Thursday, May 7, 2009

Insurance and Idol chatter

I used to work in the claims/member services department of a Health Care insurance provider.

I say that before I share the following so you know Ive been there...however.............

My DD is having her first experience with Medical Bills, insurance & collection agencies. It seems she had an office visit that left her with a balance due.

Unfortunately it appears the Doctors office failed to put her apartment number on the bills they sent her.

She claims she never got anything.

One day she gets a call from a collection agency. It's about the "Never received bills".

She calls me for advise and I suggest she call the doctors office and see if she can get things straightened out. She trys for over a week to speak with the woman in the doctors office billing department. When she finally does, the woman tells her, "I can't tell you anything because it has gone to the collection agency"


She calls me and I agree to try and call the doctors office for her. I call and get put on Hold...for a long time. I decided to try and look on the Insurance's website and verify that they received the original claim.

It appears that they did and that the visit fell under an 80/20 coverage after her deductible.

I tried to call the insurance company to verify everything I was looking at since even through the bills shows $$$ going towards her deductible, when I look at the deductible information it doesn't have anything listed there.

I call the Member Services number. I don't pay good enough attention so I miss the number to press for Medical. I push -0- several times....the universal way to try and get a human...and finally a gentleman comes on the line.

I briefly explain what I need and he said I had reached the "Pharmacy department". I apologize and ask if he can transfer me to the proper department. He says , Yes, and asked for my phone number. I offered my account/member number and he said, NO...I need your phone number.

I give it to him and wait.

A man voice comes on the line and here is the conversation:

Mans voice: Hello?

Me: Hello?

Mans voice: Hello?

Me: Hello?

Mans voice: Hello?

Me: Hello. Can you hear me?

Mans voice: Yes

Me: I'm trying to reach XYZ Insurance. Who am I speaking with?

Mans Voice: Is this Cheryl HXXXX?

(finally realizing that the voice I thought I was hearing was in fact the voice I was hearing)
Me: Baby?

Mans voice: (Laughing) Yes.
Are you Kidding me? Seriously? The insurance rep transferred me to MY HOME PHONE NUMBER!

My DH & I had quite a laugh as I tried not to scream at the stupidity of the situation.

So guess what I have to do tomorrow? Yep, try to deal with the insurance company/doctors office/collection agency.

I've already warned the DD that she may owe the $$. No help from me as I just got a bill for $500 for the CT/MRI/Doctors visit about my shoulder. Apparently it fell under my Deductible/80-20.


Idol watchers.....what did you think about the results show? I'm no sure who looked more shocked, Chris or Alison.

Should make for an interesting final three.


The boy is finished with his Karate class and I get to go home!!!!

Til later...........................

1 comment:

Jenn(ifer) said...

Omg!!! That conversation part was hilarious...but I'm so sorry J is having to deal with this already. ((I'll be dealing with things like this VERY soon))

As for Idol..I am PIST (no nicer way to put it) that Allison is gone & Kris is still here. SORRY KRIS FANS but Allison could SANG he was just ok. Adam will win. I just feel it he is going to take the whole cake. Danny murdered "Dearm On" btw, and I've ALWAYS been a fan of his...but omg it was rough to listen to.