Hello I am your nurse, and how will you be paying for this?

[Mama Val]

I have a question because I have never had to do this before.

I work in a alcohol/drug detox center and when we admit our patients we are supposed to have them sign their admit paperwork on admit. Now I have always been taught that if a person is incapable of makeing a clear decision then the signature is illegal. I think someone who is intoxicated or in withdraws is in no shape to be signing paperwork, but we are damned if we do and damned if we don't. I understand that if we were in an emergency room then it would be allowed.

Another think I really don't like is when we admit the patient we get their medical history and then we go over the payment sheets. I don't think I should have to get this patients medical and financial history. I feel that it put me into a conflict of intrest;yes you can be treated but how can you pay, if you can't pay are you going to leave or stay and lie on your paperwork and worry about getting found out and going to jail or not being able to come back here when you have to come back next month (sorry for the long rant) Our billing department thinks its easier for the nurses to get this paperwork done when the person is admited, they are too lazy to walk across the building to do their own paperwork. I am not a billing clerk, if I was I would have nicer looking shoes and a bigger butt.

[renerian, BSN, RN]

Aussie -A grand for that..............wow that is good. I had my hysterectomy in 99, two nights stay with complications for a total of 30,000. I had insurance but my portion took a payment schedule to cover........

renerian

[OC_An Khe]

If you were getting paid directly from the patient / insurer carrier instead of by your employer, wouldn't you want to have the information on how the patient will pay? I don't know a MD or any other healthcare professional or institution who don't know or ask this question.

Does the US ration healthcare this way or not treat uninsured? You bet we do and everyone of us is involved in these practises. Conflict of interest goes on everyday. You may not be aware that it does (although you should be) as most places gather this information before the patient hits the floor. What do you think RN case managers do?

All RNs should be aware of the money aspect of the profession, unless you want to work for free, or non liveable wage, with no respect given to the profession. This is how our system works.

Now if you want to change the system....well, that's a different thread.

[NRSKarenRN, BSN, RN]

Grommett= Eustacian tubes in US language and they sure did help my then 18 month old!

[sjoe]

ocankhe writes: "If you were getting paid directly from the patient / insurer carrier instead of by your employer, wouldn't you want to have the information on how the patient will pay? I don't know a MD or any other healthcare professional or institution who don't know or ask this question."

It seems to me that most of us realize that healthcare has to be paid for one way or another (and we are usually NOT donating our own time and skills in order to keep costs down).

But for many nurses the question is whether we are to serve as billing clerks or financial screeners as well as nurses.

In other words, are these duties a legitimate part of nursing responsibilities, or is the facility obligated to provide clerical employees to perform these tasks? As ocankhe indirectly points out, we are NOT getting paid directly by the patient/insurer carrier, so why would we be involved in financial screening?

I don't think anyone argues that, given our present "system," these tasks do not need to be performed, but many nurses believe they already have enough things to do without getting involved in this.

One of the things I liked about working for the VA, corrections, and later, Kaiser, was the fact that insurance and financial matters were NOT a part of anything I did and I did not have to even think about them. (I had enough other things to do, goodness knows.) The facilities dealt with these matters, which was IT'S proper responsibily, and NOT a responsibilty of nursing.

IMHO.

[canoehead, BSN, RN]

I think that in some cases the patient would be reluctant to reveal information that would be pertinent to the nursing diagnosis (homelessness, unable to pay for meds) if nurses also act as stand ins for the financial dept. It could ultimately create enough readmissions to make it worthwhile to add the extra person on nights to seperate care issues from payment issues.

[renerian, BSN, RN]

I wanted to add in home health I have had to collect money from clients as well as checking their medicare/medicaid/insurance card and do indigent work ups. Came with my job. Alot of nurses did not like doing it. It did not bother me.

renerian