Some Whining

Just a few words of whining about the ways that insurance companies are driving me crazy. I am not solipsistic enough to think that I am the only one with complaints, but here are today’s aggravations:

A very large insurance company needs to ensure that I am recording the BMI (body mass index) in the patient chart as part of a HEDIS review. (If you are not familiar with HEDIS, Google it.) I have the data on hand so it takes about five minutes to complete the survey. I then attempt to fax the completed document to the secure receiving fax machine. No go – not a working number. Over the next few hours, I make several more attempts to submit the data. I felt no urgency to complete the task, but I simply wanted it off my desk. The next day I call the person listed as the project manager. Of course, the contact telephone number is the gateway to voicemail hell. But a miracle does occur – we receive a return telephone call. Several telephone volleys later the transmission problem is revealed: the receiving fax machine is out of paper. This very large insurance company prides itself on cutting edge data mining – and it’s using a fax machine without a memory? And collecting data on paper? Shouldn’t there be an app for that?

A very large pharmaceutical management company will only allow my patient to have thirty days of a blood pressure medication at a time, even though the prescription was written for ninety pills. This is an inexpensive, generic product that the patient has been taking for a long time. A trip to the pharmacy once a month is inconvenient and a waste of gasoline. An overdose is unlikely, and it’s even less likely that my patient would sell the pills or otherwise misuse them. The management company agenda is clear: collect a co-pay every month and while waiting for the pharmacy tech to return from break the patient will stock up on peanuts, magazines and small electrical appliances. My suggestion to the patient: just pay the retail price of $10 for ninety pills and completely bypass the insurance company.

An aside: mail-order pharmacies present their own challenges. My favorite: a patient who received his shipment of five medications quickly after we submitted the electronic prescription. Imagine his surprise upon opening the package: no lids on the containers and 450 loose pills in the padded envelope.