Archive for the ‘Medical Administration’ Category

Service of Why Don’t You Say So?

Tuesday, February 21st, 2017

Say so

Communications is often not our strong suit. The cost? Customers pay the price in wasted time and/or mistakes.

Taxing

I ordered an item online from a high end men’s store and noticed, in checking out, that I was charged tax. For clothing that costs $110 or less, New York residents don’t pay tax. While it wasn’t much, it irritated me that tax appeared on my bill but because it was the last day of a super sale, I approved the order and wrote customer service [which was closed on the weekend].

TaxFirst thing Monday I got a response telling me that they will charge the correct total {without the tax} “when the order is ready to ship.” I was notified, but the tax was still there. So I whipped out another note–thank goodness for cut and paste and email. The correction was made.

Given that the store has a NY branch and that I assume more than one customer orders from NY, it would have been easier to note on the invoice that NY residents won’t pay tax for items under $110. Staff in billing should be similarly instructed….although I suspect that I may be the only one to care.

Check this out

I was having an annual checkup and on arrival dropped into the ladies room to wash the subway off my hands. There was a note warning patients not to urinate if they were having a sonogram. The office offers sonograms in a few parts of the body so out of curiosity I asked one of the technicians whether this directive applies to all sonograms. She said that it only applies to pelvic ones. So couldn’t that one word have been added to the warning?

Do it yourself and guess

USPS self service and binI used the do-it-yourself package mailing system at the Grand Central post office. One of the questions is “Will your package fit in the bin?” which it would. When done, I tried to open the adjacent bin and it was locked shut. So I had to wait in line anyway to find out where to put the stamped package. An exasperated postal worker, who looked at me as though I was dumb, pointed in the direction of a large canvas container on wheels placed well below the counter where nobody would see it with nobody nearby to secure it, either.

Was there a note stating what to do with a package on the bin parked next to the scale/shipping computer? No. Was there a note above the hidden container that collected packages? No. US Postal Service customers take note: Bring along your ESP next time you drop by.

Cross street please

When a business posts its NYC address on its website, if on an avenue, please note the nearest cross street.  I’ve lived in NYC most of my life and I don’t always know this information. [See 666 Fifth Ave and 546 Broadway, in photo below.]

Have you noticed that increasingly few businesses put themselves in their customer’s shoes in planning websites or procedures by anticipating questions or sharing clear instructions in the first place? Do you have other examples?

 Cross street please turned

 

Service of Harried Healthcare Staffers: Impact on Patient Patience & Security

Wednesday, July 27th, 2016

Nurse at desk

A friend wrote this post and the timing was perfect. It took two days for my husband to receive a prescription last week when it formerly took hours. One misplaced prescription spawned countless phone calls because the pharmacist never got the first digital request. Before the “new and improved” system—I wrote in April about NY State’s electronic prescription law–often meds were waiting for him on his return from his appointment. Thank goodness it wasn’t a life-saving medication.

She wrote:

Have you noticed that the support staff in many doctors’ offices seems overworked?  Because they are, you may have been on the receiving end of deep sighs, harrumphs, blank stares, disconnected calls or worse. And because these things happen so frequently, I guess we have to learn to live with them. But when, within a 24-hour period, three harried-health-care-worker incidents occurred that not only inconvenienced me but also potentially put my identity, my health and my mother’s health at risk, I got angry.

Bloody Irritating

receptionist in dr officeThe first incident involved a blood draw at a hospital that consistently earns a top ranking on the U.S. News & World Report list of top hospitals in the country. The patient who had registered with the receptionist just before me gave her a hard time about something. I wasn’t really listening but I was aware that the patient had raised her voice before storming out. I was next in line, and as I approached the check-in desk I instantly decided to be extra-nice to the receptionist, who clearly was frustrated.  I made some upbeat small talk as I handed her my prescription, which was written in typical physician hieroglyphs. She narrowed her eyes and asked no one in particular, “Why can’t doctors write more clearly?!” Since she was having difficulty deciphering his handwriting, she summoned a colleague for assistance. I watched as the second set of eyes narrowed, and then a what-do-you-think-this-prescription-says guessing-game commenced.  I quickly offered to call the doctor to get the definitive word about the prescription—which, of course, is what the receptionist should have done–but I was ignored. So, because I was facing a time crunch, I proceeded to the lab, had blood drawn, and then headed home. By the time I reached my house, there was a message on my answering machine from the lab manager informing me that they had not drawn enough blood because they had misinterpreted the physician’s instructions. As a result, I needed to return to the hospital. Not only was that inconvenient, it also left me wondering whether their final interpretation of the doctor’s handwriting was correct or not.

Facts? What Facts?

Patient recordsLater that day, I brought my elderly mother to an appointment with a pulmonologist. Although this was the first time she was seeing this doctor, he is affiliated with the aforementioned hospital, where she’d had several admissions. This facility keeps a centralized database of patient records, which is accessible to all doctors affiliated with the hospital. Because the doctor’s staff neglected to send us paperwork in advance, I spent 20 minutes entering mom’s current health data. She takes lots of prescriptions, and the dosages and names change frequently. As a result, she always carries an up-to-date list in her handbag.  At the conclusion of the appointment the staff gave us a report with test results and other info. My mother glanced at it and noticed that some, but not all, of her current meds were listed, and the report included several mistakes in dosages. I knew I had not entered incorrect info on my mother’s paperwork, so I asked the receptionist how all these errors had happened. Did the old records override the new ones? Did someone choose not to enter the new info because they were too busy? I’ll never know because I didn’t receive a coherent explanation. What’s the point of providing a list of a patient’s current meds if the info isn’t entered into the patient’s records? More importantly, how can a doctor make sound recommendations to a patient if the doctor doesn’t have up-to-date facts?

Vanishing Act

medicare cardThe third incident occurred the next morning at a surgeon’s office. I had been there at least five times over the past four months for treatment of a complication following a procedure. At my April appointment I provided updated insurance information and watched as the receptionist photocopied my brand-new Medicare and insurance cards. By the time I arrived for my next appointment, in July, that info had vanished. There simply was no record of it. When I told the receptionist which of her colleagues had photocopied my cards, I was met with blank stares. I ask you: Where does this stuff go??? The incident was disturbing because those cards included everything needed to steal my identity. Although the receptionist reacted with a shrug of her shoulders and a “yeah, this happens every day” attitude, their carelessness was a big deal to me because it has the potential to cause significant consequences.

I get angry and concerned when mistakes are made by health care employees because there simply is no room for error in their industry.  Am I unrealistic, or do I have a right to feel this way? More importantly, what can patients do to ensure that no one involved in their health care cuts corners?

 

blank stare

Service of a New Twist on Identity Theft: A Hemorrhage in Medical Care

Thursday, August 13th, 2015

identity theft

Identity theft has spread from retail and banks to hospitals according to Stephanie Armour who reported the new contamination in her Wall Street Journal article, “How Identity Theft Sticks You With Hospital Bills: Thieves use stolen personal data to get treatment, drugs, medical equipment.

The only way that Kathleen Meiners, the mother of a man in his 30s with Down syndrome, could stop harassment by a hospital that claimed he’d had an operation was through the newspaper’s intervention.  Mrs. Meiners figured her son would quickly be off the hook after bringing him to the hospital so staff could see he’d had no procedure for a leg injury. But someone had to pay for the operation the identity thief had undergone so the hospital, ER physicians and radiologist continued to go after her son, eventually via collection agencies.

There’s more. With the thief’s medical charts “folded into” the victim’s, a person who doesn’t have diabetes might be shown to have it or the thief’s blood type might be listed as theirs. Mrs. Meiner’s son had no drug allergies but was listed as having some. Guess what? The victim can’t see the messed up medical records to untangle them because of privacy laws that protect the thief’s information.

Mrs. Meiners son isn’t alone. Armour wrote about a Florida woman who was charged for a foot amputation who showed up at the hospital to point out her two feet to no avail. A man learned someone had stolen all his benefits when he was refused a prescription refill.

Armour continued, “Fueling medical identity theft is the surge in electronic medical records and data breaches at insurers and health-care providers. Medical identity theft—in which someone fraudulently uses data to bill for medical services—affected 2.3 million adult patients in 2014 versus 1.4 million in 2009, according to a survey published in February by the Ponemon Institute LLC, a research concern.”

EmergencyTo help stem the tide, insurance companies have formed a Medical Identity Fraud Alliance and the FBI, Department of Health and Human Services [HHS] and the Justice Department are also investigating, according to Armour. And hospitals are getting into the act she wrote.  BayCare Health System in Florida asks patients if they want the veins in a palm scanned which is then “converted into a number that correlates with the patient’s medical record.” Other hospitals ask to see photo ID and are increasing digital security. Medicare cards distributed by HHS will no longer imbed social security numbers or show code according to a law the President signed in April.

“Unlike in financial identity theft,” wrote Armour, “health identity-theft victims can remain on the hook for payment because there is no health-care equivalent of the Fair Credit Reporting Act, which limits consumers’ monetary losses if someone uses their credit information.” In Ponemon’s survey “65% of victims reported they spent an average of $13,500 to restore credit, pay health-care providers for fraudulent claims and correct inaccuracies in their health records.”

Armour reported that social security, Medicare and Medicaid numbers are sold on the black market for $50 vs. $6-$7 for a credit card number. The latter can be cancelled quickly hence the lesser value. “Sometimes, health-care providers are the perpetrators,” she wrote. “Federal prosecutors charged Dr. Kenneth Johnson with using Manor Medical Imaging, a Glendale, Calif. clinic, to write prescriptions for drugs and then sell them on the black market.”

Were you aware of this twist in identity theft? What can be done about it?

Identity theft 2

Service of Little If Any Assistance: Physician Admin Staffs Fall Down on the Job

Thursday, April 16th, 2015

Health admin staff 1

A friend, asked: “Have you done any posts about the outrageously discourteous way patients are sometimes treated by admin staff at doctors’ offices?”

I probably have, but neither recently nor covering any of these instances so I kept on reading as I trust you also will. I wish that her experiences were the exception. I fear that too many of us have similar ones to share.

She continued:  

health admin staff 2“I often wonder if these people are lazy, stupid, incompetent, or all three. Earlier today I brought Mom to a long-ago-scheduled appointment with an ophthalmologist. I called 30 minutes before the appointment to ask if the doctor was running on time with his appointments. I was told that he was. Mom and I arrived 10 minutes early, told the receptionist that we were there, then signed in on the clipboard. We spent the next 30 minutes watching patients who arrived after us get called in to see the doctor before us. When I checked the list we’d signed I found that four patients had signed in after Mom. When Mom asked the admin for an explanation, she was told there had been an emergency with a patient. That explanation may fly in a cardiologist’s office but I’m not buying it from an ophthalmologist.

“Although I wanted to walk out, we stayed so Mom could have her procedure. After it was complete and there was no longer a chance of alienating the doctor, I told him in so many words that his staff stinks. It’s unlikely we’ll go back. This won’t be the first time Mom or I have left a doctor’s practice, not because of an inadequacy on the physician’s part but because of incompetent staff.

Prescription“In another annoying medical-related incident, we learned that the results of Mom’s blood test, which had been performed March 25, still had not arrived at her cardiologist’s office as of March 30. We called the lab and learned that lab personnel had faxed the results to the wrong number. The transmission failed, of course, but apparently it didn’t occur to anyone at the lab to check the number on the test prescription or to call the doctor’s office and confirm it. Instead they did nothing whatsoever.

“Last week I received a bill for $240 for a simple procedure I’d had done in a dermatologist’s office. It was my first appointment with this doctor. I have a very pricey insurance policy that, in the past, always has covered this type of procedure 100 percent, so you can imagine my surprise at receiving this bill. Upon closer inspection I found a line that said: “No insurance information is on file at this doctor’s office.” Really? Was it my imagination that I spent 15 minutes filling out paperwork before the doctor saw me? Was I hallucinating when I handed the admin my insurance photocopiercard and saw her copy it on the photocopier?

“I try to give people the benefit of the doubt when it comes to a lot of things but this lack of courtesy and common sense by admins in medical facilities makes me absolutely crazy. I’m sure I’m not alone.”

My friend asks for strategies on how you navigate through the oceans of incompetency in this industry. I’d like to know if you’ve experienced similar inexplicable glitches, if there seem to be more nowadays or, on the other hand, if the doctors you see are backed by teams of efficient, smart administrators?

 health admin staff 4

 

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