Pavement

 So just for fun, this week was month end from hell.  Literally.

We are in process of standing up a giant change in how we do business.  Right now, to obtain an authorization from a payer, I must first log into one system and find out which patients require that authorization.  Then I check that system and another one for the necessary medical documents.  Then I check a third system, which is our current "system of record" which is supposed to be the one we rely on if there are ever disconnects or discontinuity between any systems.  Once I check that third system, I then get to ... well, throw up a hail Mary.  

Because during the course of any single day I may deal with a dozen different insurance companies.  Or more.  And where some have phone numbers and forms we fill out and fax for a requested authorization, some have on-line systems we refer to as portals.  And as many insurance companies as there are out there, there are about four times the number of portals.  Some are home grown.  Some are quite obviously built by people who have heard the words "web site" before, and may actually be able to spell HTML if you spot them at least three and a half letters.  And no, that's not a slight against non-English-speakers, it's a shot at people who attempt to do that which they are painfully unqualified, inexperienced, and utterly incompetent to attempt.

Then there are these other web sites built by third party providers.  Some are fantastic.  Some are so terrible I can smell them from here.  Through the internet.  And some are quite obviously designed by the people who own these insurance companies who are absolutely 100% opposed to giving up any pennies they've managed to pry from the hands of those whom they promise to care for.

The thing about insurance is that, let's face it, none of us are going to die healthy.  We're going to die sick.  And in getting there, we're likely to try to avoid the end we all know will come.  And in many cases, that's abetted and encouraged by the medical system.  Because, let's be honest, it's in everyone's interest to keep us alive.  We're a paying customer for some of these folks, and it's a lot easier to keep a customer you have than bring in a new one.

Starting next week in theory we will do away with every single one of those internal systems, and replace all of them with one.  We're going to add in a few other real treats.  Such as the ability to inquire of certain insurance providers if the patient's actually one of theirs, and their accounts are currently in effect.  In real time, without phone calls.  

And in some rare cases, we may even be able to get a list of services that the insurer has approved for the patient.  Possibly.

So that should, in theory, save us a lot of time.  It will first take a hell of a lot of time to get all of the information out of the old systems and into the new one.  And we also need to convert a lot of that institutional knowledge and expertise into that which will be required in the new system.

For example, I have a particular patient, let's say, who is sick and needs a certain medication.  Right now, after being with this company a little over two and a half years, I know right where to go to look for it.  And if I have a patient in certain states who are, lets be honest, utterly and incredibly concerned about the cost of medical supplies - so much so they will strictly limit the amount you might be able to use.  Even if the doctor says otherwise.  Unless the doctor is willing to waste some of their incredibly valuable time in filling out a form and signing it to indicate that yes, the patient is getting four shots a day, so they will need four syringes a day, and when they limit us to three a day for say ninety days, we have to get the doctor to sign a piece of paper and quite possibly argue with another doctor to get permission for us to send four twenty-cent syringes to a patient every day, instead of three.  

And to pour more gasoline on the flames roaring above, this week we lost one of the best supervisors we had in the company.  She made every day fun and enjoyable, she was the life of the party, and she organized many morale-boosting events.  With the support of her boss.  

And that was Wednesday.  Today, my team found out our supervisor, who had replaced the fun one who moved over a new team and left me and several of my teammates behind (she couldn't take all the expertise to her new team), was going to be stepping back from her job, and we would be needing a new supervisor.

Adding, of course, to the chaos which has been our training regime, our data transfer ramp-up to get us familiar with the new system, and everything else that's going on.

And no, I have absolutely no intention of applying for a promotion in the current team.  I am hanging on by my fingernails to what sanity and connection to humanity and reality I have left.  At the end of the night tonight, when I punched out, I had accumulated nearly 50 hours of work time this week.  And that is not counting the slightly over 5 hours which I took off on Monday to get my second Covid shot.  I worked two hours fifty minutes on Monday (I'd intended to do only two and a half, but got stuck in something rather complex), and I still put in 10 hours overtime.  Which marks the 27th consecutive week I've had overtime.  

After four weeks, that's a lot.  After three months, that's getting towards hellish.  At six months, that's pretty much insanity.  And it's also called burnout.

I do like my employer, and I like being able to make a real solid difference.  But what I do truly hate is feeling like I'm failing everyone when I'm cranking out a great deal of productive work - and being a resource for those around me.  I just don't want to die from stress.  No job is worth that.  So I gotta take better care of myself.  And I'm going to start doing that.