family practice issues and general life events

Posts tagged ‘computer’

Is there anybody out there?

There is an ever increasing number of patients that I see, that are feeling all alone.  A little crazy, sad, depressed, etc.  And I wonder if it is a recent phenomenon or if I have just been unobservant, and it has been there all along.  Or if it might be due to more patients being comfortable enough to open up about it.

Or if it might be our ever increasing need to broadcast every part of our lives.  The need to post countless pictures and status updates on Facebook, tweets on Twitter, checking in on FourSquare, is it a need to be seen or is it maybe a sign of a need to know that someone cares.  Maybe it is a way to connect, and yet the connection can often feel empty in itself.

There is no one who needs to know what you ate for lunch, and yet I would venture most of us have posted pictures of a meal or two.  (I am just as guilty.)  And not all thoughts are gems.  And something posted carelessly can come back at you in the end.  But maybe the problem isn’t social media, maybe it is merely allowing us to see what many of us keep hidden just beneath the surface.

The danger in this is that we become immune to posts that appear to be attention seeking.  The person who posts “I just want it all to end.” may not be taken seriously when they are at their lowest.  And yet, I am sure many of us have seen these posts.  But if that is your way to connect with others, it is probably not going to save your life, because if someone were to decide that you were serious, there is the potential delay between the time posted and the time they try to find the appropriate authority for help.

And then there is the thought that many are posting just for attention.  Of course you want attention, but is that the healthiest way to get it.  From strangers and acquaintances?  Does it mean something if they don’t really have a personal connection with you?

There is something to be said about true human contact.  I know telemedicine is supposed to be the wave of the future, a way to get specialists into communities that would not otherwise happen.  And maybe it will work eventually, but living in a community where the psychiatrist is a “Doc in a Box” does not appear to be overly satisfactory to patients.  There is something to be said about human contact to help with healing patients.  I cannot tell you how many patients ask me to take over their psychiatric needs because they don’t care for their “Doc in a box.”  They don’t like talking to the box.  Something always seems to be missing in those relationships.

Human contact is under-rated in this rapidly changing environment of social media and electronic medical records.  While I think EHRs are a good thing, the biggest complaint patients have when their physicians change is that “they are no longer talking to me, but they are looking at their computers.”

As humans there is a need to know that someone cares, that someone is out there.  Unfortunately we are teaching the next generation not to go outside and play, but to make connections online.  And how much can you truly know about someone that you cannot see, and have never met.  There is much to be learned from facial expressions, from posture, from touch.  These cannot be duplicated from a machine, and a “there, there” on a computer screen is a poor substitute for a pat on the shoulder.


Computers hate me

This post is all about computer problems, but truthfully the biggest problem is the user, ME!  now this is not just a made up issue, but I have the ability to cause computer problems while just touching a computer.  For example, when my new tablet was set up, they (our computer people) forgot to hook it up to the printers.  Well no problem I could do it.  So I attempted to install the two main printers I needed.  Well one worked just fine, the other was apparently missing a driver, so I attempted to download it from the site.  No bueno.  It did not work at all.  

So I could not print prescriptions, orders or anything.  So one afternoon, when the hubby was out of the office, he let me borrow his tablet for convenience.  And the next morning he complained that I had somehow changed his font.  (Which I hadn’t touched)  In fact, he tells me that whenever I have used his computer in the past, I manage to alter it in some ways. I truly have no idea how.

And then there is a problem of converting between computers.  While at work I use a tablet with a touch screen.  So you can only imagine how foolish I feel at night, on my laptop (not touch screen) when I am tapping the screen with my finger to get the cursor where I would like it to go.  Weirdly enough, the tapping doesn’t work.  And it isn’t really great at the office, because my new tablet is too sensitive sometimes opening up internet websites when I graze it.

I had planned to get off the information super highway at 25.  Like my parents did.  (Though they were also dragged back on it themselves)  I knew how to do web searches and email, what else did I need.  And while I was an early adopter of medical records, well that was more out of convenience than any attempt to be at the forefront of technology.  I tried to avoid Facebook, didn’t understand Twitter, never was on MySpace, and have gotten to the age where as a kid, I used to think of as old.

Anyway, I am on the highway, but don’t see an exit, so I will continue to deal with my errors.  My most common one?  Now whenever I do a formulary check, it freezes my system.  I am hoping when we do our next upgrade that will go away, but in the meantime, I will stop attempting to check formularies.  I already use Ctl-Alt-Del way too much as it is.

What is the funniest thing to me about this whole issue?  Well I have been asked to speak about the implementation of electronic records and how to receive the incentive bonus from CMS, twice.  I am the expert, and I would swear the thing hates me.

My 5010 nightmare- maybe coming to a close?

It has been a little longer than normal since I have posted, and my excuse is that I have been busy.  Not that everyone else hasn’t been, but well work life seems to have been busier than normal.  Previously, I have written blogs about a firewall that was blocking payments and how I could not get through, and that maybe things were finally getting better and they are.  This week we finally got our first check from Medicare for claims since 12/19/2011.  It was for $12.45.  Woohoo, I can finally retire!

I laugh because I actually think that it is hilarious, all this time and work, and complaining about not getting paid for almost 3 months, and when we finally get through, the amount is not quite the amount you expect, because the deductible started over on January 1, and most of the claims on that sheet went to deductible.  All this work and time waiting, listening to the crickets chirp.  Or wishing their were crickets chirping, because it would be something better than silence.

After this time, arguing with the clearing house about their responsibility only to be told to look at their website, which for the longest time said absolutely nothing, and then eventually outdated and somewhat misleading information.

First it was my fault, no, it wasn’t.  I did all the steps, I was told were required for a smooth transition.

Then it was my EMR vendors fault.  Well,. they sent me a new update on January 1, which was downloaded within that week.  Followed by one more update the end of the month.  So maybe slightly- though I did send them a not so nice email as well during my frustration, to which they replied within 10 minutes intially, and then 5 more times within 30 minutes and able to fix the problem by the next morning, and considering it was 5 pm when I sent the first email, I was happy enough with their response.

So that takes me to the end of January, where the clearinghouse has yet to notify me of any problems, or to answer why I have not heard anything in a month from ANYONE (insurances included) to looking at my balance sheet saying “Holy (insert profanity here)!  Why haven’t I gotten paid.  How am I going to make my bills, pay my employees, …”  To only get told I am 1700 in line with a waiting time of 7 and a half hours.  Well that was when their system did not cut me off and hang up on me.  And after all that time I was on hold what was their answer.  “Well you should look at our website daily.”  Well at least they are consistant.  Though they continue to refuse to answer my question “how can you take my money without at least warning me that there is a problem?”  Their answer is still I am sorry for your difficulties and your disatisfaction, but we post things on our website daily.  You should read that.  And when I threaten to leave them, it isn’t any better.  Still with the damn website quote, and does not answer my question, and that I am required to give them 30 days written notice.  Which I will, as soon as I know I am up and running with the new group.  Just have to wait for Medicare approval.

Finally, the clearing house appears to have gotten their job done (only 60 days late, and not willing to take any responsibility).  However, that day Trailblazer crashed.  Nice.  It takes them about 4 or 5 days to get back up and going, and then we get messages that we are not an eligible provider.  Apparently even though Medicare claims that our contract is still good so far this year (we will have to renew this year, it is just not our turn yet) Trailblazer has forgotten to tell us, we need to sign a new form.  OK done.  Now for the new denials- all of our claims are duplicate claims.  Seriously?  It is a wonder, I haven’t gone postal yet.  All of this, filing and refiliing, denials and everything else to get the anti-climatic check of $12.45.  Awesome

However, I have gotten in contact with some great people that have helped.  Apparently, I helped my professional organization find out there was a problem, and they narrowed it down to Trailblazer having the biggest issues.  They determined that the physicians in Oklahoma and Texas appeared to be having the biggest problems.  Talking to some billers across the country, those using a clearing house seemed to have more problems than those that didn’t.  So guess what?  I had both issues.

And in the middle of this all, apparently Trailblazer is installing new software to help fix the problem (which apparently started last year)  I have heard from my congressman and Senator and one state Senator, but since things are improving we are hesitant to have them do anything.  Because there is no desire to cause further stalling on the issue, especially now that payments (did I mention $12.45) are finally slowly coming in.

As for my relationship with my clearinghouse- Well it will come to an end when I receive approval from Medicare for my new billing company to file how the prefer to do it.  After 6 years, I think it is time, and my loyalty apparently means little to them.  But I did let my colleagues in the area know that their clearinghouse was at least partially responsible for them not getting paid.  Helpful website indeed.

But I had good news on Thursday, I finally had enough money to catch up all of my bills.  I didn’t have to take out a loan.  I still didn’t get to take home a paycheck, nor did my husband, but maybe next month.  It is really sad that Wednesday, I saw 40 patients, and my hubby saw 33 patients in the office and 7 in the hospital, and we were longing for the days that we saw 17 and took home a paycheck.  But maybe as things start rolling, we will be able to see some of what we have worked for.  I hope so, because I didn’t go to medical school hoping to support 6 other people and not get paid myself  (we are now down 2 employees, after one dying at the beginning of the month, and the other being fired).

Anyway, as the computer glitches resolve, we will move foward.  Looking ahead to the crashes and glitches that will come with the conversion to ICD-10.  Oh happy days ahead/

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