Can we solve these problems with IT?
My fax machine has too many faxes in it every morning
Reassuring Lab Results just arrived (by fax, mail, local printer, etc)
I am a specialist – seeing a new patient for the first time.
I am a provider writing a prescription for Clarinex
The patient has seasonal allergies
Has tried “everything else”
The drug reps left a pile of these and I gave some to the patient last time she was here
They work “wonderfully”
She wants more
So I write a prescription
Which she takes to CVS
And they want to charge her $107.50
Because it’s not covered
So she calls my office
And my nurse says she’ll work on it
So she gets the chart
So she looks up the insurance company (BlahBlah Healthcare)
And then she calls the “prior authorization” phone number
And waits on hold
Until a person answers
Who sends a fax
Which the nurse gets 4 hours later
And gets the chart again
And she fills out the form on the fax
And she puts it on my desk with a “sign here” sticky note on the signature line – and pointing to the (empty) justification section
I get it on my desk the next morning
I fill in the blank sections of the form and put back on the nurse’s desk
Who faxes the form …
3 days later the patient calls and asks if this is done.
Different nurse pulls the chart and sees the copy of the fax that was sent to the insurance company – so she says yes.
Patient goes to CVS who tries to charge her $107.50 again
Patient goes home and calls the office
Nurse pulls chart again
Nurse calls BlahBlah Healthcare. Turns out they haven’t processed it. They will process it and will let us know if it’s denied (They won’t let us know it it’s approved).
Nurse calls patient and tells her to try CVS again in a few days.
Patient gets angry and yells at nurse
Nurse was depressed anyway and quits her job – slamming the door on her way out, hitting a child in the head as he comes in for his 3-year well-child visit. He is conscious, but has a laceration on his forehead that will require repair. The kid’s mother says she’ll sue the physician “for everything he’s worth” as she drags the kid off toward the emergency room.
She hits a raccoon on the way home, barely missing an Oak tree as she tries to avoid little Rocky.
She calls her physician and requests some Xanax to “calm my nerves” – beginning a life of dependence on benzodiazepines and poverty. She stops making payments on her mortgage, loses her home, and was last seen living over a ventilation grate near the Misys offices in New York City.
