Using Websites to Provide Client Information

Hello ... I'm Jim Huffman, and I've created this web site to let you know about the examination the insurance company is requesting that you have completed. We want you to be informed, and we want you to be as comfortable as we can with our procedures.

Here are some questions folks frequently ask about their exams. But if you have other questions, please contact us, and we'll provide any information you might need. You can either email me at huffmanjim@hotmail.com or you can call me at (336) 227-0958.

About me ...

Who are you? Glad you asked. I'm Jim Huffman, and I'm the nurse who does exams for your insurance company. We work through a company called Portamedic, which handles the paperwork and billing hassles. (This is not an official Portamedic web site, and is not authorized by them. If you're looking for Portamedic's home page, click here: http://portamedic.com)

What are your qualifications? I'm a registered nurse (RN). If you'd like to verify my license, you can do so quickly at http://www.ncbon.org I graduated from Regents College nursing program in June of 1980. (The college changed its name in 2001; it's now known as Excelsior College). If you'd like, I'd also be happy to show you my nursing license when I meet with you ... I carry it with me at all times.

How much experience do you have? I began working as a nurse in June of 1980 at what was then Alamance County Hospital (in a later merger, it and another hospital became Alamance Regional Medical Center, in Burlington). I was a medical-surgical nurse for 2 1/2 years. I went out on my own in December of 1982, and have operated a full-time, free-lance solo nursing practice since then. I've worked in a number of areas, including critical care (ICU), geriatrics (care of the elderly), and home care.

How much experience do you have with sticking people for blood? A lot. Insurance companies began requiring blood sticks for many applicants in the late 1980s. I have probably drawn blood from several thousand people, and will often stick 8 or 10 people in one day. I am not perfect. But I am able to get most blood sticks in one try, and will probably be able to get yours.

Are you an employee of the insurance company? Are you an insurance agent? No, to both questions. I'm an independent contractor completing examinations for the insurance company, but I am not their employee. And I'm not an insurance agent. I'll be happy to answer medical questions about your examination, but if you have insurance questions, please ask your agent, who can help you with that end.

About your examination ...

Why am I required to have an examination? Your insurance company uses the information we collect to make decisions about providing you with the insurance. Normally, it's an automatic requirement, depending on your age, and the amount of the insurance. Occasionally, the company will require one because of something in your medical history, or because of your height or weight.

Do I have to do the exam? If you want the insurance, the exam has to be completed. If you refuse the exam, the insurance company won't sell you the insurance.

I'm going to be busy for the next several months. Can I put off the exam until then? Ultimately, you're the one who determines when the exam is completed. However, the insurance company will not finish processing the policy until your exam is in their hands. Insurance companies also give us a limited amount of time to complete the exam paperwork until they "close the books" on a case. If you need to put the exam off for more than a week or so, please let me and your agent know so we can make arrangements. And please remember: the exam can easily be completed in 30 minutes or less. I can sympathize with busy people because I'm busy myself. But I really will respect your time, and your schedule.

This is a family policy. Do my children have to take an exam? Usually no one under age 18 has to have any exam completed. There are exceptions to this rule, but your insurance agent can provide more information if a child under 18 needs any work done.

What does the exam involve? If you have to have a paramedical exam, we will ask you health questions, check your blood pressure, height and weight, and collect a urine specimen. If you need a blood sample, we will collect blood from either your arm or your finger, depending on the insurance company's requirements. If you need an EKG (an electrocardiogram: a heart test) we will hook a few "stickers" to your body, which will provide a reading of how your heart is operating.

How long will the exam take? Usually 15-20 minutes, unless we get to talking, in which case you probably need to tell me to get lost, that you have things to do. If you have a long medical history, it might take longer, but almost never more than 30 minutes.

What kind of health questions do you ask? I'll be asking about your medical history: your doctor's name and address, and when you last saw your doctor, operations you've had, hospitalizations, medicines you're on -- that sort of thing. I'll also ask questions about your family history: ages of family members or ages at which they died, their health history, and cause of death for any who have passed away.

I have some embarrassing medical or personal history. Do I have to give it to you? The insurance company needs a full medical history. However, you should know that nurses like myself deal with all kinds of illnesses and diseases. You are not going to surprise me with something you've had or something you've done. And honestly, I won't remember it 2 days later.

I'm afraid you might tell someone something I tell you. I understand your concern, but it's not going to happen. I don't tell anyone about folks I see. I won't even tell someone I've seen you. No one will know unless you tell them. I certainly won't. You can count on that.

I'm very embarrassed about my weight. Can't I just tell you what it is? Unfortunately, the answer is no! The insurance company requires me to actually weigh and measure you. However, you should know that I see many people, and honestly, if I didn't write it down, I wouldn't remember what your weight is. However, I won't say your weight out loud, and I won't repeat it to anyone else.

I'm not good with getting urine specimens. Can't I just get one before you get there? Again, the answer is no ... I have to be there when you get the specimen.

But I have trouble urinating when a test is needed ... A lot of people do. What I suggest is avoiding urinating 2 hours before the exam. Drink some extra water. And if the extra water "kicks in," tell me when I get there, and we can do the urine first. And you will be surprised, too, to see how little urine is needed.

I've had drug tests where they watched me urinate. Do you have to watch me? No, definitely not.

The insurance company has told me I need another one or two urine specimens. What is the problem? The short answer is, "I don't know." Insurance companies don't tell me why they request second urine specimens. (Often, the company will request another 2 specimens on separate days). Your agent can often get the exact reason they are requesting it. But usually it's no more than that a minor bladder infection showed up in the first test.

Can I have the exam if I'm having my menstrual period? If you are having your period, mention that. For most insurance companies, it's no problem, but a few request that we wait until your period is completed. If you are having your period on the day I do the exam, please let me know so I can note that on the lab slip. And if you'd rather wait until your period is done, that's no problem.

Do I have to undress for the exam? No. If possible, wear light, loose clothing, but there are no special requirements. If you are having an EKG done, you should not wear pantyhose, and you should avoid using lotion on your skin ... the machine has trouble getting correct readings with either of these.

Can you use blood work or other tests I had done at my doctors? Not normally. The insurance company requires certain specific tests, and your doctor's office would not have done that combination of tests.

What tests are done on the urine sample? Each company has specific tests done (I do exams for some 50 insurance companies) and so I can't say for sure which ones your company is requiring. However, the normal tests would be ones for sugar in the urine, kidney and bladder infections and disorders, and others.

Do you test for drugs? Yes. Almost all companies test for both legal (for example, high blood pressure medicine) or illegal (for example, marijuana) in urine samples. This is something done on everybody, and they're not picking on you.

What blood tests are done? The 3 biggies are an AIDS test (technically, it's a test for HIV antibodies), blood sugar levels, and cholesterol levels. There are other tests done, too, but these are the main ones most people are concerned with.

Do I have to fast (not eat) before you take my blood? Some insurance companies require fasting, and others do not. If fasting is required, I will tell you about this, and you should have the appointment done first thing in the morning if at all possible. (Another possibility is to eat a light, early lunch, and then do the exam late in the afternoon, maybe 5:30 or so). Even if the insurance company you are dealing with does not require fasting, it's still a good idea. Even a couple of hours without eating will improve your lab results. Fasting means nothing to eat or drink, except water. You can drink as much water as you wish. You should also avoid tobacco or alcohol for 12 hours prior to the exam.

Are the needles you stick me with unused? ABSOLUTELY. The needles I use on you have never been used before, and never will be used again. There is a seal on the needle which I will unseal when I do the exam. When completed, I dispose of the needle in a portable container I'll have with me.

I'm really afraid of needles. I usually faint when I get stuck ... First off, you're not the first one. Getting light-headed when you have a needlestick is something that happens to a lot of people. When I call to make the appointment, tell me that you are afraid of needles. And remind me when I get to the appointment. I will take time, and I will not hurry you. I will do what I can to make you comfortable. If you'd like to lie down (on a couch, recliner, or whatever) we can do that. That way, in case you feel faint, you won't fall. If you'd like to watch TV or something like that, that may help. And while you're welcome watch anything that I do, you may want to not watch me stick you. That's the one thing that really bothers some people. But the main thing I want you to remember is that I'm not going to laugh at you. The big dark secret is that I'm not that fond of getting stuck myself, and I've done it to thousands of other people. But it's always a different thing when you're the one getting stuck.

Do you or my insurance agent know the results of the lab tests? No. Neither of us get the results. I collect the specimens, and ship them to a lab designated by the insurance company. The lab, in turn, faxes the results to the insurance. I know nothing of the results.

Can I get a copy of the lab work? Speak to your agent about this. Since I don't get a copy, I'm not able to help you directly, but the agent may be able to get the insurance company to send a copy to you or your doctor.

Will I be notified if something comes out wrong in the lab work? Yes. The insurance company will let you know that something turned out wrong, and will provide the results to you or your doctor. If everything is normal, your agent will normally deliver the policy to you.

Where is the exam completed? I will try to do the exam wherever it is convenient for you. I can do it at your home, your work, or wherever you would prefer.

When do you do the exams? Again, this is at your convenience. I can do them any time from basically 7:30 a.m. to later in the evenings. I also do exams on Saturday mornings. If you are able to do the exam during the day (for example, on a day you have off, or at work) I can complete it faster. My evenings just get booked up pretty quickly!

Is there a charge for my exam? Except under very unusual circumstances, the insurance company covers all costs for the exam. There's no charge to you at all.

I have an aunt in Honolulu who needs an exam. Do you travel to Honolulu? I wish I could help you, but my wife doesn't want me to go to Honolulu without her! I am connected with a network of other examiners all throughout the US, and we can get an exam completed almost anywhere.

I need the insurance quickly. Can you do something about that? If you need insurance approved quickly, the first thing you need to do is mention that to your agent, who can help shepherd things along. Do the exam as quickly as possible (if needed, I can often do the exam the same day or the next day). Remind me that you're trying to rush this through. All of this will help.

I'm nervous about you coming to my home. Can I have someone with me? Absolutely. The insurance companies do want you to be completely candid when speaking to me, so they normally want no one in the same room. However, if you would like someone there in the house with you (your husband or wife, a friend, or whoever), that is perfectly acceptable to me.

My house is a mess! Are you going to notice my housekeeping? Probably not. In the first place, I'm a pretty typical male, and I tend not to notice unless things are pretty bad. But honestly, I don't care. Your home is your home, and homes are for living in ... not for showing off to me! Besides, I have four children, I work out of the home, and my wife and I homeschool our two youngest. So, our house isn't always the cleanest, either!

I have medical background, and I'd like to do what you do. We often need new examiners. If you have medical background (nurse or EMT, for example), and have experience drawing blood, I'll give you a number you can call to see if this is for you. We'd love to have you on board!

Do you have more information about your business? I realized several years ago that many nurses were interested in doing what I do. So I wrote a book about it, and set up a web site. You can read more at http://networkfornurses.com. My book (Dare to Be Free: How to Get Control of Your Time, Your Life, and Your Nursing Career) was published in November of 2000, and is available from any bookstore or on-line bookseller. If they don't have it in stock, they can order it.

And thanks for reading. I'm looking forward to being of service to you.

And while anyone is welcome to print information off of this web site for their personal use, the site in its entirety is Copyright (C) 2001 by James Huffman.

How to Save Time, and Make More Money

This is a response to an online discussion group, of nurses (and others) who do exam work for insurance companies. One woman asked about how she could make more money, and how she could complete her work more quickly. This is my response.

An important thing to remember about controlling your work is that while time is not money, time is a tool, and we should all use it wisely. Focus on what you are doing, and you will make more money, and you will be better at what you do.

1. The fastest way to get a higher percentage is to sign on with several companies. Make certain that each one knows you are doing this. And keep insisting on a higher percentage. When "favors" are asked of you (doing exams at odd times, etc.) make certain that you don't do the "favor" without linking it to a percentage raise. Be ruthless about this. If it troubles someone, too bad for them.

2. I can usually get an exam done in 15-20 minutes. The fastest way to shorten time is to avoid chit-chat with the client. You don't want to appear unfriendly, but you are there for business, and not to be their friend. I remember one competitor who laughingly recounted that she had spent 3 hours at one appointment. (She and the client -- another woman -- had actually done some folk dancing while she was there). This examiner didn't last long.

3. You will also find that there is a percentage of the population who are hypochondriacs, and love to talk -- at length -- about illnesses and meds. You must gently inform them that you cannot talk about this, that you must get their exam done, and be on to your next appointment. If they ask you for medical advice (hypos love medical advice) remind them that it is unethical for you to advise them medically. Which it is.

4. If I have any doubt at all, I collect the urine specimen first. This helps if they forgot, and can't get the specimen right away (they have time to drink some water while we're getting the rest done).

5. While they are getting the specimen, do every bit of paperwork you can. Don't just sit there.

6. To save time on blood draws, always examine both arms first. This helps you find the best vein, and saves the time and frustration of more than one stick. When people volunteer that "they always stick my ___ arm at my doctors," I just tell them that each day is different as to how the veins stand out, etc., and I have to make the call that day. (If you say it with a smile, people don't get mad). The ONLY time they get to dictate which arm are the obvious cases, such as a woman who has had one breast removed, and has been told to avoid sticks on that arm.

7. If someone is just being impossibly slow, one way to speed things up is to get the blood draw done, and then plead that you must hurry "because I have to get the blood processed quickly." Which is true.