slow response time, came long after the medical crises was averted.)

6 comments
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July 14, 2009 at 9:47 pm
Steve Newton
The important point about this post is that most of the people working in similar positions in the health insurance industry are not evil, and would prefer to do the right thing when possible (I exempt medical reviewers from this claim).
During the past eighteen years while on the same health insurance plan as Dick, I have had to get approval for (between various family members) no fewer than nine different surgeries, multiple physical therapies, and lots of other items. At times I have developed fairly long-running telephonic relationships with different customer service reps and mid-level administrators. From that experience I have learned that
(A) Doctor’s offices misstate the truth about what they have sent and in what format it was sent and when it was sent just as often as the insurance companies do. I’ve got definitive proof, because I’ve had insurance folks make me copies of faxes in which the doctors’ office had sent documents on different days than they told me, or failed to check boxes like “recommend approval” or simply failed to attach the one or two page clinical summary that would get approval.
(B) Lower level customer service reps (about 85% of the time) are not allowed to volunteer information, but have to answer truthfully if asked specific questions. What I’ve noted is that if you listen carefully they will often “tickle” you with enough information to know what question to ask, but subtly enough that the supervisor listening to the recording either does not catch it or has deniablity.
(C) Medical reviewers can be intimidated, especially if you know the disparity between their credentials and those of your own physician. That’s why you should always know your own doc’s resume, and then directly ask the medical reviewer, “Is cardiology your professional speciality?” [If he lies to you, you own the company, and if you are smart enough to get his full name you can check.] If he says, “No, but I have lots of experience and a company policy to guide me,” I have asked point-blank, “But are you willing to go on record in disagreement with considered recommendation of a cardiac surgeon with 22 years experience, trained at the Mayo Clinic, and the recipient of a 2.4 million dollar Federal research grant in bypass follow-up care?” At this point you will usually win the argument, so long as you have ascertained that he actually has decision-making powers. Why? Because you are the 1/10 of 1 percent who knows how to play the game, and it is not worth the risk to him personally not to approve spending the company’s money to keep some litigious SOB (me) from dragging him personally into court [which you can do].
My point? Truly, a broken system in many ways, but still navigable and if you do your own homework you can accomplish amazing things.
July 14, 2009 at 10:41 pm
kavips
Exactly.
July 15, 2009 at 5:02 am
Mark H
Still surprised that this stuff is still sent via fax. My primary care physician now emails everything. If I’m not mistaken, at least some of the Stimulus money was going to upgrade medical systems. My regular Dr, my cardiologist, and my orthopedist (I’m an old man with multiple issues) now have electronic records.
July 16, 2009 at 12:50 am
kavips
I know it sounds odd Mark, but apparently not all Dr’s offices are on broadband.
That little wire going into the phone jack, slows things down quite a bit…..
July 16, 2009 at 8:38 am
Steve Newton
K
It’s not necessarily that: most records are still on paper and the time it takes tech-illiterate and generally overworked people to scan them for electronic transmission is far longer than the time necessary to feed them into a fax machine.
July 17, 2009 at 8:09 am
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