PennWell Dental Community
web, TweetDeck and friends - Pilot episode
At last! Perhaps unintentionally and probably only temporarily, BCBSTX opened discussion with dentists on Twitter this weekend. Please join in with any compliments or complaints you may have collected concerning the way BCBSTX has treated you. Just so you’ll know, everyone chooses a stage name on Twitter. They call me “Proots.”
http://twitter.com/BCBSTX
I personally don’t think the official who signed off on this idea at BCBSTX Headquarters actually understood the accountability that comes with participation in a social platform like Twitter. I also suspect that this modern portal into the deep interior of the slow-moving organization will close soon. Here is Proots Rule number 1 - It is impossible for a command-and-control organization to be half-way transparent. Rule number 1a - Shielding PR employees with anonymity creates its own problems.
For example: What is likely to happen if a graffiti artist with a backpack full of spray paint finds a virgin white box car on a hidden side track?
Pilot episode: “web, TweetDeck and friends.”
In this episode, we discover that the blank canvas provided by the anonymity of BCBSTX employees yields artistic latitude. Fill-in-the-blank characters beg for uninhibited branding - and that happens to especially appeal to my creative side. Did I mention that I’ve done some screenwriting? How about a real-time, online sitcom built around BCBSTX and its humor-packed struggle against truth in the marketplace? I intend to use both real and imaginary (all unpaid, of course) characters, depending on what fits the facts that are pried out of BCBSTX concerning the NPI number and other issues.
For those who might complain that I am an unprofessional journalist, let me first of all say that I’ll try to be more professional if and when I ever receive pay for this… maybe. Secondly, in my defense, let me suggest that the nation is in the early stages of a recurring “wild west” in journalism comparable to the crazy wiki years following the appearance of the Gutenberg press in the fifteenth century, and again in the 1800’s - when historical events in the frontier were made much more interesting in New England newspapers by a few imaginative reporters who, like me, were left to their own imaginations to fill in the blanks. Why not? At least I’m transparent about it.
The mix of fact and fiction by story-tellers is nothing new. It started around campfires long, long before Beowulf, and is still the basis for novels, as well as religions. As we all know, the mixture of fact with fiction is also nothing new for modern news reporters either. It’s just that according to a professional code of ethics, they aren’t supposed to get caught doing such things. The fact is, interesting stories are useful for floating otherwise vanilla facts. In my mix of fact and fiction, I hope to illustrate the as yet unrecognized power of intertwined social networks in changing the behavior of very large and politically powerful institutions, such as BCBSTX.
This weekend, I read the 57 comments that had been posted on the BCBSTX Twitter site since it started in December. Most of the short responses were posted by “web,” who I think almost has a degree in fashion design and a few by “TweetDeck,” who I predict is web’s supervisor in the PR department of BCBSTX. I say he has a degree from Michigan State in public relations, and dropped out of a class on Internet marketing, taught by Ari Adler (a real person), who is an adjunct professor who also works for Delta Dental of Michigan. I haven’t yet decided where web is from, but I think she will be from Texas. Probably Houston.
To keep this story moving, you can see that I have taken the artistic license to develop the characters - perhaps even linking them to real people you might have met in past adventures on this forum. What are web, TweetDeck or Ari Adler going to do? Are they going to come out and shame me into to admitting that I’m wrong? We should be so lucky to be so entertained.
I performed some light statistics to BCBSTX’s history on Twitter. Here are the results: In December and January, there were a total of 17 comments posted on the BCBSTX Twitter site. 47% of them were BCBSTX ads or other PR pieces, 24% were responses to visitor compliments, and one (6%) comment at the last of January was a response to a client by web - promising to personally help with the client’s BCBSTX preferred provider list: “It looks like the doctor isn’t in our network. Is there a time today we can call you? We may have some options to help.”
In February and March, the BCBSTX Twitter site became busier with 33 comments. However in these two months, there were no compliments from visitors and only 15% of the comments were BCBSTX ads and other PR pieces. The majority of the comments, 55%, concern problems BCBSTX clients are having with their plans. More and more often, web asks them, “When is a good time to have someone call you?” Web, bless her heart, has become a handy complaint compartment for BCBSTX. I hope she is paid well.
If as a client or provider, you have ever tried to speak to a BCBSTX representative on the phone, you understand how nice it is to find a friend like web. Here’s one of my documented experiences: On May 1, 2008, while pursuing still unanswered questions about the NPI number, I had waited two days to talk to a supervisor named Wilma Jaimes (a real person), who finished eating a juicy peach while I waited just a few minutes longer. I caught her sloppy eating habits, loose facts and more on a microcassette audio tape. With employees like Wilma, it is no surprise that BCBSTX clients are attracted by web’s personal attention.
As one might expect, I immediately took the opportunity to submit my own question for web and/or TweetDeck. Surprisingly, after lying low for several days as complaints from customers started coming in, TweetDeck responded to my question yesterday evening:
“@BCBSTX Do dentists have to have NPI numbers to use your dental insurance? D. Kellus Pruitt DDS”
7:58 AM Apr 18th from web in reply to BCBSTX
“@Proots I believe it is required of all, but let me check and get back to you.”
about 11 hours ago from TweetDeck in reply to Proots
I hope TweetDeck and Wilma Jaimes get the opportunity to meet soon. A year ago, Wilma thought the NPI number was a requirement for licensure in Texas. Rookie mistake. And she’s a supervisor.
So here’s today’s story to help fill in the blanks: TweetDeck had an emergency meeting with his boss this morning. Although I’m not sure yet what it was about, I suspect it concerns the recent developments on their Twitter site. I think TweetDeck talked someone into the idea in September, and now he is being called on the carpet. I’ll tell you more budding rumors following his response. Stay tuned, and whatever you do, don’t tell BCBSTX about this or they’ll shut their Twitter site down before we’re through with the first season.
D. Kellus Pruitt
http://twitter.com/BCBSTX
I personally don’t think the official who signed off on this idea at BCBSTX Headquarters actually understood the accountability that comes with participation in a social platform like Twitter. I also suspect that this modern portal into the deep interior of the slow-moving organization will close soon. Here is Proots Rule number 1 - It is impossible for a command-and-control organization to be half-way transparent. Rule number 1a - Shielding PR employees with anonymity creates its own problems.
For example: What is likely to happen if a graffiti artist with a backpack full of spray paint finds a virgin white box car on a hidden side track?
Pilot episode: “web, TweetDeck and friends.”
In this episode, we discover that the blank canvas provided by the anonymity of BCBSTX employees yields artistic latitude. Fill-in-the-blank characters beg for uninhibited branding - and that happens to especially appeal to my creative side. Did I mention that I’ve done some screenwriting? How about a real-time, online sitcom built around BCBSTX and its humor-packed struggle against truth in the marketplace? I intend to use both real and imaginary (all unpaid, of course) characters, depending on what fits the facts that are pried out of BCBSTX concerning the NPI number and other issues.
For those who might complain that I am an unprofessional journalist, let me first of all say that I’ll try to be more professional if and when I ever receive pay for this… maybe. Secondly, in my defense, let me suggest that the nation is in the early stages of a recurring “wild west” in journalism comparable to the crazy wiki years following the appearance of the Gutenberg press in the fifteenth century, and again in the 1800’s - when historical events in the frontier were made much more interesting in New England newspapers by a few imaginative reporters who, like me, were left to their own imaginations to fill in the blanks. Why not? At least I’m transparent about it.
The mix of fact and fiction by story-tellers is nothing new. It started around campfires long, long before Beowulf, and is still the basis for novels, as well as religions. As we all know, the mixture of fact with fiction is also nothing new for modern news reporters either. It’s just that according to a professional code of ethics, they aren’t supposed to get caught doing such things. The fact is, interesting stories are useful for floating otherwise vanilla facts. In my mix of fact and fiction, I hope to illustrate the as yet unrecognized power of intertwined social networks in changing the behavior of very large and politically powerful institutions, such as BCBSTX.
This weekend, I read the 57 comments that had been posted on the BCBSTX Twitter site since it started in December. Most of the short responses were posted by “web,” who I think almost has a degree in fashion design and a few by “TweetDeck,” who I predict is web’s supervisor in the PR department of BCBSTX. I say he has a degree from Michigan State in public relations, and dropped out of a class on Internet marketing, taught by Ari Adler (a real person), who is an adjunct professor who also works for Delta Dental of Michigan. I haven’t yet decided where web is from, but I think she will be from Texas. Probably Houston.
To keep this story moving, you can see that I have taken the artistic license to develop the characters - perhaps even linking them to real people you might have met in past adventures on this forum. What are web, TweetDeck or Ari Adler going to do? Are they going to come out and shame me into to admitting that I’m wrong? We should be so lucky to be so entertained.
I performed some light statistics to BCBSTX’s history on Twitter. Here are the results: In December and January, there were a total of 17 comments posted on the BCBSTX Twitter site. 47% of them were BCBSTX ads or other PR pieces, 24% were responses to visitor compliments, and one (6%) comment at the last of January was a response to a client by web - promising to personally help with the client’s BCBSTX preferred provider list: “It looks like the doctor isn’t in our network. Is there a time today we can call you? We may have some options to help.”
In February and March, the BCBSTX Twitter site became busier with 33 comments. However in these two months, there were no compliments from visitors and only 15% of the comments were BCBSTX ads and other PR pieces. The majority of the comments, 55%, concern problems BCBSTX clients are having with their plans. More and more often, web asks them, “When is a good time to have someone call you?” Web, bless her heart, has become a handy complaint compartment for BCBSTX. I hope she is paid well.
If as a client or provider, you have ever tried to speak to a BCBSTX representative on the phone, you understand how nice it is to find a friend like web. Here’s one of my documented experiences: On May 1, 2008, while pursuing still unanswered questions about the NPI number, I had waited two days to talk to a supervisor named Wilma Jaimes (a real person), who finished eating a juicy peach while I waited just a few minutes longer. I caught her sloppy eating habits, loose facts and more on a microcassette audio tape. With employees like Wilma, it is no surprise that BCBSTX clients are attracted by web’s personal attention.
As one might expect, I immediately took the opportunity to submit my own question for web and/or TweetDeck. Surprisingly, after lying low for several days as complaints from customers started coming in, TweetDeck responded to my question yesterday evening:
“@BCBSTX Do dentists have to have NPI numbers to use your dental insurance? D. Kellus Pruitt DDS”
7:58 AM Apr 18th from web in reply to BCBSTX
“@Proots I believe it is required of all, but let me check and get back to you.”
about 11 hours ago from TweetDeck in reply to Proots
I hope TweetDeck and Wilma Jaimes get the opportunity to meet soon. A year ago, Wilma thought the NPI number was a requirement for licensure in Texas. Rookie mistake. And she’s a supervisor.
So here’s today’s story to help fill in the blanks: TweetDeck had an emergency meeting with his boss this morning. Although I’m not sure yet what it was about, I suspect it concerns the recent developments on their Twitter site. I think TweetDeck talked someone into the idea in September, and now he is being called on the carpet. I’ll tell you more budding rumors following his response. Stay tuned, and whatever you do, don’t tell BCBSTX about this or they’ll shut their Twitter site down before we’re through with the first season.
D. Kellus Pruitt
Replies to This Discussion
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Permalink Reply by Darrell Pruitt on -
Episode 1 - Routine Delay
Delay is business as usual for slow-movers like BCBSTX, and don’t expect modern communications to speed them up much, if at all.
As I mentioned earlier, when I called BCBSTX a year ago to ask about their NPI policy, it was two days before I was able to speak to a supervisor with the authority to answer my questions over the phone. Her name is Wilma Jaimes. From the four day (and counting) delay in a response from TweetDeck on the BCBSTX Twitter site, it appears that in the last 12 months, the Internet has not improved BCBSTX’s notoriously slow reaction time. BCBSTX provides us with classical, archetypal humor based on self-deceiving arrogance - a perfect sitcom platform.
“Companies need to realize their markets are often laughing. At them.” - Thesis number 20, “The Cluetrain Manifesto,” written by Levine, Locke, Searls and Weinberger.
As I pointed out earlier, one or more boneheads in leadership positions at BCBSTX should have realized that no social network is designed to accommodate command-and-control PR plans. It is oh so well known in the blogosphere that the marketplace described nine years ago in Thesis number 20 can be a cold and lonely place where bad things publicly happen to deception in entertaining ways.
I think what I am trying to explain is succinctly described in a paragraph from the opening of Chapter 10 of “Naked Conversations” - a book about blogging published three years ago, written by Robert Scoble and Shel Israel. The title of the chapter is “Doing It Wrong.”
“One simple rule for doing it right is be real. If you are going to blog, be authentic. Keep your conversations naked. Let people know who you are and where you are coming from. If you don’t, blogger vigilantes will forum torch-lit mobs to expose your false or character blog, and they will continue their assault until they have driven a stake through the heart of your deception. There may be no rulebook or designated enforcement squads, but the blogosphere is filled with members committed to keeping it a ‘clean channel,’ unadulterated by clever, cute, or contrived entries.”
Get a stake.
I just searched “BCBSTX” on Google, and not only is the caustic comment on the PennWell forum, “Why the long NPI, BCBSTX?” on their first page, but the BCBSTX Twitter site is their fifth hit. It featuresTweetDeck’s reply to me from two days ago, promising to answer the still unanswered question about how NPI number affects their clients’ dental insurance policies.
A couple of years ago, BCBSTX began publishing a junk-mail piece titled “NPI Times” to promote the adoption of NPI numbers by dentists in Texas. Lots of healthcare dollars were spent, not to actually provide healthcare, but to publish and mail “NPI Times” - a four-page, professional-quality monthly newsletter that celebrates a part of HIPAA. Is it any wonder why Americans receive so little for the money they spend on BCBSTX insurance when their advertising budget includes the needs of the US government? And that is a needy bunch.
I find it strange that in the last year, BCBSTX employees have learned so very little about the identification number they promote. Let me show how their path to knowledge began.
Flashback
The history described below is drawn from a spamphlet dated, April 29, 2008:
------------------------------
BCBSTX threatens to break contracts with Tarrant county employers
I received my NPI Times April 2008 edition today from BCBSTX. They are once again warning me that if I don’t get an NPI number, a couple of local employers who paid BCBSTX for dental insurance will have wasted their money. It appears that BCBSTX intends to break contracts over the NPI number. That takes courage. I say go for it, Blue.
I think the Texas Insurance Commission should know about this. Maybe the Attorney General should also be informed. If anyone is interested, I have the hard evidence, and more is on the way if a supervisor from BCBSTX calls me back tomorrow. This is exciting.
After glancing through the NPI Times, I called the BCBSTX number provided and asked what I should tell their clients who pay me for my treatment in full at the time of service. I recorded the conversations. Be my guest. Please listen in. If I should digitize the recording, I’ll share that with you as well some day.
After a few minutes of automatic telephone routing I found myself speaking to a human. She asked me for a BCBS identification number. I replied, “I don’t have a contract with BCBSTX, but I have a question about the NPI number.”
The BCBSTX representative named Amber replied cheerily, “And what can I help you with?”
“I don’t plan to get one, and I have patients that have BCBSTX insurance who know that they are going to have to pay at the time of the visit because you have stated that you will not process claims without an NPI number. And so they are going to ask me whether their insurance is worth anything or not. And of course, when they can’t do anything with it I am going to have to tell them that if their insurance isn’t paying, it’s not my fault.”
(long pause)
I resumed, “You see what I’m saying?”
Amber replied, “I do see what you are saying. Yes.”
“So what should I tell my patients when they come in and pay me for services? Should I tell them to file the claim themselves?”
“I would be concerned though that even if they filed the claims themselves and list you as the rendering provider we might run into the same problem…”
“And then you would have a problem with your client, but you wouldn’t have a problem with me.”
Amber said, “Right. It would be more between us and our members, but since you are the rendering provider it would still involve you in a way.”
“In what way?”
“Only because they are actually submitting you as the dentist doing the services and we simply cannot process the claim without having that NPI number on file. I’m just wondering if there is any way we can get around that, especially since it is reimbursing the actual patient.”
“Yea. Well that, I think, is your problem, but not my problem. Right?”
Amber said, “That would be something that would involve us, but the fact that you are the dentist doing the services and you are not interested in obtaining the NPI number… I mean… That does complicate matters a little bit for…”
I break in, “It complicates matters for you.” (no response) “Then I can tell my patients that Blue Cross Blue Shield will honor their insurance, even though I don’t have an NPI number. Is that right?”
“Not necessarily. Let me check and see if there is anything we can do because I don’t want them to have problems because it is not their fault…”
“And it’s not my fault,” I quickly added.
“That’s up to you if you don’t want to get the NPI number.”
“Right.”
“If you don’t mind holding for a second, let me talk to my supervisor and see if she has anything we can at least tell your patients that would help them out.”
“That would be great.”
After several minutes the BCBSTX representative came back on the line. “If it’s alright with you, rather than waste your time keeping you on hold - my technician is actually talking with Provider Relations for you…”
“OK! That’s great…”
“I don’t have a definite answer just because we have not come across this before…”
“I can’t believe that.” I chuckle. She chuckles as well. “That’s incredible.”
“If it’s alright with you, let us investigate and see if we can at least give you something that you can tell your patients, see if we can work with you in some way on this.”
“Well, my bottom line is, my patients will pay for my service at the time I provide it and you can deal with your client. That’s the bottom line. Let me know what you want me to tell your client.”
“OK. That will be fine. I will speak with you as soon as I get an answer.”
“Thank you.”
“Have a good day.”
An hour or so later I received a phone call from BCBSTX.
“Hello, Dr. Pruitt. My name is Joanie and I am the technician on the floor here today at Blue Cross Blue Shield of Texas.”
“Right.”
“You talked a little bit ago with one of our representatives about the NPI number?”
“Right.”
“I checked with our provider unit, and the NPI number is not a BCBS requirement. It is a national requirement by the American Dental Association.”
“Wait a minute. The American Dental Association is not a lawmaking body.”
“OK. But the NPI number is being mandated because of the HIPAA regulation.” (she hesitates) “I mean it’s a federal… “
I cut in, “It only covers people who transmit electronically.”
(silence)
I whisper to Joanie, “Do you not know that?”
She stammers, “OK it’s not…”
I repeat my question a little louder and incredulously. “Do you not know that?” Now I am giggling.
Joanie becomes defensive. “There will be a time when no claims will be processed without an NPI number. I mean it won’t be immediately, but in the future, you will need an NPI number.”
“I’ll deal with it in the future.”
“OK,” she tells me in a dismissive tone.
(a pause)
“Now, what I have a question about is this. Your clients are going to come into my office and they are going to ask me ‘What do I do about my insurance?’ because they are going to pay me. What do you want me to tell them?”
“They can submit their claims, but they may be rejected for not being able to cover them because you do not have an NPI number.”
“So I can call my patients right now and tell them that their insurance is not worth paying for?”
“The claims may be rejected if you do not have an NPI number.”
“Dear Sir. I have just been informed by Joanie at Blue Cross Blue Shield that your insurance is not good in my office.”
“That is not what I am saying.”
“OK. What are you saying then? How do you want me to word this letter?”
“OK. I think I will have my supervisor call you back tomorrow.”
“That’ll work.”
“Alright?”
“Thank (click)…you.”
I’ll let you know what happened on April 30, 2008 in the next episode. Maybe TweetDeck will have responded by then.
D. Kellus Pruitt
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Permalink Reply by Darrell Pruitt on
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Will BCBSTX overcome stage fright?
I apologize for the delay in sharing Episode 2 of “web, TweetDeck and friends.” Since I am depending on reluctant and unpaid actors in this real-time reality sitcom, the pace of the story - a contemporary milestone in dark humor or, if one is a BCBSTX fan, a classical tragedy that we already know will not end well - is understandably out of my control. In an effort to keep the plot moving forward to what promises to be a dramatic conclusion, this morning I sent TweetDeck an edgy follow-up to my earlier question about BCBSTX’s NPI policy.
“@BCBSTX Six days, no answer. I have no NPI number. Can BCBSTX clients use their dental insurance in my practice? Simple question.”
6:20 AM Apr 25th from web in reply to BCBSTX
If you recall, in the first episode, Sidney “TweetDeck” Jones, a ladies’ man and recurrent hairclub for men member, promised to get back to me. Does anyone else find it interesting that the old-fashioned telephone, including all the routine BCBSTX routing, misconnections and juicy peaches is faster than the Internet for providers who need to speak with a BCBSTX representative on behalf of BCBSTX clients’ financial interests? Sometimes technology is wasted on slow-thinking boneheads.
Regarding my conversations with Amber, Joanie and Wilma that occurred a year ago, I wish to take this opportunity to point out a couple of discrepancies that might otherwise go unnoticed and unappreciated in the PennWell Community Theater. I assume readers have figured out by now that some BCBSTX employees, including a floor technician, a supervisor and one “over-all” supervisor, cannot keep their stories straight concerning basic information about the NPI number. It’s fun to watch their impromptu sketches. Like Second City veterans, they portray their characters so close to the vest, yet so transparently.
The simple question, “Why should I get an NPI number?” is a magic nidus for free-falling chunks of imaginative reasoning from virtually anywhere in the dental benefits industry. The NPI is a lot like the HIPAA Rule - it can be whatever one needs it to be. The inevitable result of such laws reminds me of a frantic, unanimous, show-of-hands vote (following extensive and desperate lobbying) for an immediate emergency just-this-one-time-I-promise lifting of the campus rule against sex in the dorm at Texas Tech University on a beautiful spring afternoon in the mid-1970s…
A few months before BCBSTX floor technicians were telling dentists that they are forced to get NPI numbers by an ADA law, Delta Dental representatives at their booth at the Southwest Dental Conference in Dallas assured me that the NPI numbers will soon be required for state licensure. They’re such comedians. You got to love ‘em.
One more thing, and then I’ll leave you alone. I promise.
In Episode 1, I asked Amber how I should tell her clients that their BCBSTX insurance is worthless in my office. After wrestling for a few minutes over who actually owns the NPI problem, and coming to a draw, she finally said, “If it’s alright with you, rather than waste your time keeping you on hold - my technician is actually talking with Provider Relations for you…”
I responded, “OK! That’s great…”
“I don’t have a definite answer just because we have not come across this before…”
“I can’t believe that.” I chuckle. She chuckles as well. “That’s incredible.”
Now let’s move forward in history a few weeks to late May, 2008. This is when BCBSTX’s NPI policy began causing its intended, tyrannical effect on my practice, as well as when the clock started clicking on harm caused to my patients by the fat, insensitive insurance giant with lots of assets. At the slight risk of gathering a crowd with lynch on their minds, I bet there are BCBSTX clients all over Texas who have been forced out of comfortable dental homes by BCBSTX’s NPI policy. When one considers that continuity of oral care is arguably the single cheapest and most effective protection from the ravages of very expensive chronic diseases such as diabetes, one might conclude that several thousand borderline-diabetic Texans might have grounds for a class-action lawsuit. I don’t know. I’m just the piccolo player.
I have to say that I’ve seen stranger things happen. So if anyone should ask, I would love to testify for the plaintiffs. Just let me know who you want me to start messing with. I work for a fee a little cheaper than fair. I easily undercut Karl Rove on everything but ethics. Nobody can sell out like the Rover.
Because BCBSTX began rejecting my patients’ claims for lack of an NPI number, as they promised they would, I not only lost patients who had been with me for decades, but I also lost untold numbers of potential patients who had been intentionally misled into thinking that their dental insurance could be used at any dentist office of their choice in the state of Texas. My office manager continues to explain BCBSTX’s tricky NPI policy to their clients who invariably go somewhere else to have their work done. As one can imagine, in a small office, it is difficult to avoid expenses caused by BCBSTX confusion, and still maintain the professional generosity to provide their clients the information necessary to make informed decisions about dental treatment options and available providers. To give away this thankless community service requires ethics - especially when an actual patient is holding on the second of two lines, ready to make an appointment. There is a lot of meaningless expense built into healthcare today, and as far as I can tell, 40% of wasted dollars is BCBSTX’s fault.
On July 7, I co-received another letter with yet another patient saying that BCBSTX could not process the dental claim that Molly already paid for in full, because I do not have an NPI number. Molly’s case was one of the last times I attempted to intercede on patients’ behalf to try to get BCBSTX to pay them what they are legally due. After playing the same version of the game “1-800-BCBSTX whack-a-mole” on the keyboard of my phone, I easily qualified to talk to a human on the first try. Then I trudged through the member identification fill-in-the-blank level. Finally, I was allowed to politely ask my new, precious friend for the alpha-numerical consultant (no name given) listed next to the 1-800 number featured on Molly’s BCBSTX denial of coverage letter. In the end, when I finally spoke to WSn45582 (plus or minus), the effort turned out to be a frustration for me, BCBSTX and Molly. However, the serendipitous conversation with a patient and kind BCBSTX employee to whom I was misdirected only started off boring: “No, I do not have a member identification number,” and “I simply have a question about the NPI number, and….” When the rep told me that she could not answer my question, I temporarily lost my sense of appreciation. At the risk of being set back to another round of qualification tests, I failed to cover my impatience when I demanded, “Why was I given this phone number?”
The rep calmly replied: “I think she typed the wrong number into her letter… And I apologize. We’ve been having to do so many letters it is not funny.”
“On this NPI thing?”
“Oh yeah!”
I immediately fell in love again with a now-forgotten alpha-numeric I met by chance.
I hope that was worth your patience. Only five weeks before being told that there were problems with the NPI thing at BCBSTX by my sweetheart, Amber said that she couldn’t answer my NPI question simply because I was the first dentist to bring up a problem with the NPI number. I told Amber that I thought her statement was incredible and we both chuckled.
D. Kellus Pruitt
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Permalink Reply by Darrell Pruitt on
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Episode 2 - Doctrine of Slow
Automatic telephone routing can make the search for a simple yes or no answer from dinosaurs like BCBSTX not worth the effort - depending on the amount of patient’s money that hangs in the balance. Insensitive and uncaring dental insurance companies actually budget for such windfall. After all, they’ve been doing it for decades. In fact, I bet that some time ago a BCBSTX executive received a bonus for stealing the cost-cutting idea of automating bureaucratic barriers from someone at Delta Dental or UnitedHealth.
For a dentist to personally go out of his or her way to put up with automated aggravation even once as a favor to a patient is a sign of compassion. For a dentist to tolerate it again and again means that the special bastard must be after something more than money.
This is why it is so convenient to have found BCBSTX employees, Sid “TweetDeck” Jones and Barbara “web” Web on Twitter. I hate telephone routing.
---------------------------------
April 30, 2008
By almost 2 PM, I still had not heard from Joanie’s supervisor at BCBSTX. She was supposed to call this morning. That saddened me. If the supervisor had called my office, I would have been either the first or second person she spoke to. What’s more, the routing in my office is quick and reliable compared to BCBSTX’s.
After successfully working through the qualification tasks, I was put back in touch with who I would soon recognize as Amber: She immediately asked, “Is this for medical or dental?”
“This is dental.”
“Identification number?”
“Well, see, that’s the thing about it. I don’t have a contract. I’m a dentist, and I had a question that… I was supposed to be called back today from a supervisor. I think Joanie was the technician on the floor.”
“Oh. Is this Dr. Pruitt?”
“Yes.”
“Oh… OK… If you would like, let me check and see what’s going on, as far as having someone call you back.”
“OK”
“I think Wilma, who’s our over all supervisor was supposed to call, but she might be out today.”
“OK”
“Can you hold for a second? (pause) The person who was supposed to call you back today was Wilma and she’s actually out sick. So she is still planning to call you tomorrow to answer any other questions that you had about your NPI situation.”
“There’s not anyone that can talk to me about this today?”
“Unfortunately, because she is the over all supervisor, she’s probably the one that can help you with that.”
“Well, when can I expect her to call back? Morning? Afternoon? Or should I call back?
“Well, she usually comes in about eight. So I can leave her a message. Is it better for you if she calls you in the morning or afternoon?”
“I guess it doesn’t really matter. I may not be able to talk when she calls, but we’ll get back together.”
“She’ll probably call you then in the morning.”
“OK! … Alright, Amber. I appreciate it.”
“You’re welcome. have a good day, Sir.”
“Thank you.”
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A year ago, I thought it was odd that when Wilma calls in sick, the entire HIPAA department at BCBSTX stays home as well. For those who might rush to criticize that I am insensitive to pick on an ill person, I assure you that within 24 hours, Wilma was on the phone with me and a microcassette recorder. I have proof that less than a day later, Wilma’s appetite was healthy. (Episode 3).
At the end of episode 1, we were waiting on Sid - an on-again, off-again hairclub for men member - to get back in touch with us about details concerning the NPI number. Here are our exchanges on Twitter (earliest on top).
Proots@BCBSTX Do dentists have to have NPI numbers to use your dental insurance? D. Kellus Pruitt DDS
9:58 AM Apr 18th from web in reply to BCBSTX
BCBSTX@Proots I believe it is required of all, but let me check and get back to you.
9:46 PM Apr 19th from TweetDeck in reply to Proots
Proots@BCBSTX Six days, no answer. I have no NPI number. Can BCBSTX clients use their dental insurance in my practice? Simple question.
6:20 AM Apr 25th from web in reply to BCBSTX
BCBSTX@Proots Just saw this. My reply didn't go through, I guess. Sending again --link to get NPI. Yes, need to have it. http://bit.ly/nJ0MB
9:40 AM Apr 27th from TweetDeck in reply to Proots
Proots@BCBSTX Thanks for the reply. What happens if I don't get an NPI number?
Proots@BCBSTX Melanie, do not call me at work again. Can BCBSTX patients use dentists who do not have NPI numbers. Y or N.
1:21 PM Apr 27th from web in reply to BCBSTX
Proots- Is it possible that Twitter and BCBSTX are an imperfect match?
7:51 PM Apr 27th from web
Proots- BCBS got a mention on The Consumerist this morning announcing Twitter: http://bitly.com/hBrpg. I'm all over it.
about 23 hours ago from web
Proots- Now I will try to find out if BCBSIL and BCBSOK require NPI numbers to process claims. Won't they be surprised.
about 23 hours ago from web
Proots@BCBSTX ...Still awaiting your answer. Can patient with BCBSTX dental see dentist who has no NPI? Y/N. Simple answer.
about 5 hours ago from web in reply to BCBSTX
BCBSTXRT@Proots Just saw this. My reply didn't go through, I guess. Sending again --link to get NPI. Yes, need to have it. http://bit.ly/nJ0MB
about 2 hours ago from web
Proots@BCBSTX You are saying that your insureds are limited to dentists with NPI numbers. Correct?
about 2 hours ago from web in reply to BCBSTX
Proots- How long before we hear from BCBSTX again, sports fans? I bet a dollar against the kitty - no reply before tomorrow.
about 2 hours ago from web
Proots- With Twitter, I can convene committees all over the nation. Now that's progress.
15 minutes ago from web
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Did I ever mention the great dental benefits idea called “Direct Reimbursement”? With DR, there is no confusion. Confusion in the marketplace is expensive for everyone except slow-moving bison.
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Permalink Reply by Darrell Pruitt on
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Proots loses a dollar
BCBSTX responded within hours instead of days. I lost my bet, so I owe the kitty one dollar. It will go toward the cast party if I don’t win it back.
It surprised me when Sid “TweetDeck” Jones from BCBSTX responded, but he actually failed to answer the question: “You are saying that your insureds are limited to dentists with NPI numbers. Correct?” I accidentally discovered Sid’s response in a private "Direct Message" on Twitter. He sounds like a busy and important man when he warns me: "Last one, and then I have work to do. If you really want help, let me know. If you are just using this as a forum to rant, I'm out."
As a professional, what else could I do? Within minutes of being secretly scolded by the sometimes bald and sometimes gray office dude, I shared what he said with everyone in the theater.
Sid followed his exasperated comment with a link to some Website where I suppose I might learn something new that will make everything about HIPAA make sense in dentistry. That way, I wouldn’t keep busy BCBSTX employees from their work… My thoughts wander to one or four times when a BCBS client in my dental chair is waiting on me, while I wait on hold for a BCBS employee to finally and suddenly buzz by me with “…You mind waiting a minuteThank you….” Oh and the music! Sweet, merciful Jesus!
I think I speak for almost everyone attending this impromptu neighborhood gathering when I announce to anyone who works for BCBSTX - or anyone related to someone who works for BCBSTX - that we would really rather hear the details about the NPI number from Sid and Barbara of BCBSTX - the secret lovers.
It will be a short wait while the scenery is being changed for Episode 3 - and then someone (yours truly) will have to round up the characters again and get them back in the mood for putting on a show. I think the BCBSTX team has scattered for the weekend or the summer. Enjoy your meal, and I will return with more backstage gossip as it occurs to me. Proots.
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General dentist in Fort Worth, Texas. I surround myself with the most wonderful staff and the kindest patients in the nation. It is our mutual confidence and respect that grants me the freedom to stand nose-to-nose with anyone in the marketplace. I’m blessed. And I like to write.
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