Saturday, January 28, 2012
Claim denied due to duplication of care. Services payed already to emergency physician.
I shook my head in disbelief.
The notification that John was in the emergency room came blinking across my screen. Of course, he hadn't called me to say anything was wrong. I looked down at my watch. I could be out of the office and in the emergency room in five minutes.
I ran down the steps and pushed my way between pedestrians as I crossed the hall entering the emergency room. The morning rush had yet to materialize. John was one of the only patients.
I scanned through the nursing notes and the emergency physician's impressions. A cat scan of the chest was already ordered. When I entered the room, John was sleepy from a dose of morphine. We discussed his chest pain. Although he felt a little worse then usual, it was the same pain that had been present for years. I palpated his right rib cage and he yelped in pain.
His labs, EKG, and chest X-ray were normal. When I perused the medical record further, I found that the same emergency physician had scanned his chest the month before when he showed up with a similar complaint. In fact, He received five CTs in the last year. Surprisingly, none of them showed a pulmonary embolism.
It took a few moments to find the ER Attending. When I questioned her about the need for another cat scan, she looked at me appraising.
He said he never had chest pain before.
I gently reminded her that she saw John recently for the same complaint, and she started to blush.
I discharged John with a diagnosis of costochondritis and a prescription for a non steroidal anti-inflammatory. By the time he followed up a few days later, his pain was gone.
As I see it, I saved John an unnecessary dose of radiation and IV dye. I relieved the emergency room physician by doing her job for her. And I reduced the cost to the insurance company by hundreds of dollars.
Apparently the pittance I bill for my services,
is asking too much.
Posted by Jordan Grumet at 6:43 PM