September 24, 2011

do your job for crying out loud!

I have an intense dislike for people who give poor customer service. I have an even greater dislike when I start getting the feeling that I'm dealing with people who would rather put all their energies into harassing me the client then in doing their job. 

So now I need to vent!

When I was ill with my MRSA wound I required medical equipment in order to heal more quickly, my insurance authorized the use of this equipment with a participating provider for a period of three months at a cost of zero dollars to me-or so I thought. When my doctor determined the course of treatment was complete (after five weeks) I returned the device. 

That is when the first call came. The company who provided the equipment wanted to confirm my insurance ID # because the insurance denied the claim. Well I had an authorization in my hand so I asked the girl are you sure you're filing with the right insurance company, because I’ve had the same number for over thirty years?

I had a suspicion they weren’t doing it correctly since I live in Virginia, the company who provided the service was is in Texas and my insurance is from New York so I wanted to confirm. I even asked twice and was dismissed, they assured me they were the experts “they do this all day long they know how to file insurance claims”. 

Then a few weeks passed and a gentleman called saying that my insurance company wasn't recognizing my insurance ID # and the claim was denied. Could I confirm the number again, so I gave it to him. I asked again whether the claim was being sent to the right insurance company; again I was dismissed because they know what they’re doing! 

Then again it happened with another person calling......

Then again it happened with another person calling.....   

photo credit

The other day I received a voice mail from Ramona, the insurance collection specialist; she asked if I would please call her back. I did; every freekin day for three days and she NEVER returned my phone call. Needless to say now I'm really pissed.

But not as pissed as I was when the letter from her came on the fourth day, saying” they would encourage me to get involved in the processing of this claim”. Charges due $4,577.00 for the medical equipment; claims to date have been denied.

The denials were NOT from MY INSURANCE COMPANY! * insert screams and foul language of your choice here*

So I'm left pondering these things.

What if I was an elderly person or otherwise a vulnerable person, not familiar with my benefits? Is it possible that the letter I received could have been construed as a bill? I think it’s possible. I’m wondering how many people would have just sent the money in thinking it was due!

This company employs a staff of people to file insurance claims and secure payment. In today's economy there are tons of people who would love to have a job and would actually work- do the job they’re paid to do.  What burns my ass is that not one person including the insurance collection specialist called the insurance company listed on the authorization form; does that make sense to you?  

I called my insurance company and they didn't have a record of one single claim or call from them requesting payment or asking for assistance on how to properly file a claim. They are participating providers (duh!) and the authorization form has the name of the insurance company written on the letterhead. And the $4, 577.00, never gonna happen, they are contractually obligated to take a reduced amount.

I arranged for my insurance company to call Ramona, they left her a voice mail too, I’m not holding my breath if she'll call them back.


  1. Sorry about all that! Customer service is pretty bad these days and I prefer to do everything by email so I can document it all.
    Hope this all works out for you.

  2. Jen,
    This stuff drives me nuts too! I was dealing with my cable/internet company last year and it was extremely frustrating....and we're talking about $100, so I can't imagine talking about thousands.
    I always try to be nice and polite in the beginning but usually ended up asking the "customer service rep" and then the inevitable "manager" if they were lying to me or if the last person had lied to me. That usually stopped them cold. All over $100 that for me was a huge amount of money and for them is a drop.
    I don't blame customer service though. I blame the company structure and culture that encourages them to solve every problem so that the company benefits, not the customer. It's rampant. But I do wish someone would take a stand within the companies, hire the right people, and remember that without the customers they would no longer have a job!

  3. ::headdesk::

    Insurance drives me up the wall. My daughter had to see another pedi a couple months ago (Same practice just her Dr. was out of town so we went to see the on-call Dr). I'm still getting bills for things that I promise I have worked out a bajillion times.


    Oh, and then there is the new company that has the loan on my Ford Fusion that keeps sending me letters telling me to send them proof of insurance and I have TEN times. Again


    So, I totally understand you on this one. Just another thing to make me dread Mondays. (Phone calls to these companies are always glorious.)

    Hope this gets worked out very soon.

    Michele @ Chemically Inclined

  4. Mark-Andrea& Michele,
    I swear sometimes I think this nonsense only happens to me! I see that's not exactly the truth.

    M, I wish they'd give out their e-mail and I'd especially love the e-mail of a supervisor or two.

    I can't say for sure but I have the name of ever person I talked to (I take notes) Do you think one of them will fess up to me telling them they were filing with the wrong company? I have my doubts!

    I totally get you, it's the whole aggravation factor. How many times before you guys get this right? Seriously folks get you head out of your behinds please! I have better things to do than spend my Monday's on the phone with you!

  5. That is so awful...and that is how they take advantage of people who don't really know anything about their benefits. Such a shame.
    Sorry that you had to go through all of that. Jeeze!

  6. My hair dresser was saying the same thing to me the other night when I went to get my hair done! Great minds think alike!

  7. Jen - so - this is seriously the BIGGEST gripe in my "new" community. We have to deal with medical supplies, etc all the time and I swear - no one realizes how STINKING INCOMPETENT they are! I'm so sorry you have to deal with this. Currently, the helicopter company is taking a lein out on our health insurance for refusing to pay for one of Alexander's chopper rides. I'm just waiting for that bill to trickle down to us. We probably overdid our allotted "life saving trips to the ER" for the month.

    Ok - now I'm getting a little bitter - which is hard to do when he's trying to give me a kiss :)

    It will all work out. If not - I know this gal that can help you do a great fundraiser or something ;) - 'cause she thinks you are awesome!

  8. Ok they alot life saving trips for you sons helicopter rides, can you hear me scream? That is just so darn wrong in so many ways I can't even wrap my head around it!

    Kristen these people are just so out of control.

    I think we mothers should just take over these business' and it will be all good don't you agree?

    As far as my situation, I did my due diligence, called my insurance company, if they don't file the claim correctly by April 1st 2012, they won't get paid.

    They can't bill me that outrageous amount if it makes them feel better but i have a signed contract that says they have to accept what my insurance pays (a reduced amount).

    Now it seems to me if they're not smart enough to secure that payment surly they can't hold me responsible, it violates the contract.


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