Unfiltered Story #57208

This happened a while back.

I work at a hospital. We’ve had a few meetings about how the computer system is being changed out to a new record keeping system that should make everything very easy. I think nothing of it until I get a call.

Caller: Your claim has been denied.

Me: What claim?

Caller: You were in on Tuesday for some lab work. The payment was denied.

Me: That’s odd. I get my insurance through this hospital. The doctor who ordered the labs works at this hospital. Why would it be denied?

Caller: It is not work related.

Me: No kidding. It’s pregnancy related.

Caller: Why did you file it under workman’s comp?

Me: I didn’t. I gave my insurance card to the clerk when I entered.

Caller: We have it under workman’s comp.

Me: Well, that’s clearly wrong. I gave my insurance card. I filled out my insurance information. Heck, I work here in the hospital so my insurance number is actually accessible in our system.

Caller: We’ve changed systems.

Me: Okay, that might explain why you can’t just look up my number from your desk but it doesn’t explain why you don’t have it on the form I filled out or from the input from the clerk who held my card physically in her hand.

Caller: Can you come down and bring your card?

Me: Yes.

I went down to billing and showed my card. She put it in the computer and I thought that was the last of it.
The next day I get a call.

Caller: Yes, your claim has been denied. You’ll need to make arrangements to pay this bill.

Me: No. My claim has not been denied. The labs are covered by this hospital’s insurance.

Caller: This is not a work related injury.

Me: Which is why I gave my insurance information when I got the labs.

Caller: We don’t have that.

Me: Yes you do. I gave the information when I got the labs. I gave the information yesterday by coming downstairs from my office with the card. I’m pretty sure you are the one with whom I spoke. I don’t know why you keep trying to put this through under workman’s comp. I haven’t had a work comp issue in 3 years.

Caller: When were you last in the hospital?

Me: I work here. But for medical issues, I had blood work, and ultrasound and, yeah, I broke my wrist at work on my birthday 3 years ago.

Caller: We only have your workman’s comp information.

Me: Did you try to submit an ultrasound as a workman’s comp claim?

Caller:…….

Me: I think perhaps the hospital needs to take another look at this new and improved computer system.

It did turn out that the system had not been designed to be used in the states. The US tends to use SS#s for many things, including medical tracking (not the insurance number but the tracking number). The system could not store tracking numbers with more than 8 digits. So it just did not save any personal information put in along with an incompatible tracking number.

It could, however, revert back to any previously stored information, thus throwing all my claims back to my last method of payment- workman’s’ comp.

Anyone who came to the hospital for the first time during that transfer period, likely got their medical care free as there was no record.
It was fixed shortly after.