Tuesday, September 17, 2013

Please Feed Ed to the Alligators: Part 1

Sometime in 2012, the wife’s doctor recommended a follow-up on something, I’m not really sure what it was about, but it was important, so a few months ago, she had that checkup. The wife is fine. That's not the point of this story. Between the first visit and the followup, I changed jobs, moved from AZ to CA, and changed our medical insurance. Apparently I angered the bureaucracy gods.

A month after the followup, I got a letter to my work address from our current medical insurance telling me that they "had not yet received the requested information" regarding that visit. It was the first letter I had seen.

I called and navigated a menu system that switched from asking for voice responses to key presses and then back to voice responses. I finally spoke to a person who changed my address and transferred me to claims to sort out the letter I'd received. Except she didn't actually change my address, and then she hung up on me.

I called again the next day, proceeding directly to the claims department.

Me: First, I'd like to confirm the address you have on file. I changed it yesterday.
Her: The address is: <wrong address>. Also, I see no record of your call...
Her: ...and it is not possible for anyone here to change your address. It must be done through your work.
Me: But the person yesterday said she was changing it.
Her: Uh-huh. Yup. Sure. So...
Me: Forget it. Let's talk about this letter.

The lady said a bunch of sentences littered with terms I suppose make sense if you're in the insurance industry. They were denying the claim because the follow-up had been recommended before we were covered and was therefore a pre-existing condition per their guidelines. However, if I could show that there was no gap in coverage between our old insurance and current insurance, they would probably pay the claim. I needed a "certificate of prior coverage." I thanked the woman, called my old insurance company, and spoke to a guy named Alex:

Alex: Yup. Certificate-of-awesomeness. You betcha. That’s what you need. Good thing we already sent you those. You’re all set!
Me: I never got them.
Alex: Sure you did. <clickity-clack> Well, OF COURSE you never got them we have no mailing address for you. <clickity-clack-clack> We have only a home address of <correct home address>, shall I use that?
Me: Why haven't you used it already? It IS my home address!
Alex: <pause> Sir? Would you like me to copy your home address to your mailing addresses?
Me: Copy my home address to all possible address fields you have.
Alex: Ok, so then do you need anything else?
Me: I need you to fax our certificates-of-awesomeness to Old Insurance Co.
Alex: But we alrea...Oh...Right. Ok. <clickity-clack>. Those will be sent in 2-3 minutes.
Me: kthxbai.

As I was hanging up, I had a brain-itch warning me that I couldn't actually verify the new insurance company received the promised fax because I had the old company fax it directly to them. But I got distracted by something shiny and I forgot all about it. I did remember to have my plan administrator change my address. When I asked, she said "Oh! HA! That almost never works when I do it, but I'll try." That was in June.

In early August, I got an unrelated letter to from New Insurance Company to my correct home address. Several weeks later I got a "This is your last chance to provide the requested information!" letter about the same claim. It came to my work address. Awesome.

I called New Insurance Co. and spoke to a man named something like Ed. He seemed pretty frustrated with me. They had sent four letters! Why was I ignoring them? They had no record of receiving the fax in June. I was starting over.

(Part 2 is coming soon)

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