Hours of Daylight – 15:30

That the health care system in this country is completly and utterly broken is not news, but the many and varied ways it’s broken continues to amaze and depress me. A big problem can be found in the interface between humans and computers. The problem is coding. See, when you go to a primary care doc and have a check up and some tests run a human builds a menu of what was done. But that menu is written in Doctor Scrawl… or, better, but only just, Nurse Scrawl. That scrawl is then translated by a human into codes that can easily be stored, retrieved, cross referenced and BILLED by computers. These codes can be complex. And, like chemistry, one missing piece can be the difference between life and death.

Some time ago i visited an internal med practice here run by St. Luke’s. Remember there are two hospitals in Boise: St. Luke’s and St. Al’s. If you’re seeing a doc here they’re affiliated with one or the other.

The completely uninpressive doctor there gave me a cursory going over and then, at my request, arranged for a cholesterol, thyroid, and tryglyceride tests. The even less impressive phlebotomist came in and despite a good vein failed to get a good stick. Her boss had to come in and give it a try. After four or five more sticks i filled the little test tube.

Now, months later, the bills have been coming and coming and coming. See, either the doc, the phlebotomist, the receptionist or (my new least favorite person on the earth) the Certified Medical Records and Informatics doofus incorrectly coded the tests. Preventive testing is covered by the paltry insurance we have out here. They did not code it as preventive. Annette, in an escalting series of frustrating phone calls, has been desperatly trying to get these two camps – the medical practice on one side, and (our favorites) the insurance company on the other – to straighten this mess out. The pratice insists they coded it correctly, but the insurance company insists it has been coded incorrectly. But here’s the thing: the insurance company will not state what it has been coded nor will they tell Annette what the correct code should be. So, in theory, this is a stalemate. The pratice says they’ve done their job correctly. The insurance company says the the practice has not and will not elaborate. Of course it is not possible to get the practice to talk to the insurance company. No, that would be a waste of time and resources and is not in the job description of the highly trained health care professional staffing the desk at the practice.

This thread will continue.