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I'm Different!
Picture of mrbill345
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quote:
Originally posted by V-Tail:
quote:
Originally posted by mrbill345:
It's not just doctor's offices. Hospital staff have to deal with the same BS. Nursing staff (where I worked) had different things that we had to document based on the patient's admission diagnosis in order for the hospital to get reimbursed. At times I would have to spend more time documenting care than actually providing care.
I can understand the need to document. My wife is a (mental) health care provider.

What I can NOT understand is the pushing to do tests and diagnoses that have absolutely nothing to do with the complaint. Dilation? Really? Because it "should be done yearly?" After having had this done maybe a dozen times since September? Refraction? What in the world has this got to do with a problem that is clearly associated with tear ducts? Kill a half hour reading charts, left eye, right eye, both eyes, with glasses, without glasses. Why? I am NOT there for an eyeglass-related vision correction, I have a medical situation, related to tear ducts. Why are we wasting time reading charts? Why does Blondie think she needs to take my glasses to "read the prescription?" Especially since I have just handed her a hard copy of the prescription?

Yes, do what you NEED to do, that is associated with my problem. Document this. Maybe ten minutes. Not an hour and a half, trying to do things that have NO bearing, whatsoever, on the complaint, just to check some boxes that are NOT required for reimbursement. The insurance company would be much happier NOT being billed for unnecessary bullshit.


I have/had no issue w/ documentation or having to do it; however adding forms to meets CMS requirements was a colossal PIA as they didn't have much to do with continuity of care and were more for reimbursement. What I objected to was the patient load being high enough that more time was spent documenting than providing care.

The problem is that you are looking for logic in a bureaucracy, a modern-day Diogenes.



“Agnostic, gun owning, conservative, college educated hillbilly”
 
Posts: 3645 | Location: Northern Panhandle WV | Registered: March 29, 2010Reply With QuoteReport This Post
On the DL
Picture of V-Tail
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quote:
Originally posted by mrbill345:
The problem is that you are looking for logic in a bureaucracy, a modern-day Diogenes.
My lamp is getting dim. Gotta order more whale-oil from Amazon. Wink

My problem is that I look for logic in too many places. The bigger problem is that as I get older I continue to lose the ability to tolerate bullshit.

The kinder, gentler, geezer is turning into a grumpy old bastard.



A mind is a terrible thing.
 
Posts: 15813 | Location: Central Florida (near Orlando) | Registered: January 03, 2010Reply With QuoteReport This Post
Eye on the
Silver Lining
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When you called to make the appointment did you specifically request a medical evaluation or state that you had a specific medical concern?

I only ask because there are separate types of visits that can be billed for and typically if someone has a medical situation it would be a separate visit from a comprehensive exam- which sounds like what you had..
Btw burton


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"Trust, but verify."
 
Posts: 3272 | Registered: October 24, 2005Reply With QuoteReport This Post
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Picture of V-Tail
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quote:
Originally posted by irreverent:
When you called to make the appointment did you specifically request a medical evaluation or state that you had a specific medical concern?
ABSOLUTELY!

Well, not really -- I did not call to make the appointment, I stopped in at the office to make the appointment.

I told them specifically that I wanted a consultation for this problem. I told them exactly what the complaint was. I repeated the whole song and dance multiple times: when I checked in at the desk for the appointment, and again when Blondie escorted me into the exam room, before she started to mindlessly go through the routine of checking all the boxes. Each time that she wanted to do something unnecessary, something that had absolutely no connection to the reason that I was there, I reminded her.

She chose not to hear me, but instead to drone on, running her checklist.

It was apparent that she was the gatekeeper and I would not have a face-to-face with the doc until she had checked all the boxes, but I vetoed every test that she wanted to do, other than read the charts.

Once the doc appeared, it was all straightforward and he got right to the point. The way it should have been, more than an hour earlier.



A mind is a terrible thing.
 
Posts: 15813 | Location: Central Florida (near Orlando) | Registered: January 03, 2010Reply With QuoteReport This Post
Only the strong survive
Picture of 41
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You may want to check out this:

http://www.lifeextension.com/M...Eye-Syndrome/Page-01

http://www.lifeextension.com/V...ort-with-MaquiBright

http://www.lifeextension.com/V...ignans-Olive-Extract



"Donald Trump is the grizzly bear in The Revenant. If you get his attention, he’ll be awake, bite your face off, and sit on you.".. Newt Gingrich.

41
 
Posts: 9335 | Location: Herndon, VA | Registered: June 11, 2009Reply With QuoteReport This Post
Non-Miscreant
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quote:
Originally posted by HRK:
lemmie get this straight.

yer in a room
alone with a blonde

and you never asked what color panties
she was wearing....


I'ma startin to worry about ya....


Aw, we need to give him a little slack. He's said he's 78 or 80. He might have forgot the necessary questions to begin the process of getting them off her.... Or what to do after he does! Big Grin Big Grin


Unhappy ammo seeker
 
Posts: 15746 | Location: Kentucky, USA | Registered: February 25, 2001Reply With QuoteReport This Post
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Picture of V-Tail
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Thanks, but that's not the problem. The initial assumption was dry-eye, but that was ruled out quickly.

The problem is actually not with production of tears, the problem is drainage after the tears have been produced. There is duct-work, nature's own sewer system, to drain the tears. Evidently, I have a blockage, so instead of draining, the tears are backing up and causing watery, somewhat blurred vision. Things start out clear in the morning, but as the excess tears accumulate during the day, things get a bit blurry.

Conceptually, the cure sounds simple. We'll see what the new doc, the specialist for this, says, one week from today.

I'm hopeful that I won't have the song-and-dance routine with the new doc; her office has requested the notes from the dry-eye doc, and the cataract doc, so they should have a good handle on things when I get there.



A mind is a terrible thing.
 
Posts: 15813 | Location: Central Florida (near Orlando) | Registered: January 03, 2010Reply With QuoteReport This Post
On the DL
Picture of V-Tail
posted Hide Post
quote:
Originally posted by rburg:
quote:
Originally posted by HRK:
lemmie get this straight.

yer in a room
alone with a blonde

and you never asked what color panties
she was wearing....

I'ma startin to worry about ya....
Aw, we need to give him a little slack. He's said he's 78 or 80. He might have forgot the necessary questions to begin the process of getting them off her.... Or what to do after he does! Big Grin Big Grin
Yup, I'm 80, but that doesn't mean I forgotten a ... what were we talking about?



A mind is a terrible thing.
 
Posts: 15813 | Location: Central Florida (near Orlando) | Registered: January 03, 2010Reply With QuoteReport This Post
Member
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My problem is that I look for logic in too many places. The bigger problem is that as I get older I continue to lose the ability to tolerate bullshit.


You need to spend some time with millennials and see how little patience they have. I have read enough of your posts to recognize patience and inability to tolerate bullshit. You are doing much better than the average patient who is put through the stupid paces to satisfy bureaucracy.
 
Posts: 2337 | Location: MS GULF COAST | Registered: January 02, 2015Reply With QuoteReport This Post
Only the strong survive
Picture of 41
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So it looks like you have problems associated with Glaucoma. Here is an explanation of some of the things that can happen to cause your problem.

http://www.lifeextension.com/P...Ear/Glaucoma/Page-01



"Donald Trump is the grizzly bear in The Revenant. If you get his attention, he’ll be awake, bite your face off, and sit on you.".. Newt Gingrich.

41
 
Posts: 9335 | Location: Herndon, VA | Registered: June 11, 2009Reply With QuoteReport This Post
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Picture of P250UA5
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So which was better? #1 or #2? #1 or #2? Big Grin




The Enemy's gate is down.
 
Posts: 5152 | Location: Spring, TX | Registered: July 11, 2011Reply With QuoteReport This Post
Eye on the
Silver Lining
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quote:
Originally posted by P250UA5:
So which was better? #1 or #2? #1 or #2? Big Grin

Razz
Seriously, did your voice your complaint to the doc or offc Mngr on your way out? I'd be curious to see how they billed it? As a comprehensive exam or as a medical visit...being a pilot, I'd spect you'd have been pretty regular in your eye appts, so I can't imagine they were trying to catch you for an exam just because it's been sooo long since they last saw you..


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"Trust, but verify."
 
Posts: 3272 | Registered: October 24, 2005Reply With QuoteReport This Post
Too old to run,
too mean to quit!
posted Hide Post
quote:
Originally posted by V-Tail:
quote:
Originally posted by mrbill345:
The problem is that you are looking for logic in a bureaucracy, a modern-day Diogenes.
My lamp is getting dim. Gotta order more whale-oil from Amazon. Wink

My problem is that I look for logic in too many places. The bigger problem is that as I get older I continue to lose the ability to tolerate bullshit.

The kinder, gentler, geezer is turning into a grumpy old bastard.


BTDT!!

I am 79, and my tolerance of useless BS (is there any other kind) has degraded to the millisecond range.

I have had new lenses in both eyes, and corneal transplants in both eyes. Fortunately, my doc seems to have mastered the system. His primary office has one receptionist. He recently opened 3 more offices in different locations to make access for patients easier. He has ONE "clerk" that travels with him from office to office.

Our GP works pretty much the same way, but only has one office and limited staff. The doctor enters all patient info on his portable computer which further limits staff.


Elk

There has never been an occasion where a people gave up their weapons in the interest of peace that didn't end in their massacre. (Louis L'Amour)

"To compel a man to furnish contributions of money for the propagation of opinions which he disbelieves and abhors, is sinful and tyrannical. "
-Thomas Jefferson

"America is great because she is good. If America ceases to be good, America will cease to be great." Alexis de Tocqueville

FBHO!!!



The Idaho Elk Hunter
 
Posts: 22135 | Location: Virginia | Registered: December 16, 2001Reply With QuoteReport This Post
Striker in waiting
Picture of BurtonRW
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quote:
Originally posted by irreverent:
Btw burton


Yes?

-Rob




I predict that there will be many suggestions and statements about the law made here, and some of them will be spectacularly wrong. - jhe888

A=A
 
Posts: 14406 | Location: Maryland | Registered: March 16, 2006Reply With QuoteReport This Post
On the DL
Picture of V-Tail
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quote:
Originally posted by 41:
So it looks like you have problems associated with Glaucoma. Here is an explanation of some of the things that can happen to cause your problem.

http://www.lifeextension.com/P...Ear/Glaucoma/Page-01
Nope. No glaucoma. That test was done multiple times at the cataract doc's place.



A mind is a terrible thing.
 
Posts: 15813 | Location: Central Florida (near Orlando) | Registered: January 03, 2010Reply With QuoteReport This Post
On the DL
Picture of V-Tail
posted Hide Post
quote:
Originally posted by irreverent:
did your voice your complaint to the doc or offc Mngr on your way out? I'd be curious to see how they billed it? As a comprehensive exam or as a medical visit...being a pilot, I'd spect you'd have been pretty regular in your eye appts, so I can't imagine they were trying to catch you for an exam just because it's been sooo long since they last saw you..
Did not discuss this with the doc. With him, it was all business, very efficient. Funny, how his time if valuable, but mine not so much.

No office manager in sight. Just the two desk gals. Discussing it with them would be about as effective as having a conversation with a shelf-stocker at Walmart re top-level boardroom stuff.

Yeah, it has been a long time since my last visit. Let's see, it was, um, wait, let me think ... oh yeah, that's right. I was never here before. This was my first visit and I was very specific about the reason for the visit. NOT a general exam, let's please just look at the problem. Blondie is not medically trained, she has no clue, none whatsoever, she is just checking boxes that do not need to be checked.

I'm not convinced that it is a nefarious scheme to milk insurance for everything they can get. It might be that, or it might be that they just blunder down the same path with everyone who walks in the door, with no thought at all to preliminary triage in order to eliminate wasted time and effort.



A mind is a terrible thing.
 
Posts: 15813 | Location: Central Florida (near Orlando) | Registered: January 03, 2010Reply With QuoteReport This Post
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Since you didn't discuss with the Doc, things won't change there.

Office procedures aren't unilaterally put in by staff, the guidance came from the Doc and he had final approval.

I bet if prompted, an experienced staff member can tell a story about a time they skipped steps and it blew up in their faces. They see it as due diligence, you see it as wasted resources. They see a litigiousness society, you only see it from your perspective.

I hate getting weighed in at the doctor when I just did it at home. My BP is checked, "never" changes. Why bother? You can bet someone is alive today because they do bother.

Perhaps if you watched your meal intervals, you might be less cranky. Don't let the sugar drop.

The CMS comments are valid but I believe there is more to it. They never know when they will be in court over you. They would be foolish to show up with a file devoid of the basics.
 
Posts: 1840 | Location: S.E. Michigan/Macomb County | Registered: October 24, 2011Reply With QuoteReport This Post
Eye on the
Silver Lining
posted Hide Post
quote:
Originally posted by BurtonRW:
quote:
Originally posted by irreverent:
Btw burton


Yes?

-Rob


Huh. Truncated my own post somehow. I was keying in that "btw burton was absolutely correct, imho, per his post regarding this.."

Ok, sorry to drift!


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"Trust, but verify."
 
Posts: 3272 | Registered: October 24, 2005Reply With QuoteReport This Post
I'm Fine
Picture of SBrooks
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I'm willing to bet a small amount of money that the specialist won't go through nearly as much stupid stuff as the general practitioner did.

He'll already have a proposed diagnoses in hand when you show up. He may run some tests, but I'm hoping they will all be applicable.


------------------
SBrooks
 
Posts: 2694 | Location: East Tennessee | Registered: August 21, 2006Reply With QuoteReport This Post
Member
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It has nothing to do with wasting resources. It has everything to do with bilking your insurance company for every single thing they can bill for. Just wait till you get the bill and see how many different line items and how much the insurance paid them.
 
Posts: 14375 | Registered: June 12, 2005Reply With QuoteReport This Post
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