I work the other side of this. We do everything we are legally permitted to do to get this shit paid but there are limits. A big one is while we can tell a provider what’s wrong with a claim and why it denied, we can’t tell them how to bill. It’s illegal. We have to be very careful how we tell them to correct a claim.

This process is inefficient and we hate it. But it’s so much worse when they hire overseas call centers to process their billing for them. I have no doubt there are many intelligent Indian people who can do this but a big local hospital in my area goes out of their way to avoid hiring them. So they fuck up a claim. We tell them, as much as we are legally permitted to, how to fix it. They either do not understand the language we are speaking (not a racist remark, a literal statement. Some of them can speak English but cannot understand it spoken to them.) or refused to follow directions and just keep telling us to do it again.

I get it. I work for the devil. But the overseas reps (and now AI bots) make this so much worse. Nobody is saving any money by doing it this way.

Please please please legislate us into obsolescence people. If I hear one more old lady tell me she can’t afford insulin anymore I’m buying a noose.