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Cody1991

Cody1991

Registration / Insurance
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Cody1991 specializes in Registration / Insurance.

Cody1991's Latest Activity

  1. Cody1991

    Ghosts of the ER (Clerks)

    Since I came in to discover we’ve had three resignations in one day (!), I think they’re getting hip to it. Lol. (Or I hope, at least) Part of my problem may be that I’m quite shy so I hadn’t really ever even tried to talk to the nurses before. I was just trying to get my job done AROUND THEM or sat in silence at the station among them. Now I don’t want to be BFF but I guess I can bend some. I think I was guilty of playing into the power game. While it’s not A+ comfortable approaching them and talking to them directly – it did make the night go much much much smoother and every time I got the OK, I was never interrupted. And I technically got more accounts done than normal, so I think it was a kind of success! I guess that old communication thing isn't just a myth.
  2. Cody1991

    Ghosts of the ER (Clerks)

    I tried something different tonight. When I was approaching whatever area I was going to, I’d find the nurse and ask if it was OK to update them now. My script was “Hey ____ (their name), is it cool to update 138 now?” They would tell me, “Sure”, “absolutely” or “can you come back in a little while we’re about to do a procedure.” No one was exactly nicer to me but they did seem more appreciative and less intrusive. A few seemed stunned that I actually spoke to them, lol. Each time I couldn’t go in, I’d drop the patient back so that my timer didn’t keep counting. Management sent no messages over chat so I guess it worked out. The only time one came in was just to ask a question to the patient and they walked back out. Thanks all for help. I’ll see how it goes.
  3. Cody1991

    Ghosts of the ER (Clerks)

    Rumor has it that management worked registration for a few hours during two whole shifts (!) on the computer on wheels and came up with that number. 6 patients per hour (10 minutes.) One of the supervisors fought for 20 minutes but then the new manger hot-wheeled the computer around in 10 and got the rule going. A lot of the seasoned clerks said, yes but they chose to do it during the slowest part of the day and in PEDS where most of the patients had been seen before and were Medicaid and so quicker to do. I work 3p-11p so it’s insansesville.
  4. Cody1991

    Ghosts of the ER (Clerks)

  5. Cody1991

    Ghosts of the ER (Clerks)

    I probably wasn’t clear. Our doctors select patients charts electronically which moves them into “treatment in progress” from "waiting to be seen/triage" after they meet them and sign onto their chart. We aren’t allowed to update them until then. So, we don’t see the patient for insurance or co-payment until the doctor has screened. Typically, it may just be an initial introduction by the MD/resident. So their status changes before their care is even really underway. Problem is that once we do go into the room, the treatment is still underway so we’re constantly being interrupted. There’s rarely a period where there isn’t someone in the room and since we do have such strict time constraints, we’re often in a hurry and clashing with nurses. It's all pretty gross.
  6. Cody1991

    Ghosts of the ER (Clerks)

    We’re permitted five minutes between patients to “correct errors.” So, I usually use this time to print out all the necessary documents (stickers, KASPER, privacy, consent) and verify the insurance of the next two patients I will pick up in order to get the update done in 10 minutes. I typically know what their insurance is and what their copay will be before I ever meet them. I use the next five minutes after that to do all the necessary documentation of the last twos copays, rinse and repeat for my shift. A few of my coworkers wanted to kind of rebel against the new rules and purposefully take time to end the 10-minute rule. It seemed like a good idea until a person was verbally warned, written warned and then fired for ‘wasting time.’ Aforementioned “meeting”, we had the whole spill about ‘we’re taking this seriously.’ As I mentioned, each time a patient is discharged without an update we receive an F-rating on the computer. The only way to repair the grade is to successfully complete another. It’s very dog-eat-dog. So, the nursing stuff just kind of adds as an extra layer of agitation. And you’re absolutely right. It is a system that pits the work of another against the other. Toxic! But thank you for your words, I really enjoyed reading them and appreciate the time you took. I will take a lot of into consideration and work on getting a thicker skin. I’m also going to bring up some ideas to management or get HR involved if I must. The 10-minute thing is sort of producing a toxic work environment.
  7. Cody1991

    Ghosts of the ER (Clerks)

    Regarding the consent/privacy forms. These were originally taken when we registered the patient in front. But it was determined that all the paperwork was "overwhelming" patients who needed to be seen quickly and so this became a part of the update process in the back. The original model is: 1) Quick reg at triage 2) Introduce yourself to the patient after their status moves to "Treatment in progress" and do an update and get Authorization, Consent and Privacy signed. 3) Run the KASPER report, put new stickers in the chart along the aforementioned signed forms. Collect any medical records requests an MD has. 4) Run insurance, verify. Go back to collect copayment before patient is departed. But we have 10 minutes to do ALL of this. (This more or less emerged after some rotten apple clerks were spending 40-60 minutes per patient. They weren't actually updating, but just picking them up and hanging out on them so that they didn't have to do anything else.) So it's just not working. It will probably change.
  8. Cody1991

    Ghosts of the ER (Clerks)

    All our triage clerks do is get the NAME, DOB and SSN and Chief Complaint. We’re not allowed to take anything but a drivers license or ID at the front window. A triage nurse calls the patient back. Once their status goes from “Waiting to be seen” to “Treatment in progress” we can update/collect pay in the back. Usually, it’s a speed thing since we’re trying to get the consents signed before real treatment begins. Ideally, we’re supposed to run the KASPER report, put a new sheet of stickers in the charts and get the consents and privacy notices signed. Then we’re supposed to verify their insurance information, run that report and collect whatever copay when we can before the patient leaves. Our management has made it to where you do everything upfront in order to collect the copay and reach goals they have set up. I agree it’s an atrocious system and many of the longer-term clerks complain about how better it used to be when our consent forms were signed up front and payments were taken upon departure. They said it changed when the ER decided to move from clip-boards to bedside computers/registration in an effort to catch the rapidly discharged patients who were slipping out. (Keep in mind that I may do 30+ patients per shift and only 3 probably pay their copays.) Also, obviously, we're often working with a bare bones staff. We are supposed to have 12 updaters on staff at all times but the turnover is massive and we usually just have 3 or 4. It seems to be a mess and I’m not sure how to fix it since we recently had a group meeting and our management made it out more like a McDonalds and just reinforced how important it was for the hospital to be paid. The main registration manager actually said "It's fair game" regarding collecting payment. Something like, "If a doctor has introduced themselves to the patient and their status moves to treatment in progress, it's fair game." This new manager is the one who has enlisted the 10-minutes or less rule. The computer literally times you once you select "register patient" and management will send you messages via SKYPE about how fast you are or "what's taking you so long", etc. The only time they are lenient about going over 10 minutes is if the patient was greeked. I genuinely appreciate all the feedback.
  9. Cody1991

    Ghosts of the ER (Clerks)

    Hello, I read AN all the time. I’m a clerk in the ER (I mostly do bedside registration, co-pays, etc.) I really like the job and for me, I’m seeing all kinds of crazy stuff, meeting all kinds of interesting patients, it’s a step up from doing phlebotomy for years and nurse aide. I wanted to be a nurse for a long time, but I honestly couldn’t hack the schooling. I found it very difficult and stressful and dropped out. But, I’m still involved in healthcare and I’m making the most money I’ve ever made in my life with excellent benefits and I have a shift I like. However… I may be in a toxic work environment but the nursing staff in our ED are incredibly cliquey. They all go out to breakfast after work with the medical residents, play music in the station and dance around with each other and have a kind of fraternity/sorority vibe. Many of them are always making plans for daytrips and other bar-going type adventures. Many of them are in their twenties. No big deal but I’m starting to really get the feeling that they just absolutely think of us as scum. They interrupt us when we’re talking to patients, they almost crash into us (we have mobile computers we push around) as in, they WILL NOT MOVE, they wait for us to move one recently collided into one of our elderly updaters and didn’t even apologize. Each area of the ER has a nurses station where we have to sit alongside the nursing staff. They do things like throw our coats into the floor to take chairs (we don’t have lockers), never offer us any candy or anything when they do and won’t make eye contact if we ask them anything or even snap answers like we’re super annoying. They’ll even talk about us (Registration, not individually) right as we’re sitting there. There are a few nice ones but very few. My question really is just about nursing in general. If I’m standing in a room with a patient holding their credit card and the patient has a clipboard and is signing consents --- is it normal or right for a nurse to push in , not even acknowledge us and start trying to do an IV or distribute medicines? Last night, a patient was paying $100 in cash and the rest on credit ($150) and had cash in her hands and the nurse came in and said “You need to drink this” and handed her a little vial of some kind of gastro medicine. She had to literally swap hands with the money and wasn’t sure what to do so she handed the medicine to me because her table was too out of her reach, the nurse began checking her IVs. I said, “Hey, I’m almost finished, she’s trying to pay her copay…” and the nurse said (without looking at me) “She has to take the medicine now” and walked out. Completely ignoring that she had MONEY IN HER HAND and consent forms on her lap. I walked out to the station afterward and politely said, “I know the ER is busy and we get in each other’s way, but we have to work together.” She literally got up and left. A co-worker tried to explain to another nurse the other night that we had jobs to do , too and the nurse said, “Well ours is more important.” True but…? (We literally are being timed by management on how fast and efficiently we do registration and insurance.) I never know how to deal with this kind of interruption. Doctors do it all the time, too. Do you think it’s actually personal or do nurses just get so busy that they don’t even really notice us or is this just this ER or is this just a common thing? I think it must be trickling down from the charge nurse. She’s only 28 or so and has a mean girl attitude. Someone had brought in a tray of cookies for the ER as a thank you. And a tech was passing them out. She approached two of us (registration) and the charge nurse yelled out, “Nuring staff only.” It’s so demeaning. Like I said, otherwise I like the job. And if I’m being honest, like many, I’m relying on the pay to live my life. I try to ignore it but these things are starting to happen at least twice a shift. I’m starting to look for jobs elsewhere in the hospital in the paygrade. I really do admire nurses, I wanted to be one and I like working around them and helping them out. But this feels really dumb and hateful. I really don’t know how to handle it. Mostly I just let the nurse do what she has to do, smile and carry on after they walk away. But sometimes it’s so belittling that it takes me a minute or two to readjust to the blow. Even patients comment on how rude it is. Does anyone have any thoughts or helpful advice? I’ve heard that in a year, half these nurses won’t even be here, so it may just be a bad batch. A few evenings ago, a student doctor was so nice to me in the room that I felt like crying which is how I knew this has just built up... lol.
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