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Call Centers with a gooey HIPAA middle

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  • Call Centers with a gooey HIPAA middle

    Open letter to my last caller - note I work for a health insurance company specifically with professional provider practices [doctor's office] and usually I speak with office manager or an office assistant.

    Dear Therapist's Wife,

    I do not care that you are married to the therapist. I have no inclination to treat you any differently than any other caller. You are not a good special. All your marital status tells me is that he's not making enough to hire someone that knows what they are doing to take care of the business part of his practice.

    I do not have a high opinion of you to begin with because you have demonstrated already that you cannot follow verbal directions with any competency. When the phone system asks you to enter the member's id and you enter your husband's provider id instead, that makes you special in a bad way.

    I feel no obligation to submit your claims for you. I do not care if you are paid or not. If you do not report the member's date of birth and gender then your claims will deny and die. We cannot adjust them. We're not allowed.

    ~You~ must gather the correct information from the patient or policyholder and resubmit your own claims.

    No Love but much Sincerity,
    Me

    [note that as I'm typing I'm pausing where I would put an explitive and consciously deciding not to do so. This job as been bad that way. It makes me want to swear. A lot. It makes me feel.... stabby]
    Everything sucks. I must be living in a vacuum.

  • #2
    Quoth Foxglove8778 View Post

    You are not a good special.
    I love it!

    I recently had two clients tell me that they could not release patient insurance information to me due to HIPAA. When I checked with our compliance officer, she gave me a response that could be used as a perfect response template for when I get that in the future. Basically, HIPAA doesn't prohibit the release of insurance information for billing purposes to a valid provider (us).

    It just annoys me when people want to cover their own arse, so rather than have to determine what IS or ISN'T covered by HIPAA, they hide behind it and refuse to give any information at all.
    He loves the world...except for all the people.
    --Men at Work

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    • #3
      did you see the joke I posted about HIPAA?

      Was the client's problem with releasing info that they couldn't authenticate you? Our legal department gave us specific criteria to confirm and specific information we're allowed to release... and then there's that whole "minimum necessary" and the info we can confirm but not release.... all in the name of "covering the company arse" nonsense. Have I mentioned that I have come to loathe my job in general almost as much as I hate HIPAA?
      Everything sucks. I must be living in a vacuum.

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