Tuesday, October 11, 2005

God I Love My Job

As an insurance verifier, it's my job to go in and "pre" the account. What I do is call the insurance company make sure the patient has benefits through them and find out their deductibles, co-insurance,and out of pockets for the year. Then I go in and look up the CPT (procedure being done) and price the surgery. Well apparently people think this is an easy job. Well not so much! First of all most of the time when I go into an account there is no info in the account. Usually the surgery schedules puts in the notes "NO INFO AVAIL". Then I have to hunt down the fax the doctor sent and that's when I see the doctor gave us the patients, address,ssn,phone number,insurance info, sometimes the doctor has already gotten pre-cert for us and everything. Usually on this sheet I can find CPT and ICD9 codes. That's how I price the surgery. In the event that there are no CPT codes then I just have to hunt down the price, which can take a while. So sometimes it sucks. But the girls out on the front line don't seem to understand this. They just think I am sitting in here surfin' the 'net and singing along with the radio...don't worry I do plenty of singin'. LMAO.

So anyways there was an account that I tried to pre yesterday but I couldn't because we had no info at all. I didn't have the patients phone number and the doctor's office was closed for Columbus Day. So I went ahead and priced the account as a self pay account. I even put notes in the account explaining this to the representative. That way in the morning when the girls on the front line got the patient they would know what was going on. (at least I though). One of our new girls got the patient and it took her and hour and 10 mins to call her insurance company and get the benefits and figure out the contract rate for that patients insurance company. Then she wants to go and try to blame it on me....Hello.. dumbass I put everything in the notes. All you had to is get the damn benefits. I swear..fucking idiots.

okay sorry I had to vent....

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