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Talk to Terrie: DOL representatives go above and beyond

July 25, 2019

July 25, 2019

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CWP Blog

by Terrie Barrie

When praise is deserved, it must be given

I am often at odds with the Department of Labor’s Division of Energy Employees Occupational Illness Compensation Program (DEEOIC), especially with the changes made to the regulations governing the compensation program.  So, when I encounter people at DEEOIC who go beyond what is expected of them, I think it’s important they should be publicly recognized.  I’m not sure that it is proper to name names, but rest assure, their supervisors will be made aware.

My husband needed surgery for a condition covered under the program.  While urgent, the need for the surgery is, thankfully, not life threatening.  We were relieved to learn that there is a new surgeon in our rural area who is highly qualified and agreed to perform this surgery.  There would be no need to travel 200 miles to have it done.

The surgeon’s scheduler called and told me that she is having trouble getting pre-authorization for the surgery.  I was a bit confused because other medical treatment for this condition – office visits, diagnostic testing, prescription, etc. – did not require pre-authorization.

The surgeon’s scheduler informed me that it will take about 2 weeks for the government to approve the surgery.  The scheduler also informed me that there was a problem with which form the office needed to complete.

There were only two dates available for the surgery – one in July and one 30 days later. I panicked. It was stressful enough knowing that a surgery would be needed but the idea of waiting another month was impossible to accept.

It occurred to us that we should reach out to DEEOIC to see if there was a process where pre-authorization could be expedited.

My husband and I could use a little work on our communication skills.  I had reached out to the National Office’s Branch of Medical Benefits not knowing that my husband had also called his claims examiner (CE).

The CE responded first, in just about an hour.  He patiently and sympathetically listened to my detailed description of the problem.  I asked if he could expedite the authorization for the surgery so that my husband did not have to wait until August.

I was prepared to provide him with arguments why the surgery would be best sooner than later.  But, surprisingly, when I was finished he explained that medical procedures for a covered condition do not need to be pre-authorized!!  He was very sympathetic.  He even went out of his way to calm me and joked a bit to lift my spirits.

The call from the Branch of Medical Benefits representative was just as caring.  She confirmed that pre-authorization was not necessary and offered to call the surgeon’s office to explain the billing process, which she did.

The CE and the representative from the Branch of Medical Benefits reduced our high anxiety levels.  They understood the stress and successfully did their best to calm us.  Their compassionate assistance should be the role model for all DEEOIC personnel.  This praise is well-deserved and we thank them.