It might frighten the patients.
United Healthcare is right now on the top of my sh*t list. This is terrible, because they are currently my insurance company (but if I can help it, not for long). First of all: they pay doctors terribly. There is at least one Medical Assistance payer that pays better than they do. Then, they can't seem to get anything right. I keep getting back EOBs (Explanation of Benefits, to those of you fortunate enough to not know) that claim we have a capitation agreement, meaning the insurer is supposedly paying us a monthly fee to care for their patients instead of paying a fee for service. We do not. So I have to call them, spend at least 10 minutes on the phone waiting for the insane Muzack to just STOP already and have someone pick up the phone.
This morning I got back an EOB with the capitation problem. I called United, punched in the numbers for the patient and our providers, got put on hold for about 10 minutes and finally got "helped" by a representative that claimed he couldn't help me because my patient's policy was held by a different group. I protested, saying that the patient's card had this phone number to call, as well a the EOB. He didn't cave, and gave me another number to call.
I called the number.... on hold for 5 minutes this time. Really bad Muzack, couldn't even tell what genre it was supposed to be ruining. Now I'm told that my patient must have an outdated card; the representative can't even look up my patient. I decide to call back the original United number I have, since I was able to get claim information using the automated system. So, after being on hold for 15 minutes, someone answers, takes all my patient's information and our provider's information and told that I don't have the claims department and get transferred. After being on hold for another 10 minutes, the call is answered by someone with a very strong accent who sounds like she's talking underwater..... but I finally gathered that she was also the wrong department... this after she took all my patient's information as well as our provider's. I have now been on the phone for 30 minutes with no results. This for a charge of $118, which United, if we're lucky, will end up paying $60. Seriously.
OK. I've got someone on here who speaks English and I can actually hear her. I've given her my patient information. She can resolve the issue of the capitation but not why we're not getting paid for the office visit and just the procedure we did. So an initial charge of $118 will probably end up getting paid $30 if we're lucky. People with United HealthCare, your insurance company stinks!
If we had a single-payer system, I would be able to always call the same phone number, enter the same kind of information each time, and get help. I would be able to type the same kinds of numbers on my telephone's keypad. My providers would have one set of ID numbers instead of 15. We would only need to credential with one entity instead of 13 or 14. I would only have to access one website to get claims and benefit information. Robyn and Lindy would only need one access point to make referrals and get benefit information....Medical students could graduate and open their own little offices like ours without having to have an entire team of billing specialists to worry about all this stuff.... Dream on.
Tuesday, October 20, 2009
Wednesday, October 14, 2009
Hahn and Nelson Family Medicine and Pharmacare/Optioncare administered approximately 100 seasonal flu vaccines on Saturday October 10. A number of pneumonia vaccines were administered as well. If you were unable to attend our flu vaccine clinic and you still want a vaccine, Pharmacare has several additional clinics coming up. You should call to make sure the clinic is still scheduled, as the seasonal flu vaccine is in short supply.
Monday, October 12, 2009
Saturday, October 3, 2009
Make some time for yourselves this Monday, ladies. Come to War Memorial Hospital in Berkeley Springs at Noon on Monday, October 5 for a light lunch and find out the latest on breast cancer screening guidelines from Dr. Marilyn Nelson. The lunch and talk are sponsored by the Morgan County Community Educational Outreach Service, the Morgan County Health Department, and the Morgan County War Memorial Hospital. Everyone is welcome!