Peter Hentges (jbru) wrote,
Peter Hentges

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Confused on a higher plane

I spent a big part of my day at work trying to figure out the connection between the contracts we execute with various health care facilities (hospitals, clinics, etc.), the services that practitioners at those facilities deliver to our members, the way those services get turned into claims, how those claims are adjudicated and paid and how all of that relates to the specialty of the practitioner (if they are a pediatrician or a neurosurgeon, for example). Before one of my meetings for a different project, the head of contracts was kind enough to inform me of the addition of various benefits packages to that mix, plus a few more variables that surround the whole picture.

It doesn't help that there are at least five different meanings that people have when they use the word "speciality" in connection with practitioners. (And don't even get me started on the word "provider!")

Waiting for the Bus--Violent Femmes--Add It Up (1981-1993)
Tags: work

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