Monday, November 22, 2010

All We Ask

First, it’s Thanksgiving week so I’m very much appreciative of the fact that 1.) I have health insurance. 2.) I have “decent” enough coverage that means I can basically get what I need to survive. 3.) I've got a job that allows me to at least try to pay for the supplies and prescriptions needed to survive this Life With Diabetes.

But that’s about as far as my gratefulness goes on that point at the moment. Especially when said insurance company and pump supply supplier decide it’s a prudent business decision to fib on what they have and haven’t done and whose fault it is.

The details: an issue with Medtronic Minimed over a recent pump supply order that has prompted this post. I ordered new supplies in late October, receiving them without issue at the start of November. I did this for a reason – to get them before the year-end deductible resets so that I’d be able to calculate what remains and what else I might be able to use before that amount returns to $0 and I must start over. Two weeks post-order, the claim still didn’t appear on the United Healthcare online database. They hadn’t received it, and a kind representative even checked to make sure it wasn’t lost in some outside-of-time abyss being processed. Nope, they haven’t received it yet.

Well, according to Minimed, the claim was sent on Nov. 1 – the same day my order was submitted and sent out. Uh huh. Claiming that everything was done electronically and I couldn’t get real confirmation of that, I was told the delay is on UHC’s end as they’re likely “processing it” and it could take as long as 45 days. Um, no, Minimed, that’s not true. Twenty minutes into that discussion, I “lost” the call – they hung up on me. Being busy with work deadlines, I didn’t call back and waited a week before trying again.

Of course, I double-checked with UHC beforehand just to make sure and confirmed nothing had yet been submitted by Minimed in the past month. Phoning Minimed, I was told the same story. Asked for proof, they argued, I demanded it again, they argued, then finally went to find a supervisor since I’d demanded one three times already. After a 38 minute discussion, the call again was lost. I fumed, but had more time this round. Called back, got same person, and then demanded the same supervisor.

That’s when they apparently “figured out” that there has been some billing department issues on their end and they hadn’t actually sent out my claim to UHC until late the past week. Again, I demanded confirmation of this and soon enough got a fax showing the submission date. Within a week or so, the insurance company should begin processing this to calculate my claim and deductible amounts that apply.

So, basically, I lost three weeks I’d planned on having thanks to some “billing department issues” and then two lying representatives.

(Sigh).

Seriously. Why is it so difficult to tell me where my claim processing stands, so that I might actually plan ahead?

It’s bad enough my deductible-year starts in January while my Flex Account year starts in June, and I must navigate that stupidity in my medical payment planning. But you have to add even more delay and hassle on top of that?

Please, don’t lie to me. Chances are, I’ve already covered my bases and know you’re lying. Don’t tell me that you used to work at an insurance company so you “know more than I do.” I’d be willing to put money on that, and I bet I can get you fired before you can screw with my claim status even more.

(Yes, I realize that this mentality is likely why I’m blacklisted by most insurers and red flags and alarms start wailing when my name appears on the screen.)

Insurer and supply company: Chances are, when I ask you a question, it’s more of an opportunity for you to “come clean” and be truthful because I already know the answer and am just testing you. Don’t insult my intelligence or lawyer-like mind. I’ll win. And you’ll end up on the latter end of whatever I decide is appropriate to throw at you. Yes, I invite you to use your imagination on that one. I’m chummy with more than one insurance commissioner at whatever level may be most threatening to you.

Oh, and by the way: I write a blog that gets hundred of hits a day and I also work for a professional newspaper. Be forewarned. Just tell the truth. Please. At a minimum, I deserve that. There’s not much I can do about the high costs of insurance and medical supplies and crappy coverage that I get despite continually skyrocketing rates. But if I’m paying all of that, is it too much to ask for a little common courtesy and honesty? No red tape?

Really, I don’t see this as being too much to ask. It’s the least you can offer to those of us People With Diabetes who are just trying to survive. Please, just be honest with us. That’s all we ask.

9 comments:

Meal Mommy said...

Insurance sucks...they make it SO hard to get anything done!!!

Briley said...

I think if you ever decide to leave the newspaper business, you should be a "medical supply/insurance bully" for those of us without a backbone.

Renata said...

That round robin crap drives me insane. They bank on the fact that you will feel like it's a waste of your time or it's useless to continue to keep pushing. You keep doing what you are doing, it helps everyone.

I've been going through the same thing with my mortgage company. We've sold our house and I haven't been able to get my paperwork for my taxes for the last two years. It' silly, frustrating a down right pain in the ass.

Scott Strange said...

Amen, Mike, amen

Jonah said...

Minimed's billing department was a big part of why they lost my business, CGMS wise.
I was sending checks in the mail (with exactly what they told me to put on the envelope- attention of so and so) and they were taking over a month to find the checks.

Wendy said...

HI FREAKING FIVE, MY FRIEND!

I **hate** this crazy cycle!!!!

k2 said...

Diabetes or not, as far as CS goes I think it depends on who the person on the other end of the phone is.
Call again and ask to speak with a manager and stay calm. Go over the dates you submitted, etc and be firm, but nice. I had a problem with my order not being submitted this month after MM changed their billing system. The woman I spoke with on Friday not only fixed it, she expressed shipped my order free of charge and I got it on Monday morning. She wasn't a manager, but she bent over backwards to make sure I was happy.

Anonymous said...

It doesn't matter when the claim is actually submitted. As long as the date the order was processed shows, your insurance company would take that into account.

Four Awesome Tindals! said...

Interesting that we had a similar issue when we ordered my daughters insulin pump. They said they pre-approved it with our insurance company, I asked for verification and they could give me time, date, and such 'n such... I thought it sounded good and that everything was in order. Then I got the insurance bill... a little over $13,000! I think I about had a heart attack! It took diligent work on my part for 3 whole weeks to get this ironed out, but finally did. I had a rep come clean and say that it wasn't properly taken care of or documented on their end... At least I finally got someone to tell me the whole story and be honest. Hopefully she still has a job... and hopefully she remains on the honest side of the fence!