I bow to you oh wise sages of case management. I am so green with this kind of CM!
Well, I did get the darn 3 pages of medicals from our company on the unco-op case. Got the name of a trauma doc. Called their billing dept, they were so happy to know it wasn't a self-pay, as she was originally recorded as, multi-trauma, out of it upon arrival to the ER, etc... In exchange, I sent the biller a PIP/AUTH for an itemized bill!! I alreday did the projection, but this will be handy for other cases. I am stating a binder, and them I will make a web site for FREE for new CM's!!!!
Then I called the hospital, same deal, got the bills, not too far off, but I fiugured two CT scans, she had head, sinuses, abd, pelvis, and x-rays TNTC!! So now I have a good idea of how many x-rays and CT scans are done on a multi-trauma as r/o basis.
I composed a letter to the doc, so when the insur co gets their bill, the doc MUST send a written report or record.
Do you beleieve we have to pay for med rec's from a hospital?? How cheasy!! $10 to search, then $1 per page.
I decided to call the radiology dept, sent her the PIP auth to get the written x-ray and CT scan reports. She promised she would send them, but didn't. I'll nag her again on Monday, NO fee either!!! So, just by some detective work, I will finally get some notes.
I had a great last 2 days. I was lucky enough to see great pt's, super-duper docs, and was very busy, and very productive. Also found out my critical pulm man is off the vent. I am sure he may yo-yo as most pt's who have been on long-term vent support do, but it's a step in the right direction. I'm really glad for him. He has a tremendous team of docs and nurses on his case!!!