>In a message dated 97-08-17 11:57:08 EDT, (Dogwood Ridge) >writes: > >> It was at lunch that I found out that all this time it >> was the speaker phone on hold to an insurance company. I somehow had >> missed the timed interruptions to the music that stated "your call is >> important to us, please hold, calls will be answered in the order that >they >> are received....." How do you handle these referral calls- I don't think >> that I refer that much but I sometimes need these wise subspecialist's >> help. > >A common occurrance in our office. We have a full time employee who handles >insurance, referrals, billing questions and collections. The more managed care >patients we get, the more time is wasted doing this. I'd love to hear some >suggestions. > >Moshe Adler, MD > > Do any of the managed care companies have a FAX authorization option for non-emergency referrals. I only belong to one IPA for HMO patients (the rest are PPO's which do not require pre-authorization) and they have a form which is faxed to a central number. The committee (made up primarily of MD's) reviews the request and the authorization is usually given in 3-7 days. For emergencies we call and have never had a problem getting an immediate O.K. The local orthopedists have even realized they can treat first in a true emergency (I had a 10 year old who's fractured wrist was sort of hanging at a 90 degree angle and didn't particularly want to wait the hour of so it still takes for an emergency authorization). If none of the companies have this available and there is one particular company you deal with frequently, you might see if they could set up something like this . I also saw the suggestion by Bill Braun which was very good. You might also see if there are any procedures they would consider allowing you to order without any authorization, period. My IPA removed plain-film X-Rays from the authorization category after it was determined that 99% of the requests by all the provders in the group were appropriate and the process of authorizing plain films became a waste of everybody's time. Michael Sachs, M.D.