The Ups and Downs Of Work

Huuuuuh. What a day. I was working on trying to clear up some of the old claims for one of the offices. I spent an hour working on the old stuff for one particular patient, checking claims and verifying payment EOBs (Explanation of Benefits) and got it all figured out. There are several claims that were overpaid and we'll need to refund (small amounts, but it has to be done) and then there were 6 claims that had unpaid service dates. Called the insurance agency and spent another half hour, forty-five minutes on the phone getting it all worked out. Three are being reprocessed, three have to be resubmitted. But, I felt good getting it all straightened out.

Then came patient of the second part. I researched all the claims and determined what wasn't paid. Called the agency and spoke with Harold. We spent about 20 minutes with him getting information to check. (They never do this quickly, insurance agencies hire the slowest typists/customer service reps in the world.) He then asked if he could put the call on hold for "a moment". TWENTY minutes later, he came back on the line (you don't dare hang up, because then you have to start all over with someone new) and I could hear him tapping keys, and every once in a while saying, "Thank you for waiting patiently, just a moment". Five minutes later I asked if he was having problems finding the claim; he said no, but his computer system was still down .... =8-O FORTY-FIVE minutes on this call, and he couldn't even begin to get info for the claim??? I told him I'd try calling back later and he said that would probably be a good idea.

Went to break (I really needed it by this time) and called back. Got Sid, who seemed to know what he was doing. Only spent about 25 minutes on this call, and he determined that he was showing two different ID numbers for our company, and that is what was causing the problem. We had been paid for the April claim, but not Feb, Mar or May. Oh, these are 2007 claims. Totalling over $15k. All we have to do is call and correct our ID number, and he will have the claims reprocessed. YAY! Went and told Ms Manager, and she said, "Oh, we already know about this problem. It stems from when the Company A was purchased by Company B, and then by us. We've been working on this for quite a while, and will probably end up writing it off." Just like it was no big deal. Needless to say, I was not a happy camper.

And it is hot. Very hot. My only satisfaction?? Duh has chosen the hottest time of the year to start having hot flashes! HA!

Tomorrow Sis is coming over for a knittering day. I think we invited 6 or 7 others, but it will just be the two of us. Unless Rafe comes over, too. He may be canceling his D&D day and if so, he'll bring a book. We'll be meeting about 9:00 for breffist at IHOP. Yum, stromberry "creeps".