Wednesday, September 17, 2008

Automated Stress (7.17.07)

gauntlet: A form of punishment or torture in which people armed with sticks or other weapons arrange themselves in two lines facing each other and beat the person forced to run between them. The lines of people so arranged.

Have you had to call your insurance company, your mortgage company, customer service of most any company lately? Then I bet you, too, have had to run the gauntlet of either button-pressing or voice recognition. Sometimes when you are enduring this, you have to remind yourself of what Nietsche said: "What doesn't kill us makes us stronger."

Yesterday, I had to run two separate gauntlets - one for medical insurance claims and one for my mortgage company because I've gotten a better home owner's insurance deal. One was voice recognition and it makes you wait until it is done giving you all 23 options for each leg of the gauntlet before it lets you say anything. The other involved the button pressing gauntlet - and that one, pfff, after you've put in your member ID, your social security number, your child's number, the president of Mozambique's number, when you finally get a real person you have to repeat all of that information anyway.

If you do know the secret for getting to a real live honest-to-goodness sensient life form, you end up getting put on hold for indeterminate lengths of time.

I have to go through this with my medical insurance company every couple of months when my daughter sees her allergist. Her bill is from a doctor with a very unique first and last name. However, when he billed the insurance, of which he is a covered provider - his billing agency does not add his middle initial. He is registered with the initial. So, although his name is on the bill (sans initial), his ID number is on the bill, the address - street, suite, city, state, zip - are all the same, the lovely automated system spits out the bill every day. The insurance company does not pay the claim in full, instead they pay out (or not) as an out-of-network provider. EVERY TIME. Even though we have been through this over and over again for the past 8 months, it still happens. Why, I asked today - after going through a long, long, LONG button pressing gauntlet and enduring two holds - the first one 7 minutes, the second 25 minutes. Why do they consistently screw up my daughter's medical claims? Because the claims are processed through an AUTOMATED system for the most part and do not go through a real human being every time.

The claim form arrives. It is scanned into the system. The system sees Dr. Johnzki Doebrowski and not Johnszki I Doebrowski. The "I" is missing. The system doesn't recognize the same medical group, the same office address, the same office phone number, the same tax ID number as the doctor they have in their file with the letter "I" as a middle initial. The system then says, "Not a network provider" and sends it off to not get paid properly. When the refusal reaches me a month later, a human being looks at it after my ordeal with said phone gauntlet and promises to "send it for review" and have it fixed. This generally takes one - two months, when means I begin to get bills and late notices.

When you finally do get flesh and blood, you know in your heart it is not that poor person's fault but by the time you reach them, you're pumped. Deep breath in, deep breath out. You try to be civil, but it is hard...very, very hard. Speaking through clenched teeth, you explain as politely as you can manage, the situation. AND ... drum roll ... they can't help you and must patch you through to a supervisor. This means another long session listening to elevator music with occasional sprinkles of, "Our company loves you. We honor our customers. We will be with you as soon as possible. Blah, blah, blah."

I've got a theory - aside from the almighty dollar the the "profit" that comes from having less human bodies to pay salaries to - these companies are all probably tied in to big drug companies. This way, they can drive you batty with their automated systems AND then make a profit when you have to be put on Prozac or Xanax because of all the stress they cause you!

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