Clear Stream

Clear Stream

Wednesday, January 4, 2017

Electronic-Everything Will Kill Us


Logged into a payer-sponsored web portal for eligibility and claims yesterday. Big red statement at the top "It's time to update/verify your credentials for Florida Blue". This painful process, even if no practice demographic data has changed, must be repeated every 90 days, they claim due to a mandate from CMS. I didn't bother to look up the actual CMS mandate, why fight every single battle that presents itself? And believe me, there is a potential fight every second of every day in medicine. I presume this is to fight fraud, to verify info, to avoid a cataclysm. The insurance company can point to this and say, "see, we have a system to keep our providers accurately enrolled and processed" but every 90 days seems like overkill. It can certainly be every 180 days, with the caveat that any changes you must log into the portal to report the changes in your demographics--you moved, you got a new last name, a new phone number, etc.... no more inaccurate networks of yesteryear, now we're into the overkill of verifying your existence every 90 days.

What if you're dead? Who logs in then? Just a question.....

After logging in, I then have to log into the verification center using different "provider identification" numbers. Then I get error messages--oops, try again later. So I try again later and after 7 times I'm able to get into my screen for my practice. Then I labor through every sub section that has to be re-verified, clarified, and updated, even though in 90 days I didn't get a new phone, didn't have my license up for a new renewal, didn't change a single thing. I get to the end, then I have to upload government issue photo ID to show that I'm me ( my drivers license). Then I can print and submit this monstrosity after reading a tiny print waiver/disclosure, like the one you get but cannot read every time your iPhone IOS updates. So I click yes and then again, "oops, we are having difficulties, try again later". NOOOOOOOOOOO.

By now 3 hours have elapsed and I'm doing this in between patients, phone calls, and the every day running of a practice. I'm in the red-zone--furious, angry, and frustrated. I call them and try to get a human to see what the trouble is. On hold for 45 mins through different menu punching options. Then I get a person and explain the predicament and nightmare. She blithely tells me, "you're fine, doctor, we got your submission, we've had many phone calls and many problems with the system today". So why didn't you update your website to say so? Why force the issue and have people plodding through it like wet cement? Too bad. We don't care. We don't have the staff. No apologies, no explanations. Shut up doctor, you did it and can move on.

Every 90 days this kafka-esque must be repeated.

Government mandates have paralyzed all of medicine into this horrible nightmare, and I pray every day for the demise of the dysfunctional mess.