Dr. Hassaballa Chosen As One of the Top 50 Most Influential Voices…

No, we get denials from insurance companies… — I was honored to be on a panel of experts for a webinar on sepsis denials by payers, especially commercial insurance companies. I had previously written about “knowing your sepsis,” especially since different payers use — and hold us to — different definitions for the same disease process. …

As both an ICU physician, and a father of a sepsis patient, I have seen its brutality firsthand. — The fever and diarrhea were relentless. For almost one week straight, it just would not stop. That was despite good antibiotic therapy. This was supposed to be the easiest round of chemotherapy — the maintenance round — and we were supposed to be home free for the summer. Supposed to…

Just never do it — I knew early on in my medical career that I wanted to be a Critical Care Medicine specialist. I knew early on in my medical career that I wanted to spend my days and nights caring for people at their most vulnerable. …

This denial is perhaps the most frustrating denial with which I have to contend — Insurance company denials are terribly frustrating. They delay prompt processing of claims. They require annoying extra steps to get paid. And, frequently, they require spending more money on denial and appeal experts such as myself to help fight them. …

I can make abnormal numbers go away…that doesn’t mean I have done the patient any good. — In the Intensive Care Unit, we are surrounded by numbers: heart rate, blood pressure, respiratory rate, oxygen saturation, and a whole host of laboratory values. Any or all of them can be abnormal, and they are frequently abnormal all at once. …

The real question is: will we have won the war of the human condition? — In 2009, my eldest daughter died after succumbing to complications of B-cell lymphoma. Whenever we speak or write about what happened, we frequently mention that she “lost the battle” with lymphoma. …

Your ego can be dangerous if you let it cloud your judgment and make you “too cool” to ask for help. — I had known the patient well. She was just in my ICU a few weeks previous with a perforated bowel and multiple abscesses in her abdomen. She was now in the hospital emergency department several weeks later with severe acidosis (or acid levels in the blood). …

The new Sepsis-3 definition has allowed commercial payers to deny thousands of dollars to hospitals on sepsis claims. — Among the many types of denials from insurance companies that come across my desk, one I have been seeing more frequently is the “DRG denial.” This is where an insurance company will comb through the medical record of a claim and deny a specific “diagnosis related group,” or DRG. …

They are absolutely essential, and they can mean the difference between life and death. — It was 9:30 PM. I was alone in the ICU. The patient for which I was caring had just had heart surgery. He was getting agitated, and so I ordered a common medication to treat his agitation. Then, suddenly, he turned blue because he was struggling to breathe. “Call a…