Doctors don’t charge for phone calls

Doctors don’t charge for phone calls.

Attorneys do: they charge in fifteen minute increments.

Doctors don’t charge for phone calls: oh, but actually that is a myth. And it’s raising the cost of health care in the US because the insurance companies are using this myth to their advantage. Not only is this costing every one of us more money, but it is driving doctors out of practice. And it’s making patients bitter and angry at the doctor, when it is the insurance that should bear the blame…

Why do I say this?

A patient calls their health insurance. “I need x.”

The health insurance says, “Have your doctor’s office call for a prior authorization.” Now, we are definitely paying the health insurance to have someone say that to the patient.

The patient calls the doctor’s office and requests the prior authorization. There, a second person is being paid to get that phone call.

The doctor’s staff runs it by the doctor. The doctor says, yes, the patient needs that or no, I would like a visit to discuss this. More time that we pay for.

If the doctor says yes, the doctor’s office contacts the insurance by phone or on line to do a prior authorization. This means a different website for every one of 1300 insurance companies in the US. We are paying the doctor’s office staff to be on the phone and on the computer to fill out prior authorization forms to get permission from the insurance if your doctor agreed that you need x or that x would be helpful. We also are paying for all of those websites that the insurance companies have to slow down giving the patient care.

I don’t have an office staff to do this. I have a bare bones clinic so that I can spend more time with patients. I call the insurance myself with the patient in the room.

More than half the time the insurance company says that x is not covered under the patient’s plan.

But wait. The patient already called the insurance to ask if they could get x. And the insurance said have your doctor get prior authorization. So in the usual office, the patient is called and told that x is not covered. The patient is angry, because they think that the doctor’s office has messed up the prior authorization. The insurance does not want to tell the patient it is not covered. So our costs spiral up and up and up, because the insurance has realized that they would rather have the patient angry at the doctor’s office, not the insurance.

And we all are paying for it with our health care dollars…..

Pandora’s Box

I read this: Was Pandora framed? today and thought, I know I have a Pandora poem….and here it is, from 2011. And another write up, Why the number line freaks me out, that too. When I think of infinity and Pandora’s Box…. it’s worrisome…

Pandora’s Box

Oh, you’d think
It would be empty by now

But I open the box again
I say what I want

And hear “No.”

I sit in want
Old wants
Buried wants
Pressure rising

I know by now
What is happening
I let it rise in me
I do not fight it
I clean the bathroom
Scrub tile and grout
Wants claw inside me
Burst like striking oil
A geyser from within
Black sticky want
Screaming up through the air
Falling everywhere
Filthy, flooding

It will take a while to clean up
this dark matter,
pollutant to poison
or fuel to sustain?

 

I took the photograph yesterday on North Beach. It looks like a popped child’s toy, pink. But it’s not…. it is all over the beach. A seaweed? Something hatching? Nature is a Pandora’s Box as well…. infinitely creative….