PFFS Suspension lifted

[Frank Stastny]

I just talked to Anthony and I asked him to post comments here. He has the answers to a lot of the questions.

I figured it would be best coming "straight from the horses mouth".

 

[Frank Stastny]

All it takes is one call from the senior to their doctor and hear "I don't know if we take this or not" and it's over.

That has happened a lot. I went to my doctors office and asked the girl who answers the phone and greets patients if any of the doctors were taking any of the PFFS plans. She immediately said no. I then asked her if she knew what they were and she sheepishly said no.

I have zero tollerance for ignorance and incompetence.

I then asked the doctor and he said they were. I suggested that he explain that to the "girl in the front". He said he already had done that. I told him he better do it again using cartoons this time.

The problem is that someone calling will not get to talk to the doctor.

A business is only as good as its weakest employee.

 

[Crabcake Johnny]

Fantastic post and why I don't sell dental discount. It's the fastest call in the world:

Client: "I just signed up with this Careington plan and need to schedule an appointment."

Receptionist: "Careington? Never heard of it and we don't take it."

Client: "Oh, but you're on the list that got mailed to me."

Receptionist: "Never heard of it, we don't take it."

 

[Slick]

The fact that PFFS is accepted on a case by case, patient by patient basis, proliferates the point. Ask a different person, get a different answer. The timid will leave at the first "no".

 

[Frank Stastny]

The fact that PFFS is accepted on a case by case, patient by patient basis, proliferates the point. Ask a different person, get a different answer. The timid will leave at the first "no".

Yep! I have found that to be an even greater problem in the country where there has never been an HMO.

Since the "girls" that work for the doctor don't have a clue what it is, they CYA and just say NO!

 

[Crabcake Johnny]

Then don't doctors still have the problem that many use 3rd party billing services and even they don't know how to process the claim.

 

[tommyk]

I always talk to the person doing the billing. They seem to understand what is going on. I provide them our billing number and they seem to be fine with it. If they have any additional questions they can call the home office. Usually they do not want to loose patients they have established and really will work with you, BUT you have to talk to the right person, most of the time the Doctor's don't know what plans they accept.

 

[Slick]

Then don't doctors still have the problem that many use 3rd party billing services and even they don't know how to process the claim.

If it makes it to billing, the provider has accepted the T&C.
The billing people should be out ahead of the doctors.

 

[Crabcake Johnny]

Yet I still get clients who call where the doctor didn't run the claim through the network first. They get all wound up when they get a letter of denial from the insurance company with a note that it needs to be resubmitted through the network.