"Health Care Reimbursement"

I realize that this is a Hot Topic in Middle Georgia at this time. Now that I have your interest I would like to discuss a recent event in my life as I experienced it. Every three or four months I have blood drawn so that my Doctor can ascertain that the one prescription I use is doing it's job and that I also am not having any dangerous side effects.

First of all I have always had the blood draw prior to the Doctor's Office Visit so that we can review the lab results. Unknown to me the Office Manger for my Doctor's practice has established a new policy. You must visit the Doctor First and then the order can be written for the lab test. Then the lab work is done. I suspect that this also allows a double visit to the Doctor's Office rather than the one I have been doing for this prescription. Is this a money making scheme. I would hope not!!!!!!!

When I finally got to the lab for the blood draw the receptionist asked for my Medicare Card. I had it ready, along with my Retired U. S. Military ID so that they could also submit the claim for proper reimbursement after Medicare paid for only a portion of the procedure. I was quickly informed that their form only had space for one Insurance Vendor. I carefully, and I might add, cheerfully explained that during recent rejections of all or part of the Claim by Medicare I had to mail the rejection Explanation of Benefits form to the Business office of the Lab involved. They then processed the claim against "TriCare For Life." That is the one exception that this provider allows. They do indeed submit the refused or reduced Claim from Medicare to the TriCare for Life Claims Office. I know that TriCare for Life must then pay the balance. My concern and comment today and the reasons I am publishing this information for all to read are:

• Is our Health Care System so overburdened that they cannot submit claims to more than one vendor?
• I suspect that all of these Claims are done On-Line via the Internet so I really cannot comprehend the extra cost involved.
• I would think that it would be very simple for the Health Care Provider, in this case the Lab, to have two blanks on the form so that the Claim could be processed much more efficiently.

As it is, the Lab now sends me an Explanation of Benefits and I make a copy and put it in an appropriate envelope, put on a stamp and mail it back with note reminding them that I am a Veteran enrolled in the "TriCare for Life" program. That is the last I hear of that specific claim.

I am amazed that in their era of High Speed Data Processing that our medical care organizations from Doctor's Offices, the Laboratories they use and the Insurance Claims Processing Offices can not be more efficient. Is it that no body cares as long as they are paid? I would hope that this is not the case. But the evidence and procedures I endure to have my Health Care Providers adequately and properly paid lead me to believe that as long as it is simple for them, I must bear the brunt of their inefficiency. This is a Shame. Here we are in the 21st Century and I have to expend postage stamps and my health care provider must wait an extra week or two to be properly paid. Simply because someone, somewhere has set up a narrow minded simple system. I am always willing and ready to allow my Health Care Providers to copy my Medicare Card and my Retired U. S. Military Card so that they may be paid promptedly.

Why do we as citizens of this great Land allow this to continue?