Almost There...

Oh my goodness, I’m about to have to get serious with these people…

Bright and early Monday morning, I decide on a whim to check the insurance website one last time, just to see if by chance the claim has shown up. I check the page, and do a double-take. I look away and back, because SURELY I am seeing things! THERE IS A CLAIM FOR XYZ SUPPLY COMPANY!!! What?! I am all kinds of excited and curious, so I open up this claim. My insurance company has this really cool feature (they may all have it but this is the only company I’ve had for years so I choose to be impressed) where they display the date a claim was received. Amazingly enough, my claim was received by the insurance company THE DAY AFTER I called the billing department and told them that either they fix it or I’m calling the Insurance Commissioner. Interesting. I’m sure the timing is merely coincidence.

Now, you would think that this would be the end of the story. But no, that’s not how things go in my world. Remember at the beginning when I placed my order? And I had to call back a few days later and place a second order for my humidifier tank because it got missed on the first call? Well…apparently because it was a second order it was a second claim.

Surely, since I had to call and basically threaten them to get the claim sent in they would have made sure any and all claims for me were sent in together right? Or at least made sure all of them were sent in at all? Yeah. Not so much. It bears saying that the contracted cost of the humidifier tank that I paid when the order was placed is less than nine dollars. However, that’s nine dollars of my deductible that I have already met and shouldn’t have to meet again. Not that my insurance company knows that I’ve met that amount-small though it may be-because XYZ Supply Company never filed the second claim. I could just absolutely spit nails (Is that only a southern saying? Well just in case for all you non-Okies, it means I was pretty mad). So I call the insurance company to see if they have the second claim for the humidifier and it’s just not showing up on the website yet. And, as before, they have no record of that second claim.

I make my Monday call to THE HAMMER. She was amazed as I was by the fact that there was finally a claim filed! And as unsurprised as I was that the date the claim was received by the insurance company was the day after I called them. I let her know that, while one of the claims has been made, I’m still missing one. She advises me that, even though it’s for such a low amount, I should definitely have them file it. Especially since I already paid the insurance-contracted rate.

Once again, I start calling the billing department for XYZ Supply Company. I start asking about my claim, and they tell me that it’s already filed for this date of service. Well, I’m not calling about that one. I have that one on my insurance, I need the second date of service filed-the one for the humidifier tank. And again it starts.

“Well it looks like we need a prescription”

No, you have the prescription that you need; you used it to file the first claim. Look again.

“Oh yes, I see that now. Well it looks like the claim was sent in to your insurance company; you will need to wait for them to process the claim.”

Well when I talked to them this morning before I called you, they show no record of a claim for this date of service.

“Well we sent it in so they have it somewhere.”

Yaknow, I am not accepting that answer. I am not going through this again for an eight dollar claim. I want to talk to someone else.

“Ok let me transfer you to a lead.”

Lead comes on. Lead gives same story. I refuse to accept this answer again, because I know that it’s complete horse hockey.

I want to talk to someone who can resolve this issue TODAY. This has been going on since February and I had to call and threaten to turn you in for INSURANCE FRAUD before the first claim was filed. I want to talk to whoever I need to talk to in order to get his issue resolved today.

“Well I can send you to a Level 3 person.”

Oh yes, please do.

Level 3 person comes on. At this point, I’m 45 minutes into this call and just about as happy as you would think. So I, once again, explain to the person on the phone what has been going on and that I want it fixed today.

“We’ve sent this to your insurance company twice, so they actually have this claim multiple times. You will need to wait on them to process it.”

No. No, they do not have this claim twice. They don’t even have this claim once! Fix it. Get it filed, get it done and get it done now.

“We sent the claim in to them electronically”

Ok great. Do you have some sort of acknowledgement from the insurance company showing that it was received? Some kind of confirmation code that it went through, or did you just assume that it went through correctly just because you sent it?

“No, I’m sorry; we don’t have any kind of confirmation code or anything. We won’t, because it was printed.”

I’m sorry. Printed? My claim was printed in order to be filed with my insurance company electronically?

“No, once it’s printed it’s sent in to the insurance company on paper. It can take up to 60 days for them to receive and process it. “

When was it sent? And who sent it?

“It was sent in on the 23rd of March, by our Insurance Billing department.”

I want to talk to that person. I want to talk to the person who physically put my claim in an envelope and mailed it to my insurance company,

“I’m sorry, that’s not possible. They only talk to insurance companies. I am in patient billing, that’s why I’m talking to you. The Insurance Billing department will only speak with insurance agents.”

I don’t care. I want to talk to that person. I pay for my insurance, I paid for my supplies, I want to talk to the person responsible for filing my claim.

“Well that’s not possible. They don’t talk to patients,”

Fine. I want to talk to your supervisor. Do you have a supervisor? I want to talk to them.

“Ma’am, my supervisor can only see the same information that I have. They will tell you the same thing that I’m telling you.”

Fine, then I want to talk to your supervisor’s supervisor.

“The Manager? Oh well they have the same information and will give you the same answer that I’m giving you.”

So what you’re telling me is that I can’t talk to your supervisor; I can’t talk to your manager; and I can’t talk to the Insurance Billing department because I’m a patient even though I’m the one paying for the insurance??

“I never said you couldn’t talk to my supervisor.”

Well you didn’t transfer me when I asked, did you? You just told me that it won’t do any good to talk to them.

So what you’re saying is that I need to call my insurance company so that they can call in and talk to Insurance Billing because they are the only people who can delve any further into this even though I’ve been calling for over two months trying to get this resolved and this is the first that I’ve heard about them?

“What I said is that the Insurance Billing department will only speak with insurance agents.”

Fine. Once again I will call my insurance company so that they can call your people and get ME the answer that I’ve been asking for since March.

“Ok great. Is there anything else that I can help you with today?”

…seriously? Just a little tip. When you have a cheesed off person on the phone and you haven’t resolved their issue, don’t finish with your standard closing. You already made them mad. Just end the call as pleasantly as possible.

No, thanks. You’ve done enough.

So not only does my insurance not have my claim, all the people who assured me, multiple times, that it had been submitted to the insurance company electronically either straight up lied or didn’t care enough to read through the-most likely epic-notes on my account. This makes me even happier than I already was to begin with. And I was already pretty flaming happy.

I call my insurance company back, so that maybe they can get ahold of the Insurance Billing department and speak with someone to find out what in the world is happening with this claim.

My friendly insurance rep answered quickly, and I asked if there was a claim for this specific date of service in February. Shockingly, they show no record of a claim for that date of service. I stand amazed.

I start telling my rep about my conversation with XYZ Supply Company, and how I was told that the people I need to talk to won’t talk to me because I’m a patient; my rep, who is annoyed on my behalf, graciously offers to call. He gets on the phone with XYZ Supply Company while I’m on the phone with him; and we hear the pre-recorded message that the approximate wait time is 12 minutes. This surprises my rep. Not so much me, seeing as I’m used to waiting 40 or more minutes. He finally gets through after waiting, only to hear that the office is closed for the day-please call back tomorrow. Hey, at this point I’m glad it’s not just me. I was afraid they had my phone number pre-routed to a recording.

Finale, coming up tomorrow!