Week 6 -… Get out of the kitchen

Mar 27, 2019

Hello! As the titles of my last two blogs suggest, I’ll reveal how my ambitions finally got the best of me as I attempted to survey over 7000 medical offices in a period of four weeks.

After the success of my pilot study and the promise of revealing results, I was incredibly motivated to collect a large amount of data. During my pilot study, I received about 5 hits (calls that were picked up and received survey responses) per 10 calls; this left me highly optimistic to survey 7000 offices with 3500 responses.

Boy, I was really, horribly, incredibly off. I used a Data Scraper to collect the phone numbers of 7000 medical offices in the Bay Area and create an excel call sheet.

As you can see from the call sheet above, while my pilot study had a hit rate of 1 response per 2 calls, I only received 5 responses from my first 500 calls. Even more, those 500 calls took over two weeks to complete. After talking to Dr. Brown, I scaled down my project to only 1000 randomized calls to represent a data-set of 7000 medical offices. Here are my results from the 40 responses that I received.

The interviews revealed two clear themes in the experience of medical billers. First, 80% of the medical billers reported that insurance claims were denied on the basis of billing errors. One medical biller found that “Insurance companies prefer diagnostic care codes instead of preventative codes on billing claims. We can save patients a lot of money by using alternate codes, but physicians sometimes use the wrong codes. So we have to appeal the claim.” However, this same relationship can go on to affect the future care for patients. Another medical biller provided empirical evidence in that “One patient came in, but their insurance wanted to be difficult because we used the wrong code on their original billing. However, the patient never returned after we entered an appeal.” These results revealed that patients would not return for care in the short-term because they could not be coded for the appropriate treatment by their insurance. However, I would argue that this forces patients to return when their disease has progressed to the point where high-cost treatment is required.

Second, 20% of medical billers also reported that insurance claims might also be denied because of job termination. A medical biller empirically finds that “Yes, we have had to cancel patient visits for treatment because of a patient’s ineligibility. They could be ineligible for a couple of reasons…they didn’t pay for their premium or their employment changed or their office policy changed.” From this interview, it was clear that employers determined a patient’s access to healthcare, while the insurance company was merely the supplier. These interviews will be key to the policy recommendation because insurance companies are largely replaceable in the medical chain of supply.

Next week, I’ll uncover how a broken nose led to my collection of the rest of my data.

One Reply to “Week 6 -… Get out of the kitchen”

  1. Krip R. says:

    A low response rate is frustrating for sure, but the fact that you made 1000 randomized calls is still pretty awesome.

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