Next time along with making the patients do some of the work here are a few other suggestions. Many IMP's make the patient come in and sit in the exam room with the doc, On Hold and pushed around from one bozo to another, and the patient has to pay their cost sharing to, and let them REALLY See and pay the price too, to have the doc do this. Now at least the doc gets to bill and 3 or a 4 for the time spent doing this. I also know of a local Psychiatrist that has an "ALL things are an office visit policy" forms, refills, prior auths and anything else... this way the patient has some skin it and also this way the insurance carriers are being "Charged" for the doctors time, one prior auth at a time.... It's very good thought and most patients walk away glazed eyes and speechless or infuriated as heck after being a part of it all. Then remind them that they only have to do this for their own healthcare needs and that we have to deal with this kind of crap all day, every day all year long....
The other thing here that tics me off to no end is the specialist dumping the problem on the lower paid, and less respected PCP's... They probably get a nice procedure or in house MRI or some other form of much better payment being the specialist... This is rude and totally disrespectful to the refering Primary. I would send the patient back with the form with a letter you can give basically to all patients, (Template it, right?) that says to the effect you will stop refering patients to their providers if they don't stop this paperwork dumping upon you and your office. You find it highly unprofessional and completely disrepectful of your own role in the patients care and the referal process to boot. Furthermore, you feel that it is bording on Med Mal because you are NOT the doc who requested, suggested, or Rx'ed the Drug and are NOT the Expert Specialist and in many cases may not even know the correct Dx codes and the like that go along with the condition the patient has that started the entire referal two offices working together in the first place process.... And that you will report them to the insurance carrier and the state medical society for not doing your share of the patient care. You believe that the patient should have this med, then they can be the ones to do the paperwork that goes with it...
Honestly, should you have to do their Prior Auth's for their surgical procedures next? They make a few grand off of what you make a couple of hundred bucks prior to either sides office expenses... who is getting screwed here? Would it be any more appropriate for you to perfectly reverse the process and suggest, Rx a med and then tell the patient to go see and bother their specialist for this med because it is a med for the condition that, that specialist is treating them for???? You know and I know that they and their entire snooty staff would have a complete litter of Kittens on you and yours if you were to treat them likewise.... You want it, your write it, you manage it and you do the paperwork that comes with it... plain and simple... They simply want to DUMP on the primary and you should tell their Practice Manager and that doctor Directly that exactly to both of their faces.... I dare them to actually be able to defend it... Like their better off practice shouldn't be imposed upon staff and doctor time wise, but the struggling and overwhelmed PCP that sent them the patient in the first place, they should have to absorb those hits to save them those extra expenses and inconvieniences???? BULL!
Even if we have to call to request a form by fax, we're on the phone for at least 20 minutes.
We only make one phone call, to the patient. Our staff tells them that their insurance company is holding up filling the prescription by requiring extra paperwork. We give him/her the telephone number and tell them we're willing to fill out a single page form if they will fax this directly to us, but we make the patient request the form.
We had to do it this way, some of the subspecialists were writing prescriptions and then telling the patients to get pre-authorizations from us -- we were fielding over a dozen requests on some days. So we had to get the patient's involved. Besides,it gives them some insight into what we go through with their insurers.
