Last photo

From Bushboys world, a “last on the card” contest, with the last photo on the phone or card.

I knew exactly which photo was there. I took it last night after spending a couple hours trying to remember how to set up the tree tent. Got it, though should still mess with it a little. It’s tricky if the trees aren’t an equilateral triangle. Which is nearly always.

I lay on the platform in the sun for a while yesterday before the tent part was up. It’s supposed to rain today. I really got the wrong tent when I got this one, it’s not really suited to the Pacific Northwest. I still love it.

Music for jellyfish

Since I am still out with post pneumonia tachycardia, my daughter and I went down to the beach yesterday.

I can sit, no problem. I can walk too, but only very very slowly. I am getting annoyed about it which means I am starting convalescence. Knowing that does not make me any less impatient.

We found two beached jellyfish. Not entirely sure if they were alive, but maybe. Do not touch.

Pink jellyfish floating in shallow water.

Anyhow, my daughter got a stick and pushed each one back out.

Which makes my heart sing.

For today’s Ragtag Daily Prompt: music.

Revolution in prior authorizations

I had a small one doc family practice clinic for ten years. Spent more time with patients. The trade off was that if they need a prior authorization, they had to come in for a visit. I would call the insurance company from the room face to face counselling and coordination of care and all that crap. This did a number of things:

1. I could bill for the time.

2. The patient saw how the insurance company treats us and our offices. The rep on the line would try to call me by my first name since doctors rarely call. I would say, “No, please call me Dr. Ottaway.”

3. The patients sometimes had called their insurances already and been told “Have your doctor call.” When I would call, the company rep would sometimes say, “We don’t cover that.” The patient would be outraged and say, “But I called YESTERDAY.” The rep would say, “I only talk to doctors. The part of the company that talks to patients is a different part.” The insurance companies can’t triangulate their way out of that.

4. I would end the call by saying, “This has been a face to face with the patient call, you have been on speaker phone and I am documenting the call and the time in the patient’s chart.” At first the calls took 25-30 minutes. Some companies apparently flagged me, and would say “Yes.” if I called, and get me off the phone as fast as possible. They really do not like it being documented in the chart.

5. Insurance companies sometimes drop patients on purpose because the person has gotten more expensive. I had a snow bird from Alaska whose insurance had dropped him. He said he’d paid on time. I said, come in if you want and I will call them. I spent 45 minutes on the phone where they made multiple excuses, lied (we can’t send you a copy of his insurance because we don’t have a fax after they’d said he was not allowed to leave Alaska and I said, “For how long? What do you mean? You don’t insure him if he’s out of the state? Send me a copy of his insurance contract!”) I finally realize that they have dropped him on purpose because he’s been diagnosed with diabetes. I say “Ok, look, I am staying on the phone until he’s reinstated and I don’t care how long it takes. And if you hang up on me I will contact the insurance commissioner in Alaska and Washington states.”

6. Patients are truly outraged at how a physician is treated when she calls an insurance company herself. I have to give my name, my NPI number, my address, my phone number, my fax number, the patient name, the patient address, the patient phone number the patient insurance number and sometimes have to do it every time someone transfers me. When they see me spend 25-30 minutes on the phone to get a prior auth, especially if it is refused, they are up in arms.

I think it would be truly revolutionary if every doc in the country called an insurance company with a patient in the room and documented the conversation in the chart. Wouldn’t that be fun?

Gonna be a revolution, yeah…..

Aces again

I am singing: “You are coming up ACES!”

Ok, but, hopefully not. Because I am talking about ACE scores, Adverse Childhood Experiences. See the CDC website, this is all based on a ginormous Kaiser study in the 1990s.

Here: About the CDC-Kaiser ACE Study |Violence Prevention|Injury Center|CDC

Yep. A very very interesting topic for a rural family practice physician.

For the Ragtag Daily Prompt: ACE.

Getting rid of stuff

This is not my forte. I was raised by pack rats and I have genes from both sides. My OCD tendencies are confined to patient charts and keeping shoes in their original shoe boxes. Otherwise my house is piler pack rat. Piler, not filer. Filing is boring. My office managers have to be Queen Filers to keep me in line. Both of them were, too.

Cleaning out the clinic was difficult. I found stuff I didn’t know I had, of course. What to do with the metal speculums? Keep for posterity or in case we run out of oil? I don’t actually know where the speculums went, they went off with a friend who is helping.

In retrospect, I think my mother would have made paper mache ducks with speculums as beaks and wish I’d kept one. Ah, well.

Weird shelves, microwave and printer.

Someone bought the weird shelves. The microwave’s owner picked it up. We had three printers running at any one time except when one would die and we’d only have two. This printer went home with me. New and old computers went home with me because one has to wreck the hard drive because HIPAA. My house currently looks like a computer/printer/scanner/file cabinet graveyard. It’s annoying.

Home office guest bedroom.

Besides this messy room, there are also 8-10 more boxes of stuff moved down to the basement. I have to keep patient charts for ten years or until they are 21 for minors. I have paid a company Big Bucks to take that over. I have to keep business records for 7-10 years depending on if it’s state or feds.

Well, I’ll sort it before I’m dead, or else my kids will.

Quimper Family Medicine contact information

Quimper Family Medicine is closed.

For Medical Records, here is contact information:

Spectrum Information Systems

PO Box 739

Enumclaw, WA 98022

phone 206-686-3821

fax 206 686 3840

The contact information for billing is by mail only:

Quimper Family Medicine

PO Box 1053

Port Townsend, WA 98368

I had the fax number set up to fax to the cloud, but Century Link botched it massively. I spent an hour on the phone with them a week ago Thursday and couldn’t fix it. Good it wasn’t in person, because I wanted to break things. They screwed up the change of address, didn’t send me a bill, didn’t sent me the email to activate the damn thing, then passed me off to someone else who hung up on me. My thoughts about Century Link currently are quite dark and not publishable on a family friendly blog.

Empty clinic right before closing.

I miss my peeps. You people, friends and patients.

empty waiting room and front door of a clinic
Empty clinic waiting room and front door.