Frazzled and Frustrated

What would a week in my life be like without any drama or crisis? I sure would like to find out. A girl can dream.

I spent most of the last week dealing with the absolutely frustrating and mostly incompetent people at my health insurance company. The first problem was a billing issue and their intent to drop my coverage which would have left me with just Medicare coverage and NO prescription coverage for the rest of the year. The problem was they had not billed me for my January and February premiums until after the due date for February. I had already been on the phone with them trying to resolve the billing blip even before I received the first bill. I'm not in a position to pay a double premium at once, especially while I was saving for the trip to my son's graduation, so I requested to make payment arrangements to pay the January premium in installments. I was told that it would not be necessary because I had a sixty day grace period. Having paid utilities and other bills for the better part of my life, grace period implied that if I paid within the allotted time the period would then start over again with the next billing cycle. That was not the case with this grace period but that bit of pertinent information was left out of the conversation I had with the billing rep. It was, in fact, a fixed grace period that I only get to use a few times a year.

Finally, after several attempts to resolve the issue and keep my coverage the company gave in and will not be dropping me. It did take a threat to call the state insurance commissioner and my insisting that since their phone reps do not document what they quote that the tapes of the actual calls were reviewed. After that review they had to concede that I had tried early on to resolve the issue. They didn't admit that I wasn't given a clear explanation of their policy, instead they said that they could see how I may have misunderstood. Irritating to be condescended to that way, but at least I'm keeping my coverage.

Since I am keeping my coverage I called to verify some points regarding my upcoming surgery and I was shocked when I was told that the criteria I thought I had to meet were not correct and now issue number two was in full swing. The criteria I was calling to clarify was given to my by one of their benefits representatives. The first thing I did was ask them to open the log and read the documentation for that original call. I was told, in an annoyed tone, that they do not document what they quote, they only document the time, date, and reason for the call. They could pull the audio recording but that needs an written request and would take weeks. I don't have weeks, I'm supposed to start the series of evaluations that will determine if I am a suitable candidate for surgery. I don't want to waste time on those if i can't be sure that I've met the coverage criteria first and I explained that and asked for the correct benefit information. That's when she told me that she could only give me a very vague synopsis of the requirements, that I would have to get it from the surgeons office. The surgeons office are the ones that told me to verify my benefit with my insurance company.

 That started a crazy round robin of telephone tag with 3 other reps, each of whom told me something different than the person before them. I asked repeatedly to talk to a benefit coordinator, who typically has more in depth knowledge of the benefits. Apparently they do not talk to members, only providers. I asked for a supervisor, but they were all out of the office. As it stands, I still do not know what the qualifying criteria are, which means I am unable to get the correct records sent to the surgeons office. I have asked the surgeons nurse to call my insurance company, so hopefully I will have the information I need before I start the evaluation process.

I love the clinics that the insurance company owns, but I am completely flabbergasted by the utter lack of knowledge and professionalism of their member service. I used to work for one of their competitors and would not have worked there for very long if I had performed so incompetently. Unfortunately I cannot change to another company until next year. Hopefully I won't need to call them again.

I hope you are all doing well. I sure do miss you.