Why didn't I think of this sooner

Tired of insurance scut work? This doctor has patients do it.

By Charles Davant III, MD

Mrs. Maxwell was an archetypical HMO patient: She needed referrals for everything. And I gladly concurred. I was happy to pass her off to one of my specialist friends, and stick him with the task of explaining to her that her problems were garden-variety, mostly untreatable, and that she might as well learn to live with them.

Such a consultation had prompted her latest visit to my office. "Dr. McCrittenden says he's not sure exactly what I have, but it's at least as bad a case of it as he's ever seen," she told me. "He wants me to take this new medication right away—but, of course, my insurance won't cover it until you call them."

My heart sank when I saw the name of her insurer. I knew either my nurse or I would be on hold until the dollar value of our time exceeded the cost of the medication. The solution came to me like a flash.

I looked her directly in the eye: "No, Mrs. Maxwell, I'm not going to call them. You are."

"But they have to talk to a doctor," she sputtered.

"And they will," I promised, pointing to my chair. "Have a seat right here."

I punched in the number and then "9," avoiding the menu of nonrelevant choices and going directly to the "If-you-are-a-health-care-provider . . . " option. I handed her the telephone. "As soon as a real person answers, ask him to wait a second, and then stick your head out the door. The nurse will get me."

There she sat for a solid 15 minutes being assured that her call "was important to them and would be answered in the order received." In the meantime, I saw two other patients and wrote a couple of prescriptions.

Finally someone picked up on the other end, Mrs. Maxwell called me in, and our business was transacted.

She looked at me. "Do you have to go through this all the time?"

"Sometimes it takes a little longer," I said.

"Poor man! You're always on the phone to insurance companies!"

It only seems like always, but now I'm saving lots of time and earning lots of sympathy by having patients make the cussed calls themselves.

Why didn't I think of this sooner!

The author, a family physician in Blowing Rock, NC, is a Medical Economics contributing editor.

 

Charles Davant III. Why didn't I think of this sooner!. Medical Economics 2002;14:40.