insurance requires an order from a doctor with admitting privileges at the hospital called a PSO. Physician Service Order. if that order is not placed and signed BEFORE you are put into an inpatient bed there is a very good chance your insurance will deny the claim.

most patients go from surgery to what is called the PACU - post acute care unit. that's where you wake up. usually the doctor will place the PSO once you are in the PACU.

however there are many patients that due to the nature of their surgery will go straight from the OR to an ICU. Like a patient who just got an organ transplant.

we are trying to fix an issue where due to timing that PSO might not get place BEFORE they are in an inpatient bed.

so I say are you fucking kidding me off mute and had to explain myself.

a transplant patient will ALWAYS go from the OR to the ICU. Always. one of the first things a transplant coordinator does, even before getting a person on the transplant wait list, is go through a very robust preauthoriztion process with insurance.

so I add, you're telling me that the insurance company approved a person getting a whole ass organ but not the bed they KNOW they will need post surgery.

and people wonder why the whole damn world is hero worshipping Luigi

everyone did laugh when I said whole ass organ so, definitely lightened the mood

WHOOPS

But also, Christ, of course they’ve invented even more fiddly ways of refusing to pay for care

like these patients are so critical it is very likely the doctor is still scrubbing out of surgery by the time they get to the ICU. and you're going to penalize a patient cause their doc couldn't click the buttons fast enough? Holy shit people

imma find a way to auto trigger that order based on surgery stop time

its so dumb

Wow yeah, that is dumb as hell

Even more dumb than BCBS of Florida trying to find new and inventive ways to deny my ADHD meds every month

("you need a preauthorization!" "who the fuck does a new preauthorization for the same med ive been taking for literal years wtf?"

I wish I could say I'm surprised. my dad does Medicare billing for one of the big hospitals here. the whole insurance system is fucked

Medicare is the worst one!!!!!!!!

he is forever fighting with them over what they owe