Just RK

I’ve worked in medical/dental offices in various capacities for over 18 years.  I’ve been the receptionist, the dental assistant, the insurance coordinator, the patient accounts trainer, the practice manager/administrator, and the consultant, among several other roles and titles. Currently, I work from home. I listen to recorded calls online from 7 dental practices in CT, NJ, WA, NY, and TN, and 2 orthopedic practices in NE.  When people call in to make an appointment, I get to hear both sides of the conversation to make sure that the call handlers are saying what they’re supposed to, providing good service, and not missing opportunities for new patients. I’ve been amazed at many things over the years working in this field.  But lately I’m most amazed at how many people call an office for the first time to make an appointment, and they don’t know what their insurance is, and they don’t have the card with them.  It’s just hard to fathom, to me, that a person wou...

I'm not one to publicly rant on a particular company, as a rule. And I won't go quite to that extreme here, but come on... Apria drives me NUTS! I try to be polite, and I am never rude, though I can be a bit firm after talking to the 7th person on that one phone call, saying the same thing every time...but I always acknowledge the person I'm talking to and understand they are not solely to blame for the problems. I go in hopeful each time... Today I'll get someone nice, and knowledgeable, I'm sure of it. We have gotten our NG tubes, extension sets, syringes, g-buttons, etc, etc, etc, from them for years. They were the only option we had on our insurance. But I can NOT tell you how many times the bills have been wrong. (Well, I can, actually...EVERY time. Literally. I have them if you want to see.) Duplicates get sent that weren't ordered, then I have to battle to get them to accept them back or write off the charges. I call them regularly to tell them HOW to reb...

Medical insurance issues and authorizations are my thing. It's what I do. It's been at least part of my job for more than 10 years now. I get journals and magazines and do seminars and continuing education in the field. Even with, and maybe due to, this expertise, I get SO frustrated at how wrong some of the practices we deal with in Braska's care can get what should be a simple process. How in the world do parents do it that don't know how the system works?!? When they get an EOB (the explanation of benefits from the insurance that tells you what they pay and what they won't for a particular visit or service), and it says something is denied, do they just pay it and suffer the economic setback or do they know that there are any of 15 things that could be wrong causing that denial to be incorrect? I've spent the morning calling our case manager at the insurance--who is little help, unlike the previous ones we've had--getting no pertinent info other than ...

I had a big long post about this, but then I realized not everyone cares or knows the lingo, so I'll try again to be straight and simple. (Yes, this is the short version.) We found out this week that our health insurance will be changing by the end of this month. Not because we want it to, and not for the better. M's employer has recently merged (supposedly, although it's more like an acquisition) and unpleasant changes abound. We've been SO blessed by the coverage provided through this job over the past few years, and I'm thankful for that. It's just really unfortunate that the positives of the job are starting to be outweighed by the frustrations. In our area, there are two options for health care and insurance pretty much. If you have Insurance #1, you go to hospital/health system A. If you have Insurance #2, you go to hospital/health system B. I've never seen anything like it, in all my years working in medicine. I've worked in both systems h...