Great Alternative to a Busy Signal
Just when you thought you've seen it all:
We got a fax from a patient who had gone to a breast cancer risk assessment screening. Although she had tested negative for BRCA 1 & 2, her horrific family history qualified her -- according to the guidelines of this particular screening -- for annual breast MRI in addition to annual mammography.
Unfortunately, her insurance required pre-certification for the MRI.
My wonderful, woefully underpaid, long-suffering office manager spent 45 minutes on the phone answering dozens of questions over and over and over. Standard pre-cert shit. Their determination was that the patient didn't meet *their* guidelines for screening breast MRI. But I had options:
- I could fax the letter saying that she met someone else's criteria for screening, or
- I could call for "peer-review."
At least the music wasn't too bad.
A minute or two later -- not long at all -- a woman got on the phone. She introduced herself as "Ms. So-and-so" (not "Doctor") and said this:
I apologize but all physicians are busy speaking with other physicians. Would you like to take the notification number or do you want to put your staff back on?No questions; no nothing. Rather than keep me waiting or making me call back, because they didn't have a doctor available to speak with me right then, they APPROVED THE TEST.