I really had to laugh at one of my clients.
Great guy with an absolutely dry sense of humour.
He’s also from what I call the “brain the size of a planet” school.
He was explaining his requirement for multiple CCSD codes to be pre-authorised in respect to a procedure he intended to perform the following week.
He explained why, due to the patient’s condition, he wasn’t at all sure which procedure and/code he would actually perform.
There were multiply big words in his explanation which I couldn’t even pronounce let alone spell in a blog post.
It would only be in theatre, when he would know the procedure he was going to perform apparently.
Have you any idea how much of his explanation I understood.
ZERO
None of it.
Moreover, I don’t need to.
All I needed to understand was as follows:
- which patient?
2. what are the proposed codes?
From that, I could call the relevant insurance company and confirm the patient details.
Then I could advise them of the codes in question, the date of the procedure and what I’d do post-procedure.
Post Procedure
After the procedure, I’d have the consultant tell me which codes he performed.
Then I’d have him send me a letter addressed to the insurance company explaining why.
Following that, I’d have the theatre notes and the anesthetist’s notes sent to me.
And then I’d forward the whole lot to the insurance company.
Simple really.
And that is precisely what happened.
Once I’d done that, the insurance company agreed for the codes to be invoiced, in the right order and at the right total fee.
It’s even better now for the MHM client is being paid next week.
One happy consultant surgeon.
Ringing Phone
Skip forward to yesterday, when the consultant called me.
He’s very grateful he’s getting paid and in full too.
But he couldn’t understand why I could do all that without understanding what the codes actually meant in medical terms.
Basically, because I don’t need to know.
And I’m certainly not prepared to spend the next 12-15 years at med-school learning all about surgery until I do
No, all I need to understand is what codes, when and then I’ll tell you how much.
Pragmatic
The consultant made me smile though when he thought it a much better idea if he stuck what he did best and let me stick to what I know best in the future.
pete@medicalhealtcharemanagement.co.uk