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BCBS-TX Must Talk to D. Kellus Pruitt DDS

6 Responses

1. Darrell, on December 12, 2009 at 8:16 PM said:

   Enforcing Evidence-Based Ethics

   How much would it hurt BCBSTX sales if my harsh criticism of their unfair business practices became their number one hit when potential clients perform the simplest of research on the discount dentistry broker? Here’s something that may interest sports fans.

   A day or so ago, I posted a link on Twitter to a Sept 20 Pruitt’s Platform article titled “D. Kellus Pruitt DDS predicts BCBSTX will abandon Twitter” (they call me @Proots).

   The grassProots “interest” in the article as measured by the sudden accumulation of clicks on the link pushed it from BCBSTX’s 9th hit on a Google search to the 3rd hit in hours. So what did I do?

   I posted the link 2 more times.

   http://community.pennwelldentalgroup.com/forum/topics/d-kellus-pruitt-dds-predicts

   Please vote early and often.

   D. Kellus Pruitt;DDS

   Oh yeah. My $5 says BCBSTX will abandon Twitter by 12 AM March 1, 2010.

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2. Darrell, on December 18, 2009 at 3:21 AM said:

   Silence – A luxury no longer affordable

   A few hours ago, the Arizona Dental Association posted a link to an article compiled by Arlene Furlong that appeared in the ADA News Online titled “ADA/NADP share views on a single claim form.”

   http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3868

   Furlong writes “Paper processing issues are among the most frequent claims problems the dental benefits industry reports to the ADA Council on Dental Benefit Programs.” Later in the article she laments: “Despite continuing progress toward a paper-free, or at least a paper-limited dental practice, there is no set timetable for such goals.”

   Continuing progress? Are you kidding me? It looks like Furlong has found a sheltered venue for free-form fiction. Everyone outside Chicago knows that digital interoperability in dentistry is going backwards. That’s embarrassing, Furlong. But then again, the ADA still officially claims that eDRs will save money in dental care. Now that’s rich.

   I responded on the Arizona Dental Association Facebook Wall with the same eagerness I’ll respond on the ADA Facebook Wall when given the opportunity. (By the way, I hear the ADA President Dr. Ron Tankersley is confirmed to open the ADA Facebook on Monday morning with a welcome address):

   “I don’t understand. Is it the recommendation of the ADA that members should pay the expense to file electronically – as well as accept the expense and risk of being HIPAA compliant – in the hopes that they will be more reliably paid in a timely fashion for work on satisfied patients who long before walked out the door? What a deal, ADA!”

   Sports fans will recognize this as the same kind of critical response from a special bastard that caused BCBSTX to shut down its Facebook in September, caused the TDA to kick me off their Facebook in October and now prevents the ADA from opening their Facebook – even though it has 1767 fans, including many American Student Dental Association members.

   Tell me (… or not), don’t you also find it erg exciting that we are the first to have reason to suspect ADA leadership of minor malfeasance, and that this insignificant bit of news if ignored could possibly grow to be worthy of a Colbert Report?

   American patients can no longer afford the luxury of silence from healthcare leaders.

   D. Kellus Pruitt; DDS

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3. Darrell, on December 22, 2009 at 9:24 PM said:

   ADA Presidents aren’t predetermined, but groomed candidates are

   Bureaucracy begets bureaucracy. If one is not approved by The Clique, one’s political chances are nil. Since I don’t get along well with power cliques, my chances are less then nil – even if I were willing to forfeit to good ol’ boys my First Amendment Right to free speech. I simply don’t want to be an ADA team member who is democratically granted the privilege and obligation to ignore, and even silence other dentists who are no different than me. Evidently, I’m not alone in my reluctance to play the ADA’s traditional games.

   The search for politically inclined dentists willing to put up with crap from authoritarian colleagues is becoming intense. The Texas Dental Association is inviting members to submit to the Journal essays which point out their leadership experiences. TDA officials aren’t saying much, as usual, but it’s nothing more than a blatant talent search. Though my organizational and leadership skills are multifaceted and international, I declined to participate. You can bet that other dentists with much more talent have also declined. Why bother?

   A TDA Journal editor who is no longer with us said that as TDA members, it is unprofessional to wash our laundry in public. According to this archaic code in a free country, Texas dentists are encouraged to report differences of opinions only to proper representatives and obediently wait for responses that may never come. This ADA code is traditionally dysfunctional. Silence causes innocent people to get hurt. We’re not the CIA, you know.

   D. Kellus Pruitt DDS

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4. Darrell, on February 22, 2010 at 7:06 PM said:

   Hey you, TDA leaders

   I’m addressing the 50 or so Texas dentists who posted admirable leadership ideals in the February 2010 Edition of the Texas Dental Association Journal. There are a couple of things I’d like to share with you if you’re listening. First of all, do you know what happens a week from today?

   The February 2010 TDAJ is dedicated as a “Special Membership Issue – Legacy of Leadership.” Appropriately, the Guest Editorial features the ADA’s immediate past-president, and Texan, Dr. John S. Findley. He writes, “As ADA member dentists we can be very proud of our Association, for over 150 years now, as members, we have had a national unifying entity, a forum where all the varied elements and interests in dentistry can come to the table and discuss the profession’s duties and obligations to its members and to society and then work toward our common interests.” – Really, Dr. Findley?

   All of those contributing to the Legacy of Leadership issue seem to posess solid knowledge of leadership theory, and you express yourselves very well. Yet as a TDA member, I’ve spent four years attempting to discuss with you increasingly urgent issues in our profession such as data breaches. Unfortunately for membership and their patients, I have had no luck at all engaging you. In fact, I’ve been kicked off of the TDA Facebook, the TDA Twitter and the TDA Forum for asking questions you refuse to discuss. (Later, I was re-admitted to the Twitter and Forum, but the TDA Facebook was closed within weeks after I was removed because the site was defenseless against a random jerk named Paita).

   I’m afraid Dr. Findley’s “national unifying entity, discussion and obligations” are nothing more than nice-sounding, cheap buzzwords. During his presidency the ADA slogan was “Image is everything” (ADA/IDM).

   ADA leaders, do you yet know that March 1st , a week from now, is the deadline for dentists to report data breaches that have occurred between September 23, 2009 and Dec. 31, 2009? More importantly, has the TDA provided membership with the information, as well as the support they need for reporting data breaches? You won’t hear Texans complain, but hurt is happening in our profession this week. How many dentists across the state know that they have suffered a reportable breach, yet dread notifying their trusting patients even more than the HHS? As leaders, it would be cruel to ignore the reality that members are silently suffering the pains of ethics that involve possible bankruptcy. From this second on, know that your colleagues who depend on you suffer very, very alone.

   I’m left with the conclusion that eloquent TDA leaders fear those they serve. That’s a regrettable shame because conversation adds immediate value to even the cheapest words.

   It’s never going to get any easier to come out into the open with me, but you might like the second issue I bring today. There are incredible opportunities for Texas dentists if you grab some courage, TDA. Allow me to share one of the latest good ideas.

   I read an article this weekend that was posted Wednesday on Xconomy.com titled “PatientsLikeMe Buys ReliefInsite to Help Patients Track Their Pain Online.” It was written by Ryan McBride, a business journalist who contributes stories about life sciences and technology to Xconomy.com.

   http://www.xconomy.com/author/rmcbride/

   PatientsLikeMe, a disease-centric online community builder, recently acquired ReliefInsite – an Internet platform which provides a way for patients to monitor and report pain levels to their doctors using the Internet.

   I hope you’re paying attention, TDA. Years ago I told you that if you would loosen up, the TDA could lead the nation in digital interoperability, including open source Evidence-Based Dentistry. However, with the real danger of data breaches and the absurdity of HIPAA, we must think laterally for this to work. That’s proven to be difficult for good ol’ boys.

   Imagine such an Internet platform for individual dentists’ to quietly perform safe, private research that directly benefits his or her patients. What a tool for learning that would be! And it wouldn’t have to be shared with anyone if the dentist prefers not to.

   But there’s more: For those Texas dentists and their patients who are interested in taking part in state-wide studies involving real-time, de-identified treatment data, they could opt-in to donate their data for research. Do you think the TDA has the balls to lead the nation in developing a dental data repository? Or is this idea another one that is so insignificant that it is not worth the risk of breaking silence to discuss with members?

   Too bad a punk closed down the TDA Facebook. We should already be on the other side of the tears.

   D. Kellus Pruitt, DDS

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5. Proots, on September 20, 2010 at 11:10 PM said:

   Modern transparency versus BCBSTX good ol’ boys and good buddies

   “TDA believes that your inflammatory comments on the NPI number and BCBTX and your drawing contest posts are in direct violation with Facebook Terms of Use and Statement of Rights and Responsibilities.” – Lee Ann Johnson, Texas Dental Association Director of Member Services & Administration, October 01, 2009 in an email sent to me explaining why I was being deprived of a TDA membership benefit I purchased only months earlier. (See “Lee Ann Johnson kicks D. Kellus Pruitt DDS off of TDA Facebook”)

   http://community.pennwelldentalgroup.com/forum/topics/lee-ann-johnson-kicks-d-kellus

   As Internet transparency undermines, sidesteps and otherwise overwhelms cumbersome command-and-control businesses, and penetrates deep into the dental insurance industry in Texas, if Blue Cross Blue Shield of Texas doesn’t evolve to coexist amicably with dentists as well as patients, the traditional protection offered by officers like the TDA Director of Member Services won’t even be enough to save them from extinction. The fat dinosaur hasn’t a chance in the new flat world where angry hobbyists like me can take out its knees just for grins.

   Sit back and I’ll show how it’s done using Twitter to enhance an opportunistic attack on BCBSTX’s Facebook. But first, a little historical background.

   Thomas Friedman, the esteemed author of “The World is Flat” – a landmark 2005 book about the effects of the Internet on society – warns that there will come along “empowered” individuals (like me) who will use the Internet to challenge the status quo. However, I don’t remember Friedman or anyone else mentioning social networks that far back. As a matter of fact, “social network” isn’t even listed in the index of Friedman’s 2006 edition of his book. Neither is “Dell Hell.”

   About the time “The World is Flat” made its literary debut, in June 2005 an intense blogger named Jeff Jarvis started what would become popularly known as “Dell Hell” – a profane grass-roots lynching of Dell Computer by its dissatisfied customers for notorious “lemony” products and lousy customer service – similar to BCBSTX. By standing up to Dell’s unfair business practices, Jarvis and thousands of equally furious Internet friends were ultimately responsible for improving the computer maker’s product and arguably saved the Round Rock, Texas company from irrelevance in the marketplace.

   If Jarvis had been a dentist, and the Texas Dental Association officials protected Dell Computer like they protect BCBSTX, his “inappropriate language” – which is far less socially acceptable than anything I’ve ever posted anywhere on the Internet – would have been sufficient to trigger accusations of “unprofessional conduct” similar to mine, and the TDA’s standard procedure for handling troublemakers would be put in motion to marginalize him in a year or three.

   But since nobody interfered with Jarvis, he quickly attracted thousands of allies and Dell eventually capitulated to the pressure from the consumers it served – but not before its reputation suffered, its employees’ morale bottomed out and the company lost of millions of dollars in sales. It took years for Dell to fully recover, but today, the company officials as well as its workers are justifiably proud of Dell’s attentiveness to the needs of its customers. I’m typing on a 2004 Dell Latitude as a matter of fact, and I can personally attest to great customer service and commitment to quality going on six years.

   I call Dell Hell a huge success for modern accountability through Internet transparency.

   Jarvis was successful at causing consumer-friendly changes in Dell even though his tools five years ago were primitive compared to today’s social networks such as Twitter and Facebook. Indeed, for those who can post content – regardless of the quality or intention – social networks sometimes amplify the voice of one individual over hundreds of anonymous officials in huge, clumsy entities like pre-intervention Dell Computer, or even today’s reportedly troubled BCBSTX.

   On Friday, I found “Blue Cross of Texas Being Held Hostage?” on Risk Mangers blog.

   http://blog.riskmanagers.us/?p=3873

   “Is Blue Cross of Texas under threat by government officials? Why have they suspended all sales activities and renewals? The answer remains elusive. We have been informed that BCBS employees are not even permitted to send out emails on the subject. A strick [sic] silence, it seems, has been imposed on their entire work force. Molly Mulebriar is investigating.”

   Because I’m an outsider and not inhibited by preconceptions about fair play in the PR industry – as honorable as the profession might be – when BCBSTX stumbled I was all over ‘em like a smelly poot.

   I imagine Molly Mulebriar is doing her investigating using boring, conventional tools like telephone calls to BCBSTX secretaries. I argue that it is more effective to go directly to the BCBSTX Facebook, drop an unconventional comment, and then super-size the stinker using Twitter:

   @BCBSTX, I read that you suspended sales. What’s going on? As you know, I posted my concern on the BCBSTX Facebook.

   It’s a comment under your post about finding a walking partner for the fall.

   I wrote, “I know my question is off subject for this particular post on your Facebook, but nevertheless,…

   “…knowing we can count on BCBSTX insurance is arguably more important to clients and providers than finding buddies to walk with.”

   Proots

   —————

   It’s been over 48 hours, and so far, BCBSTX hasn’t touched my comment on their Facebook. As noted earlier, we’ve collided before over the NPI number, and I won. I’m sure more than one BCBSTX official recognizes my self-portrait and knows how I work. If BCBSTX employees with college degrees in public relations react in a conventional way to my challenge on their Facebook, it will only bring more Internet attention to their as-yet unexplained, serious problems that they need to be dealing with instead of wasting time with me. The insurance company reportedly halted sales for crying out loud! I’m sure if this unsubstantiated report were widely known, it would frighten BCBSTX patients as well as preferred providers everywhere in Texas. I bet BCBSTX phone lines are going to be even more tied up than usual on Monday morning. What do you think?

   As empowered consumers increasingly and justifiably demand better accountability from leadership, transparency will change way current leaders will be doing business a few short months from now – that is, if they are still around. Good ol’ careers rightfully hang in the balance, and one can expect huge turnovers in BCBSTX as well as the TDA starting in 2011. That’s my opinion.

   Darrell K. Pruitt DDS
   [aka Proots]

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6. D. Kellus Pruitt DDS, on January 26, 2015 at 12:00 AM said:

   I was wrong

   This morning, I was reminded that once one posts a ballsy remark on the internet, it never disappears. “BCBS-TX Must Talk to D. Kellus Pruitt DDS” is the optimistic title of an angry story exposing government/corporate leaders’ misapplication of HIPAA requirements for personal gain – allowing regulatory advantage over small businesses in healthcare for power and/or profit. HIPAA’s National Provider Identifier requirement, which was illegally forced upon at least one dentist who never digitally transmits patients’ identities, is the focus of the article. It was picked up by the Medical Executive-Post on August 14, 2009.

   BCBS-TX Must Talk to D. Kellus Pruitt DDS

   The last comment (mine) was added on September 10, 2010 titled: “Modern transparency versus BCBSTX good ol’ boys and good buddies.” Since then, the thread was forgotten until hours ago when my diatribe unexpectedly surfaced from the archives to become the 7th most popular post out of thousands. What’s more, the ME-P boasts over half a million readers. It can be argued that the sudden popularity of the obscure article signals a significant spike in interest in the NPI and/or BCBSTX… perhaps a tremor preceding an earthquake?

   In a short-lived, monthly BCBSTX publication called The NPI Times! (circa 2007), it was announced that BCBSTX will no longer be allowed to process clients’ dental claims without dentists’ NPI numbers. The ten-digit identifier benefits BCBSTX, not doctors and patients.

   Not long ago, I contacted my U.S. Representative Marc Veasy (D – Texas, 33rd congressional district), and explained to his assistant how BCBSTX’s self-serving misapplication of HIPAA’s NPI requirement cost me several individual as well as families of patients over a period of several years. Though the NPI number is required for HIPAA-covered entities who transmit patients’ identities digitally, mine has always been a paper-based practice, using the U. S. Mail. We NEVER send patients’ identities over the internet.

   Even after explaining to Representative Veasy’s assistant why it was wrong for BCBSTX to cite federal law as the reason many of my patients had to find dentists with NPI numbers, he told me that this is a problem between me and BCBSTX which I would have to resolve on my own. “Good luck,” he said.

   My own Washington Representative whose local office is just down the hall from my dental practice – less than 50 feet from where I am sitting right now – simply does not seem to care.

   
   I was wrong.

   D. Kellus Pruitt DDS

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