Friday, March 6, 2009

Vent, Vent, Vent

"Your call is important to us. Please stay on the line until your call is irrelevant to anyone."


I am sure you all know the frustration of trying to work with 800 numbers when calling about a myriad of things. It seems like no matter what the situation any more you have to dial the standard "1-800-iam-nuts" number and deal with being sent from person to person.  That is if you ever reach a real person.

The farmer and I are lucky enough to both work for employers that provide full family health insurance coverage. This includes prescriptions as well. Because our pharmacy will only bill the primary insurance I save our receipts and bill the secondary myself. I really don't mind doing this because we only average a couple of prescriptions every other month or so. I usually wait until I have a stack and then send them out all at once.

The beginning of the year is when we have to pay our pharmacy deductibles so it usually the biggest out of pocket expense for the year. I sent off our January receipts the first part of February for reimbursement of our co-pay. Yesterday I received a letter with a copy of the receipt and pharmacy explanation of benefits (EOB). The explanation of benefits was circled in red and the letter stated that it was not clear how much was paid by our primary insurance and they needed that explanation of benefits in order to process this.

After looking closely at it I saw that it was no different than any other EOB our pharmacy provided and everything was there including the amount charged and the amount paid out of pocket. After calling the 1800 number for the person writing the letter, being forwarded through many menus and put on hold, I finally reach a nice young man who did not understand a thing I was telling him. I began to question my ability to speak in English. Perhaps I sounded like Woodstock from the cartoon Peanuts.  He finally told me he would contact the person who had written the letter and find out the situation. 

In the mean time I was told to call the primary insurance and the pharmacy and talk with them. After talking with the primary they said I would have to have the pharmacy print out a EOB but that they had paid a small portion and the rest went towards our deductible. OK, I knew that.  I next paid a visit to our pharmacy and after waiting in line for twenty minutes was able to talk with the clerk. She looked over the letter and the copy of the receipts and told me that what I was holding in my hot little hand WAS the EOB and that would be all they could print out for me.  Gah!

This morning I call the secondary insurance again but am informed that I can't talk with the woman who wrote the letter because she in on a phone line that can't be recorded. Apparently they need to record every conversation. So I have to rely on the person answering the phone to email her and wait for her response and then call me back and on and on. I am so frustrated with this system it is making me crazy (not that is far to go). At this point I don't really know any more than when this process began. 

I can only imagine what elderly people go through. This system is so messed up. Something needs to change.

12 comments:

Country Girl said...

The whole insurance system is messed up. In mid-January, I went to my primary care doctor for a checkup. Because of my family history, she ordered a stress test. And because of the insurance company refusing to grant me one (I don't exhibit the classic symptoms of someone who would warrant such a test being performed), I am finally getting my nuclear stress test this coming week. A full two months after beginning the process.
Yes, this is insane. And it needs to stop.

Jeannelle said...

Yes, I agree.....the health care and insurance systems are in dire need of repair. I live in dread of any of us needing medical care, with the huge expense for every little thing and the run-around from insurance companies. You are right....what must it be like for elderly people to deal with this. Good post, Egghead.

Twisted Fencepost said...

I had to handle everything Medicare for my parents before they passed. And I had to learn it all in a very short time. Finding someone to help me understand it was like pulling teeth. I can't imagine my parents having to deal with that in their conditions. And what I really despise are people who expect you to understand and get huffy with you when you start asking questions. Not to mention the whole automated thing when you don't get to talk to a human at all. Or it tells you to call a human and you get a voice mail and you message gets lost in the email black hole.

CeeCee said...

I'm so sorry you've had to deal with that run around. My dear FIL (age 80) has taken to asking me to deal with things like that when there is a "press 1, press 2...." part of phone calls. He just can't get his head around all the run-around.

One trick I learned while working for a dialysis unit in the insurance section----when dialing a 1-800 number, you can often bypass their silliness by simply hitting the "0" button when it starts asking for you to hit 1 or 2 or....

Putz said...

big Q sais he would fix it, didn't you believe big O when he said he would fix it...all computerized, compartmentalized and fixed...he said so

Gayle said...

I think it is all so difficult because they are counting on more people being like me. I get way to frustrated and can only deal with the run-around for so long, and then I toss it all and never get my money. When enough people don't bother that is quite a paycheck for them.

Linda Reeder said...

I think Gayle is right. Frustrated customers save them money.

♥The W.O.W. factor said...

First of all..Egghead..GREAT choice using Lily Tomlim! I LOVE her!!
There are soo many things wrong within our system these days...
I am so very glad my folks have "The Best" insurance so they don't have to go through any of this crap..
If they didn't, and I had to help? I'd be squeezing myself through the phone lines to strangle a few!

noble pig said...

Seriously I have never heard of such a weird thing...seriously totally screwed up. I guarantee it's being done on purpose.

Carolynn said...

Sounds to me like the insurance company is simply stalling so they don't have to pay out your claim right away. It does sound frustrating though. I hope you don't have to get more prescriptions filled just to deal with it.

tipper said...

Bureaucracy run a muck! Hope you get it fixed!

rhymeswithplague said...

It has nothing to do with being elderly. It has everything to do with being patient! (Not that you wanted to hear that....)

You must have prayed for patience, because in order to be true to His word, God would have to send you tribulation, because the Scriptures say "tribulation worketh patience"....

End of sermon... except... in the future, be careful what you pray for....

:)