Dear Miss Managed Care,
Our HMO has recently expanded its coverage. We now continue to provide care (and bill) our dead subscribers. These subscribers have a very low rate of complaints about our services. However, they have a tendency to be stiff-necked, and unresponsive to repeated calls from our care managers. What is the proper way for our care managers to deal with this new class of subscribers?
Poor old lady...
This old lady walks into the Doctor's office and says, "Doctor, please help me. I have a terrible problem with farting. It's not really a social problem, because you can't smell it or hear it, but I must have farted 20 times since talking to you." The Doctor nods his head and says, "Take this bottle of pills and use them all. When they are all gone in about 2 weeks, come back to see me." The old lady comes back 2 weeks later and is angry. She says "What was in those pills?
- Billing is not a doctor's "core competency."
- Doctors are seeing more patients and need their staff to help them in seeing and processing the patients.
- Doctors have trouble collecting money from patients and insurance companies.
- Doctors waste a lot of time and money doing their billing "in-house."
- Claims processed in-house do not get submitted in a timely manner.
- Doctors (and their staff) do not have time to resubmit rejected claims.
- Large numbers of claims are rejected due to staff errors or outdated software.