Path to SFA, Part one

I have always hated hospitals. My mother died in one about 24 years ago. I didn't like the smells, the perceived secrecy, even when it came to my own Mother's care. When I would ask her Dr. questions, he would all but snap at me, "Why don't you ask her!?" Guess he didn't realize that asking and answering wasn't something we did in our family. And no, HIPPA wasn't invented yet, besides, I was family. But I am getting off track.
As much as I had professed my hatred for hospitals, imagine my surprise when some 13 years later I found myself actually applying for a job in the business office of local hospital in the small wild west town I was then living in. I already had a great paying job as jobs went in that small town. I was making good money at a local auto dealership in the finance office. In fact, I was the F. and I. guy (gal). I was "promoted" from parts dept. where I had been very happy. Selling finance and insurance just felt sleazy. I was always honest with customers and never pressured them into decisions which is why selling is just not my forte'. If they say no, I say okay. It would become the end of my life long affiliation with mechanics and parts and dealerships.
I saw the ad in the local paper and applied. The hospital business office manager was new to this hospital and I found her a bit wacky. Full of nervous energy, somewhat attention deficit perhaps, but very personable and honest, she laughed at things that apparently only she found the humor in and I liked her immediately. My interview went well but I didn't think much of it. I really had absolutely no experience in all things business as it pertained to hospitals. The next day she called and asked me when I could start. I gave the dealership two weeks notice and so, in that fall of '98, began my hospital career.

Two of us were hired at the same time for the business office. On the first day we were shown to the data room which was inside the business office but it was a separate, rather large room that housed a couple of desks, computers, a long table with a monstrous printer fed by a box of folding perforated green computer paper, file cabinets, a modern copier/printer, and a good old fashioned AS400 operating system. Once we were there, the manager shut the door and we never saw her again that day. We both wondered what we were hired for. She had told us both that we would be doing data entry. We sat there most of the morning not sure what to do. We had been given no instruction. Eventually we organized and cleaned the long neglected space and found some filing to do, but mostly, we just sat in that room and conversed for almost three days before the manager actually showed us our tasks.
My office mate moved to her own desk amid the cubicles of the main office and became a Blue Cross B.S. (stands for bull shit but they hide behind blue shield) billing clerk. I remained in the data room which I now shared with the hospitals' I. T. guru. (We became and still remain great friends). I became responsible for charge master maintenance, printing daily reports, downloading Medicare claims, sending electronic claims, and doing the nightly billing backup run. Some where along the way they decided that it would be okay for me to reconcile the hospital bank statements every month. Oh the joys of a small town business!
My favorite job was entering patient charges. I would receive charge sheets from all the departments and enter them into the system which would ultimately become a patient bill. I had to be a bit of a detective and spot any missing charges. For instance, an inpatient on the floor who was post operative should have a MAR (Medication Administration Record) sheet, an OR patient who had a rotator cuff repair should have a charge for a shoulder immobilizer, and so forth. Since charges were still recorded by hand on a paper charge sheet by each individual dept and then sent down to my in-box, there was a lot of room for human error and forgetfulness. I became the charge police.
The OR became my fascination and obsession. Their charge sheets were the most complex and challenging considering the foreign language contained therein. Bair Hugger, what the heck is that? Corkscrew, really, a corkscrew? Cyro cuff? Bone plug? Insufflation tubing? Just what are they doing up there? I would have to make several phone calls to the OR several times a day to get answers to my many questions and often they would be so busy that it might be two days before anyone could get back to me. So much was my fascination with what went on in the OR, that I planted a seed in the high speed, somewhat disordered brain of my boss and sat back and watched it grow.