(Acronyms)
TGIF: "Thank God It's Friday"
WTF: "What The F!ck"
DIAF: Die In A Fire
WTF: "What The F!ck"
DIAF: Die In A Fire
I have a simple job I like very much: coordinate enrollment of physicians in health plans. Mostly I create and track paper, a comfortable endeavor for someone like me who probably has OCD (but hesitates to cop to it because it would interfere with my dedication to being lazy). The problem with my lovely job is there are two faces of health plans: HMOs and PPOs. The HMO side is a breeze. The PPO side is nothing less than a nightmare.
PPO Nightmare
For starters, there is no director in charge of the PPO as there is for the HMO. That got dumped "temporarily" on a guy who is already overworked about 12 years ago. So the day-to-day stuff falls to me (which now, after five years, is fine, although at first it was scary as hell). Only that guy won't just let me handle it. He waits - lurks even - until the last possible minute, then second-guesses, pointlessly badgers, and nit-picks every little thing.
Four years ago, the president of the PPO Medical Advisory Board (the group of doctors that approves new physicians for membership in the PPO) died. He has yet to be replaced. He was the guy who signed the contracts, so I have four years of contracts, unsigned, waiting for either his replacement or the end of civilization, cluttering up my workspace.
The health plans keep buying each other, merging, splitting - and in all that, they lose our doctors. Just *poof* - gone. So I have to resubmit applications years later, and meanwhile their claims get rejected and they don't get paid for the work they've done, and their office managers call me - not the health plans - screaming or in tears or both to fix it.
And the doctors themselves do all sorts of cute footwork - going independent, then joining a different group, then going solo again, all without mentioning to us - and their claims get rejected and there is screaming and tears ... or they move their offices and don't mention it, and claims get rejected, and ... you get the idea.
Four years ago, the president of the PPO Medical Advisory Board (the group of doctors that approves new physicians for membership in the PPO) died. He has yet to be replaced. He was the guy who signed the contracts, so I have four years of contracts, unsigned, waiting for either his replacement or the end of civilization, cluttering up my workspace.
The health plans keep buying each other, merging, splitting - and in all that, they lose our doctors. Just *poof* - gone. So I have to resubmit applications years later, and meanwhile their claims get rejected and they don't get paid for the work they've done, and their office managers call me - not the health plans - screaming or in tears or both to fix it.
And the doctors themselves do all sorts of cute footwork - going independent, then joining a different group, then going solo again, all without mentioning to us - and their claims get rejected and there is screaming and tears ... or they move their offices and don't mention it, and claims get rejected, and ... you get the idea.
So all week I worked on getting an update ready to send out to the health plans. A few new applications, a couple of resubmissions, a change of address, and some terminations. It took longer to do than it should because (1) I am having a hell of a time adjusting to the medication I'm on and (2) all of the applications had expired licenses and I had to wait until I got updated copies from the office managers.
The "temporary" director signs the cover letters for these updates. I had printed them out Thursday afternoon and left them for him to sign. He signed them all, then when I went in this morning to get them, he asks why a particular doctor isn't listed in the summary of changes. Because of the medication I couldn't remember off-hand and had to go back to my desk to check the database; meanwhile he's talking at me about "he's on staff, he was approved by the Board, why aren't we sending out his application?"
Finally I get words in edgewise: "Because his license is expired and I haven't gotten the new one."
AND THEN he has the GALL to ask me, "Well, did you call them?"
The only reason I didn't quit right then was because two things tangled on my tongue: "No, dumbass, I figured I'd just throw his application away and pretend I knew nothing about it forevermore," and "You know what? YOU call them, I quit."
The PPO doesn't pay me a cent for the work I do, and easily 85% of my workday is filled with PPO crap. I'm done. Monday I'm talking to the HMO director (the HMO is the side that actually pays the temp agency to have me there) and let her know that either the PPO has to (1) get a director, (2) demand accountability from the health plans if not the doctors and (3) start paying me, or I have to no longer do PPO work there. Otherwise I have to quit. I can't handle that level of stress at work with everything else I am trying to manage; I'll be damned if I do it for another week for free.
Tune in tomorrow when I should be less cranky and getting to some overdue posts on August's Top Droppers, great blogs I found through EC, and my paranormal adventure.
2 comments:
It sounds totally frustrating. I hope you get it worked out because it sounds as though the one part of your job is enjoyable for you. No one should be doing excess work without compensation.
I'll wait to read the update.
Sara, good to see you back! Thanks also for your comment; I do enjoy my work, I just hate having to do things twice and doing the work of two people for free.
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