Tag: Healthcare

T-Shirt Message #3

trE

Encouraging messages that have been AI-generated as I grow through the messes and joys of life.

I know it’s not an actual “T-Shirt”, but I didn’t envision my dude looking suave in anything other than a button-down. His voice was as smooth as butter, and he looks like how I’ve always pictured my maternal grandmother’s father (whom I’ve never met) in my head. AI-Generated Image: An older White man with his hands clasped and a sweet smile on his face, wearing a beige shirt with the words, “Thank you for being there” on it. Created with Canva.

When you help someone in need, they remember it.

Everyone thinks of changing the world, but no one thinks of changing himself. –Leo Tolstoy

No act of kindness, no matter how small, is ever wasted. –Aesop

Have you gotten your copy of my new book: a collection of serial tales & flash fiction, Séduire (E-Book and Paperback) yet?

I recently signed up to write on Substack as well. Poking the Bear’s Belly for Fun is a place of healing as I speak about the most recent events with my place of employment, as it pertains to racism and discrimination. I welcome your visit.

Please Scrutinize Your Healthcare Bills, People.

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I say this as a person who has been in the medical field for 23 years, and who was a medical biller for 10 of them.

AI Generated Image: A Black woman is sitting and reviewing a medical bill. She has a frustrated look as her long curly hair layers lovingly around her face. She is wearing a soft version of a purple top and the background is blurred out.

Earlier today, I had to place a call to my insurance carrier and have them call the billing department for my provider’s office because I have been billed twice for services rendered on the same date.

Disclaimer: I had one appointment on the date mentioned below, and it was for my annual exam only, which is a service covered at 100% by my insurance plan.

I went for my annual exam on 02/18/25 and my provider’s office coded the actual annual exam, it was processed and covered at 100% and paid accordingly, but they also billed me for a 99214 code which is the second to last CPT code for an established patient office visit. One of the highest billed charges for an established patient for in-office services.

Now, I know these people didn’t think they’d get someone who did medical billing for 10 years calling them today with a representative from their insurance carrier, but they got the WRONG one and the RIGHT one today.

My insurance representative informed the billing representative who took the call that they will need to send a corrected claim to reflect the annual exam only (which means, they’re going to end up having to refund the payment for that OV (office visit) code they billed incorrectly, too) and the bill I received from them for $30.00 is currently being held or contested until after the coding review.

I don’t play when it comes to my bills and you DARN sure ain’t gon’ get me because I scrutinize every EOB that is emailed to me. And I do so happily because I have seen way too many people pay bills without actually reviewing them and matching them up with their insurance policy’s coverage and benefits.

People, please review your healthcare bills with a fine-toothed comb. Ensure what you receive is correct and on par with what YOU KNOW is in line with the services rendered.

I was informed I should receive an updated bill and resolution in 7 to 10 business days.

My inner Ghetto Queen is saying, “BAYBAY, I will R O L L up to their corporate office at the hospital and ACT A WHOLE FOOL over $30.00. You not gon’ get me for preventative services that’s covered at 100% with my plan. Nah, nah. You remove that OV code, send a corrected claim, and give my insurance carrier back their refund when it’s all said and done. And don’t do it, and watch me email the CEO of that hospital organization.”

Be on the lookout, beautiful people. Take care of yourself and make sure no one is taking advantage of you and your medical benefits. It’s only going to get worse as time moves forward under this current administration. Mark my words. Stay vigilant, loves.

R A N T  O V E R!

The Weekend Is for Fun and Relaxation

trE

After a rough week, I am glad to see the weekend!

Photo by Polina Tankilevitch on Pexels.com

What I do isn’t easy. I try to explain to people who ask what I do for work what I do instead of just stating my title. But, I’ll start there today–my job title. I am a Patient Experience Navigator, III, formerly a Central Scheduling Specialist, III. I schedule patients for radiological scans and invasive procedures.

My daily goal is to be sure my patients get the best scheduling experience possible, and I make or exceed my goal with every encounter. How? I love speaking to people, however, I am not a socially-thriving person outside of my work duties. I am an introvert and I prefer peace and quiet and I have a small circle of friends.

I take a wide range of calls, both inbound and outbound, and work various queues when they are assigned by our Work Force Management Team. I am well-versed in two different big markets (Greater Winston-Salem, NC & Greater Charlotte, NC) and I operate in four different pods, skilled for sixteen various forms of calls. Are you still with me? To put it plainly, I can learn anything and am used basically everywhere.

I am one of forty cross-trained agents and the only agent cross-trained in two big markets who also works the number of skills and pods that I do. I also train new hires part-time. I tackle our Teams chats for our Guru and SuperUser chats, which means, I answer questions all day (whenever assigned) and add on patients for appointment slots many agents do not have access to see.

To make it even plainer, my team depends on me, and I depend on them.

I am high-functioning with a double dose of energy and I am keen on how I operate while being detailed-oriented. There is no one in our department like me. And that’s really thanks to my brain and how it’s wired. I have hundreds of zip codes and cities memorized and can tell an agent where to schedule a patient based on their city (or county) and zip code. So, as you can imagine, my personal Teams chat and email blows up regularly. I get messages from our supervisors, other agents, our referring providers’ offices, etc.

Adjusting to a new queue

This past week, I was assigned to the oncology queue because my co-worker who works that particular queue was on vacation. I have never worked the oncology queue by itself. I typically take the oncology calls that come in or are placed outbound, but I have never worked the entire queue. Let me tell you . . . I have a newfound level of respect for my co-worker.

I am an Empath, so the majority of my calls can be heard (and seen; our calls are not only recorded, but visual displays of us operating in the system are recorded, too) with me empathizing with our patients. I am also the type of person who can track moods and adjust to them accordingly.

A phone call with me will render you feeling differently than before you answered my call or I answered yours. I assure you. If you’re sad, my goal is to make you laugh. If you want to vent. I am here to listen. If you are not feeling so hot and chemotherapy sessions have you nearly at your wits’ end, I can drum up something to say as a means of comfort. That being said, my calls tend to be a bit longer because of this, but my higher-ups do not care. They know I am doing the job necessary and I do not get penalized for it and it does not affect my quarterly metrics. I get 96.09% or 100% throughout every month for my calls.

Because of this, my calls are used in training sessions throughout our markets, so, many agents know my voice. When we have company functions and I finally meet these new agents, when I speak, they actually shout, “OMG, TRE! It’s you! I listened to you every single day for two months!” or something to this effect. I still haven’t gotten used to this and I am often bewildered by it, but grateful they’re learning, too.

Oncology is a BEAST! There are so many invasive procedures and specialty scans to schedule and they are often ordered with a priority of ASAP (to be scheduled within 3-7 days) or EMERGENT (to be scheduled within 24 hours).

The providers, I believe, are rushed as well because most of the orders placed are incorrect and have to be documented as such and sent back for clarity and updating. I had the Greater Charlotte Market Oncology queue this past week and I am still overwhelmed by this week’s events.

At one point, there were over 310 orders in the queue. Whenever I cleared 15 orders, 20 more would appear. It is a neverending and constant workflow of exhausting review and scheduling. I also ran into leaving a TON of voicemails. Why? Most patients are in some form of therapy (to assist with pain) or treatment when a call is placed to them, so they are unavailable to answer the call. Our method for calls: we place three calls over 6-8 days.

If a patient has not responded to those 3 calls, a letter is sent to the patient notifying them of the attempt to schedule their appointment ordered by their Oncologist and then the order is sent back to their Oncologist so they are aware.

By the end of the week, I felt positive I had at least five more gray hairs. But I ended Friday with only 154 orders in the queue. I tackled it to the best of my ability with the assistance of another agent on Wednesday and Thursday so we could get the order number down below 200, and we DID IT!

The oncology queue has gotten so maddeningly insane that it is impossible to be manned by only one person. I now understand what my co-worker has been telling me over the past few months. She is mentally drained and thoroughly exhausted by the end of each day. I can say now, I know why.

I am grateful to see the weekend

After tackling the oncology queue and going about my days as usual responding to emails and chats, I am so happy to see this weekend. It came right on time! It has been a rough week, and I am completely drained from it. We have our company cookout today from 11:00 AM until 2:00 PM. I am about to get myself ready to go to it and spend about an hour and twenty minutes there.

It is going to be one of the hottest weekends on record, so I will not stay long. My people meter depletes after a certain amount of time. One of my Work Force Managers will usually pull me to the side and say, “You look out of it. Is your people meter at 0?” She knows me well. I’ll usually laugh and say, “YOU KNOW IT!” And shortly after, I will leave.

I intend to read, relax, cook, and watch movies this weekend. I will also treat myself to a seafood lunch later today from one of my favorite family soul food restaurants.

After the week I’ve had, I’ve earned it!

day’s end

trE

the dog sits and stares
at me–wonders, what ….
I think she knows today
nearly pummeled me
into submission

I walked a tightrope with
loose ends and software
glitches
my voice is cracking
and the last bit of
fight I have in me
will be used
to clean this day
off my skin

tomorrow isn’t promised
but I’m already praying
it comes with more
of an appeal than
what I struggled with
today

many of us can
conquer the hard times
and jump over the
obstacles but how
many of us are willing
to admit we want
just one day of
struggle-free experiences

just one day of
getting it done without
tiresome negotiations

just one day of
not wondering how
intense the next day
will be before it even
arrives

it’s nearly day’s end
and while I have all
of this welling up
inside me, I still
believe “joy comes
in the morning.”

*Originally shared via LinkedIn on Thursday, August 25, 2022 after a stressful day of work.

relentless

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another day tried to
dog us–take us through
the ringer, but we
persevered–willingly
available to help each
other overcome an
overwhelming beat-down

one’s not told just
how stressful working
with people can be when
one pursues a career
where people are the
ultimate focus

we’re given the “idea”
of satisfaction at the
end of the day just
because we can help
make a difference in
the lives of others,
but this work isn’t for
the weary

relentless; an understatement
when it comes to the
remarkable human beings
I share these tasks with;
we are made of lightning
and “Hadouken” forces,
strengthened by a togetherness
that cannot fail

by the end of your call,
if we haven’t made your
day an excellent one, then
you haven’t talked to
us

The Eyes Don’t Lie

trE

Living with keratoconus and the treatment I’ve sought.

Important things. Photo Credit: Tremaine L. Loadholt ©2021

I had my follow-up visit with the Duke Eye Center for my recent diagnosis of keratoconus on Friday, October 22, 2021. The news my ophthalmologist/corneal specialist shared was good. There is no scarring and no significant change in my eyes — no additional con-caving or coning of my corneas. This is good for multiple reasons, but I’ll just mention two of them. 1. Negative progression of the corneas is minimal. 2. It keeps me out of the tunnel with surgery (a cornea transplant for both eyes) as the light at the end. If you remember, I mentioned not wanting to even think about surgery, so I am ecstatic about this recent news.

My ophthalmologist wanted the same tests done as my previous visit, but two more had been recommended as well. One process required a numbing agent for my eyes. The nurse’s assignment was to assess the pressure of each eye. She announced her need to get near me in order to do this — as she rolled on her stool closer to me, my breathing halted. I am not a person who cares for people in my personal space, however; I recognize sometimes; it has to take place in certain situations. As she dropped the numbing agent in the first eye, I stopped breathing and she held her hand up to go to the other eye and said, “I need you to breathe, Tre. This doesn’t work if you don’t breathe.”

I instantly exhaled and inhaled as I normally would. I apologized — informing her it was simply my body’s natural defense and reaction to someone getting so close. She smiled and said, “It’s absolutely normal and expected, but you still have to breathe.” And breathe, I did. After the numbing agent had been applied, she said softly, “Blink. Blink. Blink.” I did as instructed. She announced coming closer to me again and this time, there was a device in her hand (it looked a lot like this, I failed to ask what it was and I beat myself up for it when I left the building) and she rubbed the tip of the device on my eyeball rotating it in small circles. She did the same thing for the other eye.

The look on my face caused her to giggle. She said, “Wasn’t expecting that, were you?” I most certainly was not! To have someone rub some type of device which captures the pressure of your eyes on your actual eyeballs was clearly not on my list of to-dos that morning when I awakened. Afterward, I saw little black dots for a few moments. It took a few more minutes before I could see clearly again without the little black dots and swirlies, and then we were off to yet another room where I would wait for the ophthalmologist.

I appreciate my ophthalmologist. His bedside manner is one I’d rank a 10 out of 10 and he’s also pretty funny. He entered the room as he did six months ago — ecstatic and noticeably happy to do his job. We elbow-bumped, and we were off to him asking me a few questions to which I had the answers. He began by telling me about the numbers collected at the most recent visit versus my previous one. He also showed me the slight change in my corneas by using the cornea model in the exam room. Just in case you’re wondering, a healthy cornea model looks like a huge contact lens and a cornea model deformed by keratoconus looks like that same huge contact lens bent bottom-up as if it were going to tear in half and come clean off the eyeball. *shudders*

He was pleased with the numbers, and images gathered from the testing. The reassurance I received from him about my current status eased my nervousness and worry as well. I am in a good place to still be a candidate for scleral contacts, however, no surgery is needed at this time. The scleral contacts are supposed to help sharpen the blurry images and my need to squint (natural reaction) to try to see small writing or images far away. To have a sharper vision will be a godsend and I await it like the day awaits nightfall.

Taking into consideration the fact I am severely near-sighted, have astigmatism in both eyes, and have also been slapped with keratoconus, and my vision has not changed drastically in the last six months, was paramount. The news was the best I had received all morning, and I could not contain my elation. Before leaving, they had advised me to continue with the changes I have made, keep up the Pataday regimen, and take as much time as I can away from devoting my eyes to the blue light of electronic devices.

Listen, I appreciate the $5.00 off coupon the center gives for the Pataday eye drops. That mess is expensive for a teeny tiny bottle. But, I digress. It is necessary, and it works.

As it stands, I have an appointment with my optometrist on Friday, February 25, 2022, for my annual eye exam and the fitting of the scleral contacts. I will follow up with my ophthalmologist/corneal specialist on Friday, May 20, 2022. He wants me to have at least a few months under my belt using the scleral contacts before coming back for additional testing. The flip in visits between the two of these doctors for my eyes will take place for as long as my ophthalmologist deems necessary. Keratoconus is lifelong and currently, there is no cure (outside of surgical procedures), so I’d better get rather comfortable with the entire process of it all.

I am thankful for decent vision insurance — I could not afford this level of care without it. By stating this, I am not flaunting the value of my healthcare coverage, but the truthfulness of the aspect to the level of care of which I am receiving. The care is not an inexpensive one and my pockets do not run deep. Take care of your eyes, beautiful people.

Originally published in soliloque via Medium.

Read more about this: The Beginning and The Follow-up.