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.)