I check my benefits statement (relatively new insurance from ANJ), and it clearly states they cover blood work diagnostics 100% as long as they're ordered by my doctor.
I call insurance company... nobody there until Monday.
Forgot to call yesterday. Call this morning.
Call goes right through to Bubbly Brianna (BB) at member services:
Me: "I got a bill from the lab that did blood work ordered by my doctor that you guys denied"
BB: "Please give me a list of all your personal information so I can find you in my computer and confirm that you are indeed who you say you are"... "oh and give me the date of service".
Me: "rattle off list of personal information to prove that I am me" and "oh 2/13/09 is date of service"
BB: "We don't have any claims submitted for you after January"
Me: "um.. would you if you denied the claim"
BB: "Yes, and we'd have a claim rejection code that would tell me why we denied it, so call the lab and tell them to send it to the right insurance company."
Call Lab Bill Services
Wait on hold for 20 minutes (yeah, really happy about this)
Finally reach Smoking all my life Sue (SamlS)
Me: "I received a bill from you that said that my insurance company denied the claim, I called the insurance company as instructed on the bill and they have no record of the claim"
SamlS: "what's the claim #"
Me: "claim #"
SamlS: "you have Big Insurance Company plan right?"
Me: "yes"
Samls: "oh yes, we submitted that claim to them today for $29 less than the bill I received
Me: "That's weird because the bill I received says you sumitted the claim a few weeks ago and it was denied oh and that it's $29 more than the quoted amount
SamlS: " Oh yeah, I see that we did send it a few weeks ago and they paid $29, so we submitted it again today, so don't worry about it, I'm sure they'll pay the rest"
Me: "um.. you're sure? Shouldn't you check to see you have the right member # or spelled my name correctly"
SamlS:" I guess, go ahead and tell me"
Me: carefully read off "member #" and spell "my name"
SamlS: "yeap we have it, don't worry about it, they'll pay the rest"
So.... how many of you think I'll be making at least two more phone calls in about 2 weeks when my insurance maybe makes another $29 payment (less than 1/4 of the bill!)??
9 comments:
The only thing I hate worse than calling my insurance company or medical billing is calling my cell phone company.
Oh wait, or the cable company.
I wonder how much $$ is wasted on customer service when they could spend it on placing competant people in their billing departments......
Oh, PPD, I feel for you. Dealing with insurance stuff is one of my least favorite things in the world. I hope you don't end up wasting too much time on this.
JLK, I just went through a bunch of shit calling my cell phone company, and the first few levels of Customer Service drove me CRAZY. It wasn't until I was like, "look fuckers, connect me to deep-ass technical support, I have a PhD in Computer Science and the shit you are spewing makes no sense, so connect me now, ELEVENTY!!!!" that I got to someone who knew what the hell they were talking about. Sigh.
Why is it that generally, customer service usually means pissing off the customer? Doesn't that seem ass-backwards?
Amen Ladies!!
I agree cell phone and cable suck, but my worst experience so far has been with the manufactures of my computer. OMG!!! I had to go through 4 different techs before I found someone that actually knew what the hell they were doing. This was after 10 hours of dealing with complete bull shit over the phone.
This reminds me a little bit of a long phone call I had with Travelocity last week, after I discovered we no longer had a return flight from next week's conference. Turns out the airline had canceled the flight a while back and never sent me an e-mail. Although I was on the phone for more than an hour with a young man from Bangalore ("Adam"), it eventually worked out for the best. I had memorized the canned music many times over, but he tried to help us get a return flight on the airline, got it canceled and a refund when he couldn't, and got us on another trip (round trip). Here's hoping your story has a happy ending, too!
I agree if they hire nice people in billing dept. it will solve so many problems.
Bleh that sounds awful! I hate having to deal w/ all that crap.
Tired Prof- I would have been so pissed to find out I didn't have a return trip. I'm glad they took such good care of you. I've had airlines change my flights before but Travelocity always contacted me, weird that you didn't get any notification.
Phone Insurance- Luckily this time both women were really nice... just not all that helpful. Somehow the reassurance that "they'll pay the rest" just isn't working for me.
B- yeap, not fun at all and somehow I think I'll be going through it all again. :(
This is really annoying. I had to do it with almost every bill as a grad student. It was like the insurance company looses every first submission hoping the patient will be confused and just pay for the bill out of pocket. I felt like I needed to hire a personal assistant just to keep up with all the phone calls.
I'm always struck by the quality of service when the customer has the advantage (i.e., can buy elsewhere) vs. where the "customer" is stuck with the current option. This sounds like a conversation I had with my bank and cable provider this week.
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