The perils of rehab

While I was at my rehab conference, I talked to lots of folks. One of the biggest issues was reimbursement.

Now I know why there are issues. If companies only hire for a bare minimum set of qualifications for their staff (see below), it's no wonder why all the case managers in the audience said they were coloring their hair due to it turning white prematurely.

Clinical Appeals Reviewer 
Job Description:

Primary Responsibilities:

    Provide expertise or general support in reviewing, researching, investigating,and resolving all types of appeals.
    Communicate issues, implications, and decisions with appropriate parties.
    Analyze and identify trends for Appeals.


Job Requirements:
Required Qualifications:

    High School Diploma/GED.
    1+ year of Telephonic Customer Service experience.
    1+ year of Healthcare Insurance experience.
    Proficiency with Microsoft Outlook, Word, and Excel, including the ability to create spreadsheets and filter data.

Preferred Qualifications:
    Familiarity with Medical Terminology

Funny, but no where did it say this person ought to be a nurse. You get what you pay for...just sayin'

More to come...

Mixin' it up...

Sometimes I am nice. I return calls, I do favors for my friends on the floor. I walk back to the unit from the SU with patients who are going that way, and their transporter's not there.

In fact, I'm getting used to the temporary office, and the fact, that I'm allowed to wander around to do my job. Yes, with stuff here, there and everywhere, I am getting my exercise walking. I need to walk anyway, since I sit for longer periods than I ever did while I was caring for people on the floor.

But if you try to tell me you're going to make me take less time doing my job to make you happy, Big Boss, I'm going to tell you the truth. You, nor your providers will get reimbursed for me or that SU work you're volunteering me for 'cause it ain't codeable. (Thank you coders and Ms. SU Guru for teaching me all the magic words to say about provider workload.)

I am here for the SU patients, you know, the rehabbers you wanted me especially for in the first place.

And if you think you're gonna mess with my people (even indirectly), you're gonna have to deal with me: She who will not be cowed.'Cause all these other coders and assorted folks who get you money are banking on me.

Any questions? I didn't think so...