Archive for the 'Medical Paperwork' category

Actual Conversation with Hospital Billing

Jun 01 2017 Published by under Medical Paperwork

The other day I got a bill for some of my husband's medical expenses. I went to my banking site to pay, and it was the same odd amount I had paid two weeks before. Figuring it was a duplicate bill, I called the billing office. According to their records, my payment had not been received.

My bank account had proof of payment posted on my account, so I asked about the process to get this fixed. The billing person explained that I had to send a clear image of the front and back of the cancelled check.

I had a PDF including that, along with all the routing information and dates of the electronic transactions. Damn, good digital information can be fun!

Now for the punchline; I could email this, but only within the body of the email. NO ATTACHMENTS.

Yes, the medical center was losing it's stuff* over ransomware about this time and requiring all emails with attachments be quarantined. Apparently the billing department had been told to trust no PDFs from their clientele.

I ended up printing a PDF and faxing it. In May 2017.

Collection agencies have not called yet.

*I'm trying to keep it PG here...

4 responses so far

Service? Try Again

Sep 14 2016 Published by under Medical Paperwork, Pharmaceuticals

I feel your pain.

pillsA lot of my patients have to deal with "mail order" pharmacies for chronic medications. Often insurers require that these "services" be used. They often present challenges for healthcare providers. Now I have a perspective from the other side of things.

My husband has been on chemotherapy since April. His regimen involves an oral drug that he takes at home, with few side effects. It is expensive, and our health insurance makes us use a specific national pharmacy. He is to get a round of treatment next week, so I called yesterday to ship the next refill. The pharmacy said they did not have the prescription. OK, I contacted the doctor's office, and they called it in (even though they had faxed back the refill 2 weeks ago - yes, medicine is keeping the fax machine alive).

This morning, I called to arrange the shipment. The prescription , given verbally, is still being "scanned in." They cannot verify the claim and arrange shipment until that happens.

Never mind that we only use this service because our insurer demands it. Never mind that we have filled this prescription monthly for 5 months. None of that is adequate to allow them to schedule the shipment. I have to call back in 2 hours. They cannot make a note to ship when approved. No, I have to call again during my clinic. I can't imagine dealing with this "service" without my medical background.

How this level of red tape saves anyone money is beyond my understanding.

No responses yet

FYI: Health Insurance Edition

Aug 18 2012 Published by under Medical Paperwork

Faithful Whizbangers will remember when I tried to amputate my finger in June. I have just now received the Explanation of Benefits from my insurer. The bill includes $233.27 for drugs, $205 for supplies, and $666 for service. The latter was divided into two separate categories; I have no idea if that occurred solely to avoid the sign of the beast.

The grand total for sewing me up came to $1104.27. If I had no insurance, this would be my bill. Oh sure, the hospital might be willing to negotiate it down some if I could show financial need.

Of course, I have employer-provided insurance. Thanks to the company's power, $651.71 is "not covered." This brings the final bill down to $452.56. I will end up paying this amount toward my annual deductible, essentially covering the entire final bill out of my pocket.

So let's review that: even though my insurer is not paying a cent for this ER visit, I get a $651.71 discount simply because of their power. No insurer and I owe the entire amount.

I am not complaining about my bill. The final amount seems fair, and I clearly had to have the wound cleaned and closed.

I wonder about the pricing and discounts and other negotiated sorcery.


5 responses so far

Exploring Health Literacy

About ten percent of American adults can access, read, understand, and act on basic health information, making this condition a major barrier to improving public health. The journal of the American Medical Writers Association featured articles on this problem and potential solutions.

An overview by Sharon Nancekivell leads off the series. She reviews the dismal statistics that complicate the jobs of everyone involved in the healthcare system. Beth A Lanning and Eva I Doyle present a meatier article, Health Literacy: Developing a practical framework for effective health communication. This piece builds on models of health communication as an interactive process between sender, receiver, medium, and message, with the culture influencing the interaction of all of these components at all times. A wonderful table examines the health communication components and suggests ways each can influence functional health literacy skills: reading, understanding, and acting. The article provides a fascinating framework for thinking about health literacy problems, and it helps one begin to think about solutions.

By the Doaks

Leonard and Cecilia Doak provide the most practical advice with Writing for Readers with a Wider Range of Reading Skills. Stating sames simply does not mean "dumbing down." Avoiding jargon, using common vocabulary, and eliminating extraneous material helps readers of all levels understand and retain material. Focused material brings better results; skilled readers may be able to keep as many as seven items in short-term memory, but three points is more typical. Most patients only read health-related text once and take action based on what they remember. Factors that aid retention include short sentences, written in the active voice and a conversational style. Present the context for new information before the information:

Information before context: Eating broccoli, spinach, collard greens, lettuce greens, rhubarb, Brussels sprouts, kale, beet greens, and carrots can reduce your risk of certain kinds of cancers.

Context before information: The foods you cat can affect your health. You can reduce your risk of certain cancers by eating broccoli, spinach, collard greens, lettuce greens, rhubarb, Brussels sprouts, kale, beet greens, and carrots.

Materials must not only be easy to read, they must look easy to read. Clear, 12-point fonts, white space, liberal use of headings, and illustrations all help break-up a "gray page" and make the document look reader-friendly. Visual aids especially assist readers; studies suggest that patient understanding, recall, and compliance may increase up to 500% when pictures are included with the text.

The most problematic healthcare documents are legal forms such as informed consent and HIPAA notices. These must be written to meet the requirements of the law, resulting in documents at a college reading level. The Doaks suggest one alternative, a two-part document. The first part could be a "plain language" notification of the material, and the second could be the actual legal text. A piece in the current issue of Scientific American examines technology-based alternatives to help patients understand their procedures and all of the risks. Interactive materials not only provide a mechanism for education that does not require face-time with the healthcare provider, it also can give feedback on what the patient spent the most time reviewing, guiding the face-to-face discussion.

Healthcare literacy presents a huge challenge for medicine and public health. These articles provide a great springboard into the topic, giving us a framework for discussion as well as some practical tips for those of us authoring materials.

4 responses so far

One of THOSE Days

Feb 15 2011 Published by under Medical Paperwork

I have begun my battle with paperwork necessary to change positions and move to a new state. Oklahoma MD licensing requires nine forms that I downloaded, including a test on medical-legal issues. From prior experience, I know the real fun will happen when I have my license and must get certified with every health plan in the new state.

Red Tape Hoops? Click for source

This week I found out that they will need to see my actual social security card. Like all good girls, I read the instructions on the card and put it in a safe place. Where that place may be is currently unclear, but I am sure the card remains quite safe. So today I filled out an application for a replacement card and brought my passport to the local Social Security office.

I was planning to run by on the way home yesterday, but I discovered the office closes at 4 pm.

So I request my card and show them the passport, the only single document that can confirm US citizenship for employment purposes. They hand me a print-out, and the birthdate is wrong. The clerk goes back through my history and discovers that in 1984, when my name changed with marriage, someone transposed the digits in my day of birth from "12" to "21." My original application in 1976 had "12" on it, as does every other form of identification I possess. I hand back my passport which includes the correct date of birth; however, birth date can only be established by an original birth certificate with raised seal. Never mind that the government put the date on my passport using my birth certificate - I must bring in the actual certificate between 9 am and 4 pm on a non-federal-holiday weekday to correct this information. Or mail in my official copy of my birth certificate and hope I do not need it for another hoop-jump in the coming 2 weeks.

I guess I should be glad that I found this now, when correcting it remains an annoyance, rather than when I needed to collect benefits. Still, I feel like I am jumping through hoops of red tape.

That feeling will only get worse as I start filling out these damn forms...

7 responses so far