multitude of diagnoses. A patient who canceled their appointment last week for what was supposed to be their final infusion was rescheduled for today. The staff person who rescheduled her is no longer working for the practice. The patient, Janet Jones, arrived and you escorted her to an infusion suite to prepare for today’s treatment by taking her vital signs. The nurse assigned to that area for today, begins reviewing the patient’s EHR, and sees an alert in the record with the end date for her preauthorization for this treatment that expired 3 days ago. The nurse explains this to you in a private area where patients cannot overhear. She asks you to take Ms. Jones to a private office and explain that the treatment cannot be done today because the preauthorization is no longer valid. You accompany Ms. Jones to an office and after explaining that the treatment cannot be done due to expiration of the preauthorization period, she becomes agitated. She tells you she needs this treatment and the reason she canceled last week was because she was feeling very weak from the treatment. The person she spoke to when she called did not say anything about issues with the preauthorization if she postponed her last treatment. Ms. Jones also explains that she no longer has the insurance since it also expired 3 days ago and she can no longer continue the Cobra benefit from her former employer because it is too expensive. She has applied for short term disability, but that has not yet been approved and she is living on what savings she has left, so she cannot afford to pay out of pocket for this needed treatment. She asks that you backdate the treatment date to 3 days ago before the preauthorization expired and her insurance lapsed.

Question You are an RMA at a very busy oncology practice where they do chemotherapy infusions for patients with a multitude of diagnoses. A patient who canceled their appointment last week for what was supposed to be their final infusion was rescheduled for today. The staff person who rescheduled her is no longer working for the practice. The patient, Janet Jones, arrived and you escorted her to an infusion suite to prepare for today’s treatment by taking her vital signs. The nurse assigned to that area for today, begins reviewing the patient’s EHR, and sees an alert in the record with the end date for her preauthorization for this treatment that expired 3 days ago. The nurse explains this to you in a private area where patients cannot overhear. She asks you to take Ms. Jones to a private office and explain that the treatment cannot be done today because the preauthorization is no longer valid. You accompany Ms. Jones to an office and after explaining that the treatment cannot be done due to expiration of the preauthorization period, she becomes agitated. She tells you she needs this treatment and the reason she canceled last week was because she was feeling very weak from the treatment. The person she spoke to when she called did not say anything about issues with the preauthorization if she postponed her last treatment. Ms. Jones also explains that she no longer has the insurance since it also expired 3 days ago and she can no longer continue the Cobra benefit from her former employer because it is too expensive. She has applied for short term disability, but that has not yet been approved and she is living on what savings she has left, so she cannot afford to pay out of pocket for this needed treatment. She asks that you backdate the treatment date to 3 days ago before the preauthorization expired and her insurance lapsed. Health Science Science Nursing MEDICAL 1001 Share QuestionEmailCopy link Comments (0)