Take the headache out of dealing with doctors and insurance companies. These time-saving strategies will get you on the fast track.by Nancy Kalish
The Problem: You Can’t Afford to Waste Hours in the Waiting Room
- See an open-access doctor. Some physicians have started offering their patients same-day appointments instead of scheduling weeks or months in advance. This discourages double booking and unclogs wait time, says Davis Liu, the author of Stay Healthy, Live Longer, Spend Wisely: Making Intelligent Choices in America’s Healthcare System (Stetho Publishing, $25, amazon.com) and a physician in Sacramento, California, who uses this system in his practice.
- Fill out forms beforehand. Ask the office to fax or e-mail any forms a few days before your visit. Bring them with you to the appointment, completed.
- Avoid the busiest times. Nab the first appointment of the day. “We tend to start on schedule,” says James King, M.D., board chair of the American Academy of Family Physicians, “but get behind because it’s impossible to predict how much time each patient will need.” Another good option? The first appointment after lunch. Days to avoid: Mondays, Fridays, and the days before and after holidays.
- Call ahead. Most receptionists are happy to tell you if the doctor is on time and, if not, how much later you should arrive. And if you do get stuck in a packed waiting room, it’s OK to ask if you have time to run an errand without losing your place.
The Problem: You Have a Question for Your Doctor but Don’t Have an Appointment
- Speak to your doctor’s nurse or the physician’s assistant. You’re more likely to get one on the phone quickly. He or she may be able to answer a routine question for you or relay it to the doctor and call back with a response. Be sure to give instructions that it’s OK to leave a message on your voice mail or with a person answering your phone, advises Liu. Privacy laws prevent doctors’ offices from leaving messages with others unless authorized.
- Ask if you can e-mail. Some doctors like to correspond with patients via computer, while others prefer not to, out of concerns for patient privacy or fears that an emergency will be missed. The receptionist can tell you if this is a good way to contact your doctor and, if so, approximately how long it will take for her to get back to you.
The Problem: Staying on Top of Insurance-Claim Forms Is Exhausting
- Create a master sheet for each family member. Fill in a blank form with all the basic information (name, address, birth date) and make several copies. Then, when you need to file a claim, just sign and date a copy and attach the doctor’s portion. Many insurance companies will even allow you to submit claims by fax, so you don’t have to search for an envelope or find time to go to the post office.
- Be sure your claim is complete. Missing details can cause the insurance company to bounce a form back to you. Check that your doctor’s statement includes his tax-identification number. “When a physician leaves this off, it may slow processing of the claim,” says Mary McElrath-Jones, a spokesperson for United Healthcare. And make sure the billed amount is itemized if there were multiple charges.
- Enlist tracking software. Often, even after careful reading, your insurance company’s explanation-of-benefits letter may not explain much at all. A product that helps: Quicken Medical Expense Manager ($50 for Windows only, quickenmedical.com). With a little information from you, it will check your reimbursements, deductibles, and flexible-spending account. And if you’ve been shorted, it will create a customized dispute letter for the insurance company.
The Problem: You Need to Fill a Prescription and Don’t Want to Wait at the Pharmacy
- Make sure the pharmacy has your current insurance information. “Incorrect data is the biggest time drain at pharmacies,” says Kristen Binaso, a registered pharmacist and a spokesperson for the American Pharmacists Association. “If you wait until pickup time to inform the pharmacist that you have a new insurance card, it could add an extra 15 to 20 minutes per prescription.”
- Ask if your doctor e-prescribes. Many doctors are subscribing to services that transmit prescriptions from a computer or a PDA to a pharmacy, cutting down on time and errors. Or ask your doctor to call the prescription into the pharmacy directly.
The Problem: You Have an Uncomfortable Ailment, and Your Doctor Can’t Fit You in for a Week
- See the nurse or the physician’s assistant. These professionals work under the guidance of the doctor and can treat simple problems. Some are even able to write prescriptions.
- Head to a walk-in clinic. No appointment is necessary at convenient-care clinics, which are popping up in retail stores and pharmacies across the country. They are generally staffed by nurse-practitioners and may be open every day. Most visits take 15 minutes or less and are typically covered by insurance. “These clinics are ideal for minor problems, checkups, and adult vaccinations,” says King. “But you should always go to your own physician for continuing care of a serious or chronic condition.” To find a clinic, log on to ccaclinics.org or call your local pharmacy.
The Problem: You Need to Go to the ER and Get Treatment Stat
- Call your primary-care doctor before you go. She can call the emergency room to let the staff know you’re coming, explain what kind of care you’ll need, and order tests ahead of time. “Of course, if it’s a true emergency, don’t waste time tracking down your doctor,” says King. “Call 911 immediately.”
- Be prepared. Every ER’s triage system ensures that the sickest are treated fastest, and there’s no way around it. “But having certain information can speed your treatment once you are seen,” says Nicholas Jouriles, M.D., president of the American College of Emergency Physicians. First, always carry your insurance card. Also keep a card in your wallet that lists all your doctors’ contact info and all your current medications, vitamins, herbal supplements, and dosages. “If you can, take along the herbal-supplement bottles,” says Jouriles. “I like to check the ingredients to safeguard against drug interactions.” In addition, bring a personal-health record with all your medical info. This will save time and help prevent treatment errors. Create a free one at medem.com (click on “For Patients,” then “Create an iHealthRecord”). Once complete, it can be printed out and saved online.
The Problem: Your Doctor Is Even Shorter on Time Than You Are, and You Want to Be Sure You Get an Accurate Diagnosis
- Make a list. Before you step into the exam room, write down answers to the following four W’s.
- When did you first notice the problem, and when does it occur?
- What does it feel like, and what makes it worse or better?
- Where did the problem start, and has it shifted location over time?
- Why, exactly, are you at the doctor’s office? (For example, maybe you want to know if you need to take antibiotics, change your diet, or cancel your vacation.)
- Be a concise storyteller. Doctors tend to interrupt patients less than 30 seconds into an explanation of their problems, which can bring them to erroneous conclusions, says Liu. Throughout your description, be as specific and focused as possible, he says: “ ‘I have chest pain’ isn’t as helpful as ‘Over the past two weeks, I’ve noticed chest pain on my left side, lasting 20 minutes, which I’ve never had before.’ ”
The Problem: Your Hospital Bill Is Error-Filled, but You Are Dreading the Hours Needed to Decipher and Dispute It
- Hire a pro. Hospitals can charge outrageous fees for services and supplies and can sometimes make billing errors in their favor. Often you can catch these mistakes yourself. But if a bill is too complicated or confusing, consider hiring a medical-billing advocate, who has the time and the expertise to scrutinize these charges. He or she will look for errors and duplications as well as any deviations from federal billing compliance guidelines, says Liu. Advocates charge $25 to $75 an hour or 20 to 30 percent of the amount saved on the bill. Generally, you’ll save money and time if the amount in question is more than $1,000. Find an advocate near you at billadvocates.com.
The Problem: You Want to Check Your Cholesterol Count or Blood Pressure Without Going to the Doctor
- Use a home testing kit or monitor. If you’re not squeamish about pricking your finger for a drop of blood, home cholesterol-testing kits, available over the counter at pharmacies, will give results in just minutes. However, a kit does not substitute for full lab work, which not only provides your total cholesterol count but also your LDL, HDL, and triglyceride counts. A good rule of thumb: If your result is high, see your doctor for further testing. Your blood pressure is even easier to test at home. Be sure to purchase a digital monitor with a cuff that covers at least half your upper arm. As with home cholesterol tests, if your reading is high, says King, schedule an appointment with your physician.
- living well.com