Snippy nurses.
I have a patient. He has a G-tube. He can only take liquid nutrition. This patient is a child. He takes pediasure. This means I need Prior Auths for his insurance.
I get a PA number on his most recent script from Friday. Great. Called the PA line to activate it. This medication has been denied because it is not for a child.
What? The child was born inbetween the year 2000 and today. He’s a child.
Called the insurance. Spent close to 45 mins on hold being bounced around. Finally find it. Childs DOB was entered into the PA system as **/**/8002. This child is not due to be born for another another 6000 years. Wonderful.
Spend the next half hour finding out if they can fix it on their side or if we need the MD to get a new PA.
Nope, new PA needed. Great. Called the doctors, informed them that they needed to cancel the old PA and get a new one. Fine, the one nurse laughs, they giggle a bit about the dob, and promise they’ll fix it.
I called back today and got Ms. PriorAuth-Nurse. (Ever office has that one nurse that handles all the PA’s.
I was informed (after spending 15 mins on hold with the office) that she was buisy today giving shots, and that she gave up after spending 15 mins on the phone with the insurance. The insurance told her that they never logged us activating the PA. Well no duh, we can’t because you fubar’d it. (I kept that observation to myself)
I explained that we can’t activate it because we can’t enter the PA in for the correct patient.
She continues to whine about the time she has to spend on hold for insurances. Look, lady, I know. Hell, I just spend 15 mins on hold to talk to YOU.
Then she informs me that she had to spend a whole half hour on hold to get the last PA, why should she have to get a new one? Can’t we just change the DOB?
No, because there is no way this insurance computer system will accept a younger than a day old, let alone 6000 year into the future.
She gets real snotty now, Suggesting that we should just give the patient the stuff and she’ll fix it “later”. Thats nice, but I already have given them a whole case already. Now I need to be paid for the other 9 cases, plus the one I advanced them. I really need the problem to be fixed by friday so I can bill the rest of the stuff. I suggest she either get another nurse to cover her so she can get it done, or try to do it during the slack time in the morning or before closing.
At this point she becomes really nasty, one of those “don’t tell me how to do my job” rants, how I’m a lowly retail tech, why do I get to tell her to waste a half hour on the phone fixing what wasn’t her problem.
I then inform her that I had spent over and hour and fifteen minutes on hold with the same insurance that day. (trying to get her all the information she needed to fix the problem. Information that would allow her to fix the entire issue in under a half hour.) I hung up on her mid rant.
Now I’m really good friends with another nurse in that office. I called back to get the secretary again and request my nurse-friend. I proceed to give her all the information to get it done, under the condition that the other nurse has to at least make a good faith attempt at fixing the problem.
If it gets ignored and its not done Wednesday, I asked her to do it herself. If that’s the case I will ask my pharmacy manager to make a call to one of his golfing buddies. (the head MD at that office)
I hope the insurance puts snippy-nurse on hold for an hour
I know its kinda mean, but I’m not inconveniencing the patient, he’s set until Friday.
Tags: Nurses, Prior Auth | |
