No news is good news in Sparkland. All is well. My energy levels are decent and my back is in good shape. Ken is hanging in there, waiting for his cardiologist appointment. He has learned to live within the limits set by his atrial fibrillation until it can be treated.
Work is pretty good, all things considered. I am only trying to deal with one semi-crisis at the moment. This situation was brought to us courtesy of the government. It is a taxpayer-funded crisis.
It's common knowledge that Canada has a public health care system. How it works in Ontario, my province, is that doctors submit their billings to the government via a series of codes. X units of H345, Y units of J567. The Ministry of Health's computers validate the billings. If the code combinations abide by all the programmed rules, the MOH deposits the appropriate amount of cash into the doctor's bank account. If the billings do not abide by the rules, we get back error codes and empty pockets.
Our lovely government published a new set of billing rules. I found out about the changes at the end of the day on August 30th, for changes to be effective as of September 1st. It's my understanding that the change bulletins went out to all the technical billing agents on August 30th in the morning. This is what I like to call INSUFFICIENT NOTICE.
The old rules were complicated, but we understood them. The maximums, the dependencies, the limits on procedures per patient per 12-month-period, etc. The new rules are just as complicated, and now we are confused. The Schedule of Benefits is written in a dialect of legalese which is difficult to understand. Considering that the income of our business depends upon a clear understanding of these rules, this situation is causing no small amount of panic among the ranks.
It will be sorted out eventually, even if it means that initially we get back a lot of error codes. My biggest frustration is my own lack of knowledge. I am responsible for supervising data entry for billing, and I knew the old rules backwards and forwards, but I sure couldn't tell you which procedure X478 stands for and why it may or may not be mutually exclusive with X479. In other words, my understanding does not go deep enough for me to interpret the Schedule of Benefits myself. Every doctor I've spoken to has their own personal interpretation of the changes. That's why we're down to trial and error for figuring out what we can and can't bill.
Usually the system works very well. I only wish that they'd given us a little more lead time to figure out these new rules before going live with them. One month would have been nice. We have a pretty good government, especially compared to what's going on elsewhere in the world and all, but still. Sometimes it is time to complain.