Friday, May 13, 2011

and I cried, like a baby!

The biggest compliment I can get at times is the one where people say they can never tell when I'm angry or upset. I always have a smile on my face. My grumpy mood doesn't need to affect everyone I come in contact with. That being said it usually takes a lot to bring me down. For me to show my emotions other than being happy. I'm pretty sure that's not healthy. In fact, I know its not. My hubs always tells me that I need to voice my opinion when something is bugging me. Instead, I will keep it locked away and bury it as far down as I can. Usually it will work, since I try to never speak in anger towards people. Sometimes, it comes back to bite me in the ass tho. I can only swallow these annoyances for so long before I explode! It's not pretty! We're talking hyperventilating, crying, sniffling, mascara running, puffy face, snotty nose mess!

This is where the story gets interesting... The other day I scheduled an older patient for an appointment for physical therapy. She explained to me that her secondary required authorization for her to be seen. She asked if I needed any of the numbers to contact this company and I said nope (first mistake) I figured I would call the number I already had for the company. Well, her insurance referred me to another outside company that handles the referrals for patients in the Southern Oregon area.

Since we were not contracted with this outside company and would also need to add us on to a payer contract, whatever that means, thats biller lingo. We are currently going under staffing renovation at work so we're a little short staffed to say the least. Charts are piling on my desk as well as coworkers desk & we're doing the best we can with the phones not allowed to be turned off at lunch, 5 physical therapists all on alternating schedules, 5 phone lines ringing, fax machine continually spitting out paper, prescriptions and reports being faxed to doctors offices and laundry (somehow, I can never escape that darn laundry) Needless to say, that chart slowly made it's way to the bottom of the stack (second mistake) I figured I had more time to call them and when I did get a chance to call them, they were on the east coast, fantastic!

On the morning of the appointment, I called the insurance company bright and early to get authorization and they said it can take 3-5 business days to get authorization to be seen. Are you freaking kidding me??? ugg! I faxed everything over with a very nice fax coversheet pleading/begging/groveling to get back to us ASAP! The nice lady I was speaking to in India (I can only assume) told me it would be best to cancel patients appointment because it may not be covered. Sure, awesome thanks bill! Yes, she gave me bill as her name. I'm 90% sure that's not her real name. Who am I to judge tho...

I called the patient up and put on my best customer service voice and tried to explain to the patient that unfortunately we would need to cancel her appointment because the insurance was not cooperating with me. Okay, I told a little white lie. I should have called sooner. Well, the patient called me on it! Apparently she is a retired nurse who knows everyone by name at this insurance company as well as their kids names! She proceeded to go off and tell me how I must be an idiot and I should have taken down the names and numbers of the people she had spoken with and if I hadn't been sitting on my ass (yes, she said ass!) this whole time I could have figured this out ahead of time. I was stunned, speechless, mouth agape! I stumbled over my words, offering apologies and I would get right on it and hopefully have an answer soon. Well, she went on to tell me she is a 75 year old woman with two bum shoulders and she can't just jump when I want her to. btw, someone should tell her not to use her shoulders to jump, maybe that's why they hurt... I wasn't going to point that out tho;) I'm usually pretty good at comebacks but I didn't feel this was the right time or place to do so.

After she was done yelling (she was out of breath) I was fearing she would have a heart attack. I didn't think to ask her if she had those emergency bracelts on. You know, the ones where the old have fallen and they can't get up?? I told her that again I was sorry and if she would like to speak with my manager she could. She hung up. HUNG UP! I was shaking and on the verge of tears! I don't cry very often. I've been called every name in the book and I can usually let it roll of my back, but this hit home. I knew I'd screwed up and I took credit for it but it wasn't good enough. I told my manager about it and she wished she was here to take over the phone call. She said I didn't have to deal with that and I should have hung up on her. That was a horrible, horrible day! Margaritas were definitely consumed that night!
Fast forward to today. The patient called back, again! AND apologized! I almost fainted! She asked if I could ever accept her apology, again stunned speechless! Of course I said yes and apologized again for dropping the ball on her. She said with that in the past she still wanted to schedule and she had talked to the insurance company and we had to see her first to get authorization. Umm, what?? So, we still could have seen her in the first place??! arg! She is now scheduled to come in and said she looks forward to meeting me in person. Whoa!! There's my long story for a hard week! I know every person is fighting a battle and that's why name calling usually rolls off my back but this was a week from hell and this is only a snippet of what happened.

I'm super glad it's Friday and Mexican food and more margaritas will be in the future, along with silly girl talk!

besos friends:)