I got up this morning and made a bunch of phone calls, FINALLY, including one that necessitated another phone call, to our pediatrician’s terrible referrals clerk, who asks in a challenging, bet-you-can’t-answer-THIS-one tone for things most patients would not know (“What’s the NPI number?” “Is she also a specialist in X?”) and then acts as if she is literally unable to write the referral without ME PERSONALLY providing that information to her, even if I have successfully answered all her other questions (the practice’s address, phone, fax, email address; the doctor’s first name and last, and specialty). The previous holder of her job had no such trouble, asking just the doctor’s surname, the reason for the visit, the name of the practice, and the day of the appointment; sometimes she’d say “You don’t happen to have their fax number, do you?,” and if I said no, she’d say “No problem, I can find it!” She NEVER asked me for the NPI, presumably because THAT IS NOT SOMETHING PATIENTS GENERALLY KNOW. I look back wistfully upon those happy times.
With another call, a receptionist claimed she could not let me make an appointment for my over-18 child, because of HIPAA. I have gone through HIPAA training twice, and this is not a thing. With only a few exceptions, ANYONE can make an appointment (or refill a prescription, or pick up a prescription) for ANYONE: I can call and make an appointment for my mom, or for my spouse, or for a friend, or for an elderly client/neighbor, or, yes, for my 20-year-old child. HIPAA prevents information from going THE OTHER WAY: the receptionist/clerk may not tell ME anything about the person on whose behalf I’m acting (unless the person in question is my minor child, or unless the office/pharmacy has a document from the person saying it’s okay to tell me things): they may not tell me how long its been since the person’s last appointment, or what kind of appointment the person is due for, or what prescriptions the person is taking, or their recent test restuls. But I may tell the receptionist/clerk anything I want: I may say the type of appointment I’d like to make for the person; I may give the person’s full name and address and insurance information; I may tell the receptionist what the symptoms are or which prescriptions need to be renewed. And the receptionist may schedule the appointment / leave a note for the doctor to renew the prescriptions, without needing to go through any sort of vetting process to make sure I am authorized to make these requests. But I know the futility of arguing with someone who is trying to enforce a rule they didn’t make and think they are required to follow, so I gave up without protest.
I ALSO made a call I THOUGHT would be terrible, and certainly there is still time for this to turn (as with so many other insurance issues) into a long SERIES of frustrating calls—but at least my FIRST call went quickly and easily. Here was the situation, if you enjoy a little empathetic cringe: I had in my hands (1) a bill from my doctor and (2) a letter from my insurance company instructing me not to pay it. (The doctor had apparently asked for a certain type of bloodwork that was not covered under the doctor’s contract with the insurance provider.) I had to call the doctor’s billing department and explain this. (WHY IS THE PATIENT EVER EVER EVER USED AS A MESSENGER BETWEEN DOCTOR AND INSURANCE COMPANY???) And the person I talked to was just “SIGH it would be nice if they would tell US these things! Okay, I’ll take care of this, you should be all set, just call us back if you see anything else about it!” (But my guess is that when they opened the file they DID see that the insurance company HAD notified them; I don’t think they would have canceled it just because I said so. I think they send out the bills on purpose anyway, because a certain percentage of patients will accidentally pay them.)
This batch of calls reminded me how satisfying it was to have Rob make all his own calls before he left to stay with my parents: he was astonished by how LONG everything took, and by how one call could lead to SEVERAL MORE calls. It’s also satisfying to think that at some point all five children will be taking care of all of their own calls/appointments. That’s going to be even better than when they all started taking care of their own seat belts.