The Midsection

So last time, after waiting on hold FOR-EH-VER, I was disconnected…see what happens next!

No they did NOT just disconnect me after I’ve waited on hold for the majority of my lunch hour. AGAIN. Annoyed, but still trying to be patient, I call back. And I wait on hold. Again. And I head back to work, grabbing a sandwich on the way because I haven’t eaten yet even though my lunch hour is basically over, all while listening to the amazing hold music. Truly, it’s amazing. To the point that I want to stab my eardrums out so that I don’t have to listen to it. Sigh.

I get back to work and am still oh hold. Finally after waiting about 30 minutes, I get a person! Yay!! Who then tells me that they don’t have the prescription. Well, my doctor’s office sent it in last week so…find it please. Oh wait there it is-they found it! So all the sudden it appeared after I told you that the doctor’s office told me that they had a fax confirmation? Again with the hinky. And I am assured that it will be submitted to my insurance company, post haste.

The end is in sight! At last, 5 weeks after my order was filled and paid for, they have what they need and will submit a claim!! I’m very excited. I get my lunch hours back again! Or so I thought.

I give it yet another week. I check the insurance website. No claim. And I have a mini breakdown-I mean seriously, what the hell is the problem?! This is your JOB. This is what you do all day every day. How in the hell an it be this difficult to press a button on whatever billing program that you use to submit my claim to my flaming insurance company?? I have used you before and never in my life had this much trouble just getting something sent in to the insurance company! < banging head on desk >

I have finally had ENOUGH. I go to my HR person at work and ask if she has any connections with the insurance company or anyone who can help me out because I have been messing with this for 6 weeks and have gotten absolutely nowhere. Unless you count the rise in my blood pressure. I make contact with our insurance broker, who is the person I was given by HR. I love this woman. She is my favorite. I have nicknamed her THE HAMMER.

I give THE HAMMER the rundown on everything that has happened since I placed my order. I point out that the only reason that I used XYZ Supply Company is that they are the preferred provider of my insurance company. I figured preferred provider meant knows their stuff and does it well. But apparently not in this case. THE HAMMER listens to my story and then I ask, am I being unreasonable? Because if I truly am then I can fix that. To which she replied, basically, hell no you’re not being unreasonable. This is stupid and has taken way too long to resolve. I was so relieved that someone who deals with this stuff on a daily basis was on my side.

I felt so much better at this point. I had been talking to my friends, coworkers, and family about this since I started having trouble. They all told me the same thing, you are being too nice; you have to get forceful with them. I don’t like to do that; I prefer to start out being nice. Yaknow, more flies with honey and all that. (though what anyone would want with flies is beyond me).

So I asked THE HAMMER, what should I do next? Something has to give, and I’m not getting anywhere. THE HAMMER is awesome. She has magic words, which she shared with me.

Are you ready for this? They are powerful, but I will totally share them with you. I’m all about the sharing.

The magic words are…

INSURANCE FRAUD

Gasp! Can’t you just hear the horror music in the background? DUN-DUN-DUUUUNNNNNNNNN!!!!!

See, to me fraud is one of those BIG words that you don’t throw around. To me that ranks up there with talking about bombs in an airport. Not funny, even if you are joking. Not something you play around with, right?

However, THE HAMMER explained to me that, since XYZ Supply Company is essentially refusing to file a claim with my insurance company, they are in fact committing INSURANCE FRAUD. I have insurance and I have it for a reason. This company is contracted with my insurance company to bill at a specific rate and then file an insurance claim.

My mission; contact XYZ Supply Company’s billing office, again, and advise that if my issue is not resolved, TODAY, I will be contacting the Insurance Commissioner’s office and reporting them for INSURANCE FRAUD.

Eek! Just saying those words to myself makes me a little twitchy. Fraud is something you hear about in gangster movies, or some crazy dude on Wall Street. Fraud isn’t something that happens to a small town girl, lonely world or not!

I plot out what I plan to say, and psych myself up for being not nice. Now, my friends and family will tell you that typically I have no problem being not nice. One might say that I excel at it. I show my love with sarcasm. So it always surprises them to see me be nice to others. I find this amusing. But in my defense, they give as good as they get, so I figure we’re pretty even.

Now, back to my planning my call. Am I the only one who does this? If I have to make a call and I need to make sure that I ask specific things or get specific information, I make an outline or a list. Always have. Same for leaving a message. For the longest time, if I had to leave a message; I would hang up, plan my message, and call back to leave it. Yes, I do know that I’m a great big dork-this is only a small thing on a long list of what makes me a great big dork. I’ve accepted it as my fate.

I decide what all I need to say and have my list all ready. I’ve prepped myself to not take no for an answer and I’m ready to go! I call, fully prepared to wait on hold another 40 minutes, but by some miracle my call is answered in just a few minutes! I was pretty excited, but I refused to let it throw me off my game. I am here for answers, and by golly I’m getting them or heads will roll!

I get a friendly rep on the phone, who asks how she can help. I go through my spiel, which by now I pretty much have memorized, and she says that she can see where a claim has been sent in to the insurance company. Imagine her surprise when I advise her that not only does my insurance company have no record of the claim, but that I have been assured on multiple occasions has indeed been submitted. And that I have been calling since the beginning of March without resolution, and I refuse to accept yet another person telling me something different than the last person that I spoke with.

I did apologize to the rep for having to bear the brunt of my frustration, but I was done being nice about this situation and told her that in those words. I never raised my voice, I just explained that I was done being passed around. She said that my issue would be submitted to the insurance team for review, and that it would be resolved as soon as possible. And this is the point that I brought out the magic words. I told my friendly XYZ Supply Company billing representative that I wanted this issue resolved TODAY. She balked, I get it, they’re probably backed up. I’m sure they have a ton of things to review. Her answer was that reviewing billing issues could take a couple of weeks.

To which I replied, “it’s been almost 2 months. This is either resolved today, or I get a call from someone on the team supposedly reviewing the issue no later than 5pm central time, or I will be contacting the Insurance Commissioner and reporting the company for INSURANCE FRAUD.”

My friendly rep wasn’t happy about this turn of events. I wasn’t mean. I didn’t yell. I didn’t curse. I simply explained in no uncertain terms, using my “I’m done dealing with you” tone, that this was unacceptable and should have been resolved long ago. I will not take another answer that is meant to appease me just enough to get me off the phone so that I can wait and call again in a week as someone else’s problem.

I don’t like being not nice. I can be not nice, but it’s not really my default (no matter what my friends or family say). After I told my friendly rep what I wanted and expected and got off the phone, I immediately felt bad. Bad enough that I called my sister and recounted the entire conversation and asked her if she thought I was too mean (she didn’t, she’s meaner than I am).

Countdown to 5pm central time. Surely they can tell that I’m serious and over dealing with this, so they’ll at the very least call me and update me on the status of the ‘review’ of my issue (still not sure exactly what needed to be reviewed, I placed an order, and you file a claim. Seems pretty simple to me). Somewhere around 3pm I start thinking that they may really not call me. Maybe my magic words didn’t work and I’m going to have to actually report INSURANCE FRAUD (Yes, I do put that in all caps on purpose. I feel like it’s definitely an all caps worthy phrase). 5pm comes. 5pm goes. No call. Sigh.

I decide that, because reporting INSURANCE FRAUD is a serious thing, I am going to talk to THE HAMMER one more time before I call the Insurance Commissioner. The next morning (Friday), I call her; only to find out that she is off for the weekend and will be back the following Monday. THE HAMMER’s officemate thought that, due to the history of this issue, it would be better to wait for her to be back on Monday as he didn’t have any background to go off of. Sounds like a plan; I set an alarm for Monday to make sure that I remember to call her on my lunch.

…..More tomorrow! Stay tuned!