Physician burnout due to bureaucrats

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According to Medical Guidelines, Your Doctor Needs a 27-Hour Workday (Published 2023)

Some doctors say that however reasonable guidelines may seem, their cumulative burden causes “constant frustration” to medical practice.

www.nytimes.com

 

[pmrmd]

I’m mostly burned out because of United Healthcare. SOBs deny everything.

Dicks.

 

[Pain Applicant1]

I’m mostly burned out because of United Healthcare. SOBs deny everything.

Dicks.

Do you mean deny prior auths, deny submitted claims, or both?

Do most of you in here follow up on your submitted claims or do you let the billing company/service manage everything? I wonder how involved most doctors are in billing.

 

[Ducttape]

If a prior auth is denied, then no charges should get billed....

Unless you are asking two separate questions...

 

[Pain Applicant1]

If a prior auth is denied, then no charges should get billed....

Unless you are asking two separate questions...

I'm wondering if they're denying his prior authorizations.
Also, separately, are they denying payments from the claims he is submitting?

I'm wondering if most people in here f/u on the medical claims that are denied or f/u on their claims at all once submitted. I work my billing from beginning to end so I understand how frustrating the process can be. I'm wondering if anyone else in here does the same. If so, I don't see how you cannot be burnt out with how much aggravation there is with billing. I bet less than 1% of providers follow a claim all the way through. If they did, there would probably be a revolution.

 

[pmrmd]

Denying PAs requiring peer-to-peers.

Huge osteophyte at C2-3? Too bad if you have them as your insurer.

 

[pastafan]

In 2022 UHC's revenue was 324.2 billion. Every day they delay payment they earn interest on the float. This is serious money.

 

[Sig123]

Did a Qutenza 9/2022 on a United patient w/ diabetic peripheral neuropathy. Prior auth approved. Still no payment. They keep denying. We will ultimately get paid but absolutely ridiculous that they are holding the $3500 payment hostage.

 

[MitchLevi]

Did a Qutenza 9/2022 on a United patient w/ diabetic peripheral neuropathy. Prior auth approved. Still no payment. They keep denying. We will ultimately get paid but absolutely ridiculous that they are holding the $3500 payment hostage.

Did this work?

 

[SSdoc33]

united CEO made $142M in 2021. not a bad little payday....

Former UnitedHealth CEO made $142.2M last year

The former CEO of UnitedHealth Group realized $142.2 million last year in what might be the biggest ever compensation package for a Minnesota-based public company. The pay for David Wichmann, who left the company in February 2021 after 17 years, was primarily in previously issued equity awards...

www.redlakenationnews.com

 

[DOctorJay]

Should probably load up on their stock

 

[Sig123]

Did this work?

On this patient specifically, minimal improvement.

But I've probably done 12 or so thus far.

All 3 post-herpetic neuralgia patients have been homeruns.

About half of the diabetic peripheral neuropathy patients have been homeruns also -- with overall improvements 50-80%.

Time commitment to do the procedure is minimal -- I schedule them on my procedure days and the MA takes care of most of the visit.

 

[10KHertz]

Yeah I hate united as well .
Almost dropped them due to delayed payments .
Then they raise my contract 20%… makes it a little better now .

 

[MitchLevi]

How do you get it paid for? I thought it was just for PHN.

 

[jsaul]

Did a Qutenza 9/2022 on a United patient w/ diabetic peripheral neuropathy. Prior auth approved. Still no payment. They keep denying. We will ultimately get paid but absolutely ridiculous that they are holding the $3500 payment hostage.

As the peer to peer doctor after granting approval always says "prior authorization is not a guarantee for payment " then I say " then why the **** did we go through this ordeal then"

 

[RoloTomassi]

Yeah I hate united as well .
Almost dropped them due to delayed payments .
Then they raise my contract 20%… makes it a little better now .

How did you go about getting that +20%?

 

[nvrsumr]

Almost dropped them due to delayed payments .
Then they raise my contract 20%… makes it a little better now .

Did u initiate the contract increase? Any pointers for anyone else looking to renegotiate? 20% would be a big chunk of change for me.

 

[Tboned]

As the peer to peer doctor after granting approval always says "prior authorization is not a guarantee for payment " then I say " then why the **** did we go through this ordeal then"

This! Such d*** strategy! Been experiencing this with Intracept. Approved after
Months and months of appealing. Payment only covers Pennies on the dollar.

 

[Orin]

How do you get it paid for? I thought it was just for PHN.

Approved now for painful diabetic neuropathy as well as PHN. 30 minute application instead of 60. No need for a block/topical.

 

[MitchLevi]

Approved now for painful diabetic neuropathy as well as PHN. 30 minute application instead of 60. No need for a block/topical.

Didn't know. I'll keep this in mind. Where do you place it? Generally on the feet?

 

[Ferrismonk]

We were using Qutenza for PDN for about a year now and it has been working well. That being said, we just stopped using it because we weren't getting paid at all. There isn't a specific approved billing code for Qutenza placement so there are several codes that they suggest you "can" use.

The most common one seems to be 64640, but this was rejected by our group and our billers because applying Capsaicin isn't really a neurolytic procedure. We tried just billing on time (99214/5), but this was denied by our billers because we were "doing a procedure" not just an OV. We argued around and around on this without success. The hospital also wasn't getting paid for the patch either despite it being authorized beforehand.

Rep brought good lunches too. Bummer.

 

[10KHertz]

Did u initiate the contract increase? Any pointers for anyone else looking to renegotiate? 20% would be a big chunk of change for me.

PM me . I’ll let you know what to ask for …