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#28081
02/12/2011 5:51 PM
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MANAGED CARE AT ITS FINEST
Just received 3 pages of paper from the "H", dated 2/4/11 asking me why my patient last filled a particular script in December 2010.
Patient expired the last middle of December. I wonder if they would consider that an appropriate reason?
Last edited by vroberts; 02/12/2011 6:06 PM.
Vicki Roberts, MD
Family Medicine of Southeast Missouri
Sikeston, MO
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I received a similar inquiry from the same fine insurer, reporting that one of my patients hadn't filled the correct number of doses of his meds, and may be noncompliant. The note went on to explain (for my edification) that noncompliant patients often have more medical complications.
I guess so, since the reason for "noncompliance" was that the patient had died 4 months earlier.
John
Internal Medicine
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There are an awful lot of insurance faxes that go straight to my trash.
David Grauman MD
Department of Medicine
Commonwealth Health Center
Saipan, Northern Mariana Islands
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How about the faxes/letters stating you have not checked labs in over a year. I got one a few weeks ago and looked in the chart and saw the labs I had ordered just a month prior (as well as the ones from 6 months prior). Patient must have paid out of pocket for those labs.
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This is absolutely worthless trash. I think this is a way that the insurance company's justify their (is it?) "medical loss ratio". That is they say that this expense is going to paying for healthcare when it is just more administrative mumbo jumbo. I think we can expect more of this with "healthcare reform" as they are required to spend more on healthcare and less on administration. They are trying to practice medicine without a license and are doing a poor job of it with claims data.
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Go get 'em, guys! I predicted 20 years ago this would occur.
Leslie
Hospital Employed Physician Who Misses The Old AC
"It's a good thing for a doctor to have prematurely grey hair and itching piles. It makes him appear to know more than he does and gives him an expression of concern which the patient interprets as being on his behalf. "
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Wow guys and gals!
Great discussion.
Most of these go straight to the trash, but somehow
"H" got my home address and sent this notice to me
there.
There is a company that my state medicaid uses to
evaluate psychiatric medications I prescribe. I
have quit opening those envelopes altogether. Each
time I get one, I call the state admin office and
tell them that the funding should be going toward
psychiatric care that I can refer my patients to,
rather than using "civillians" at a desk with a computer
program to evaluate me.
I think review is good, but most of this is a waste of
everyone's time and money.
Vicki Roberts, MD
Family Medicine of Southeast Missouri
Sikeston, MO
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