Hi Moshe, >A common occurrance in our office. We have a full time employee who handles >insurance, referrals, billing questions and collections. She spends many >hours listening to the music on hold, and messages about how our call is >important to them (if it was really important, why don't you pick up the >phone and talk to me?) While on hold, she usually takes care of paperwork >that doesn't require a phone call. Of course, she's not available to talk to >parents about other problems during this time, so she always has lots of >voice-mail messages to listen to. The more managed care patients we get, the >more time is wasted doing this. I'd love to hear some suggestions. A possible approach is to work with a managed care company to determine what "threshhold" of referrals it considers within its parameters. Try to structure an agreement with them that for as long as you remain at or under this threshhold, based on a rolling three month average, you will be exempt from calling in for authorizations. Should you go above this threshhold, you would have to call for authorization until you brought your experience back under the threshhold. This should appeal to the MCO on two levels. One, you are offering them the utilization rates they are trying to achieve and two, you are offering to reduce their cost of administration. If you are on capitation, you may then turn this utilization performance to your advantage by noting to them that since they don't have to do it anymore, they can give you the capitation they normally retain for such administrative purposes. Bill Braun --------------------------- Medical Practice Systems Inc. (216) 382-7111 (Voice) and The Health Systems Group http://www.hlthsys.com Mergers - Planning - Management Services Marketing - Managed Care - Education & Training