last call

This afternoon, I had my coat on and had said my goodbyes when one of my coworkers said I needed to take a call...billing situation. The call was about a very similar situation as I described in a previous blog, except that this was a conference call to me and on the other end was the insurance company and the patient. A few days earlier I had a mild argument with the insurance company and afterwards called the patient to let him know the situation. I told him he might want to call the insurance company and see what he can find out.

You see, the physician's office has very little leverage. The patient pays his medical insurance premiums. Insurance company has the money. Physician performs service. Physician wants money. Goal of insurance company: collect premiums and pay out as little as possible. I can call every hour on the hour, but what do they care? Now the patient, or even better, the patient's Human Resources Department, they are the ones with some leverage.

So when the other end of the phoneline is the insurance company AND the patient, I am happy. I know the customer service rep won't be saying, "screw you, you ain't gettin' it." Not this time. Not with the patient listening. It was all very friendly-like and I was promised it would all get a good looking into.

And the patient thanked me several times for being so helpful. And he should. Because, honestly, it is above and beyond. As far as my boss goes, I should just send the patient a bill. Let him fight NOT to pay. But the doc only wants his money, and who can blame him?

I want to win.