5-7 Working Days to process Dr.'s Orders???

linearthinker, DNP, RN · Sep 2, 2011

Seems pretty standard to me. I am waiting on some government paperwork they told me could take 6-12 weeks. Consider yourself lucky.

xtxrn, ASN, RN · Sep 2, 2011

If they only had your info to process, it would be different :) You're probably one of hundreds stacked up on their desks. When I had to deal with the LTD paperwork, it took several weeks. That's how it works. Slow for those waiting- just another day of shuffling papers to them....

AgentBeast, BSN, RN · Sep 3, 2011

Bureaucracy:uhoh3:

xtxrn, ASN, RN · Sep 3, 2011

Unfortunately I got injured at work and had to fill out insurance forms for Short Term Disability as well as for Disability coverage that I have on a few financial products at the bank.
The insurance company had requested some further documentation from my physician in order to determine eligibility of the claim.
I picked up the three pages from my chart at the doctor's office that the insurance company had requested. As soon as I got home I got the fax cover sheet done along with a photocopy of the prescriptions pertaining to the injury. I faxed it all (5 pages including the cover sheet) to the insurance company at exactly 10:28 am, which was 09:28 am their time.
They told me on the phone it usually takes 24 hours to upload the documents into their system. Then I was told that the person overseeing my claim started her holidays today until September 20th. Another person was covering her. I finally got ahold of that person around 4pm and she indicated that it usually takes 5 working days to review any new information. That's 5 working days to review 4 pieces of paper??????
I then contacted my bank with regards to my loan and line of credit disability coverage. These documents were faxed on August 23, 2011. This guy indicated that it was loaded into their system on August 29, 2011 and will take approximately 7 working days to review.
I wonder what would happen if a Dr. wrote new orders for a Patient/Resident and the nursing staff indicated that it would take 5-7 working days in order to review and process the orders?

The people doing this don't deal with processing orders- they shuffle paperwork, and may not have any schooling beyond the company's training. The people who decide who can get a CT or MRI at some insurance companies are high school grads, deciding if a MD-specialist can get the test he/she wants for his/her patient.... just how insurance works. :down:

checker1981 · Sep 3, 2011

I work for a big insurance company and we say 14 day turn around time just to cover ourselves. For the most part we get the work done in 2-3 days depending on what is in our queue. We keep a few days of work within our queues so we don't have empty queues so people are not working. It's just the way insurance companies work. And it also depends on how their system works. If your claim is complicated people may skip around it "cherry pickers". I have seen work sit in our queues for 7 days before because people don't want to drop their hourly production if something wasn't done correctly. Maybe you can call them and ask them to increase the priority.

Kooky Korky, BSN, RN · Sep 3, 2011

Seems pretty standard to me. I am waiting on some government paperwork they told me could take 6-12 weeks. Consider yourself lucky.

I really don't like this type of answer. It reminds me of when our grade school teachers would punish the whole class for something that 1 kid had done.

2 wrongs don't make a right.

OP, hound them a little. Nicely, of course. Try to get a supervisor and that one's supervisor if you are suffering financial hardship. If you're not, I guess let it go.

Truth66 · Sep 3, 2011

Thanks for the interesting replies.

Oh I've been calling daily with both insurance companies. Some of the questions that they ask are so pathetically stupid.

For example, the latest delay involving the Short Term Disability related to medications. They couldn't figure out why, in spite of my injury, that I couldn't be working modified light duties at work. I indicated that based on the effects of the medications that I'm taking (narcotics for pain and a muscle relaxant for the tightened muscles in my back) my judgement is impaired at work. I can not work as a nurse while my judgement is impaired. Somehow they don't understand this, which is why they requested more documentation and delaying the processing of the claim. The documentation recently submitted included three pages from my chart and a photocopy of the three slips outlining the effects and side effects of the three meds that I'm on. All indicate the drowsiness effects of the medications and for some reason they take 5-7 days or more to read simple facts.

My Father-in-Law was over this morning and reminded me of a very interesting fact. If a person calls up an insurance company to take out insurance on something (whether it be life, disability, home, auto, etc.) the insurance company moves pretty quickly in order to generate a sale and having the benefit of another customer to pay ongoing premiums. Yet, when it comes time for that individual to collect on the insurance, the insurance company moves incredibily slow.

This reminds me of what happened when my mom was killed as a result of a medical proceedure gone wrong. The insurance company did pay the death benefit fairly quickly. However, when we learned that she had accidental death coverage and tried to collect that, the insurance company stalled for well over a month, even after we submitted a copy of the autopsy report to them. Finally after about a month and a half, I stated to the insurance company that she did not die of natural causes or from a disease/illness, she did not commit suicide, so unless someone is prepared to tell me that she was murdered in that hospital, it was accidental death. They paid out within a few days later.

One of these days when I'm able to sit longer at the computer I'll post on this site what happened to me. I think it would shock even some of the seasoned nurses here.

xtxrn, ASN, RN · Sep 3, 2011

Thanks for the interesting replies.
Oh I've been calling daily with both insurance companies. Some of the questions that they ask are so pathetically stupid.
For example, the latest delay involving the Short Term Disability related to medications. They couldn't figure out why, in spite of my injury, that I couldn't be working modified light duties at work. I indicated that based on the effects of the medications that I'm taking (narcotics for pain and a muscle relaxant for the tightened muscles in my back) my judgement is impaired at work. I can not work as a nurse while my judgement is impaired. Somehow they don't understand this, which is why they requested more documentation and delaying the processing of the claim. The documentation recently submitted included three pages from my chart and a photocopy of the three slips outlining the effects and side effects of the three meds that I'm on. All indicate the drowsiness effects of the medications and for some reason they take 5-7 days or more to read simple facts.
My Father-in-Law was over this morning and reminded me of a very interesting fact. If a person calls up an insurance company to take out insurance on something (whether it be life, disability, home, auto, etc.) the insurance company moves pretty quickly in order to generate a sale and having the benefit of another customer to pay ongoing premiums. Yet, when it comes time for that individual to collect on the insurance, the insurance company moves incredibily slow.
This reminds me of what happened when my mom was killed as a result of a medical proceedure gone wrong. The insurance company did pay the death benefit fairly quickly. However, when we learned that she had accidental death coverage and tried to collect that, the insurance company stalled for well over a month, even after we submitted a copy of the autopsy report to them. Finally after about a month and a half, I stated to the insurance company that she did not die of natural causes or from a disease/illness, she did not commit suicide, so unless someone is prepared to tell me that she was murdered in that hospital, it was accidental death. They paid out within a few days later.
One of these days when I'm able to sit longer at the computer I'll post on this site what happened to me. I think it would shock even some of the seasoned nurses here.

It's always about money- and the people processing your info probably have no medical training at all.... :twocents: :down: