Monday, October 30, 2006

1st fight of the week

Switching to a new job means having new insurance company which translates to getting used to working with either a) Incompetent people who don't understand the policy or b) Competent people who tries to get away with not paying for services that are covered by the policy.
Secondo had her shots months back and I got a bill from her Dr. saying that my new insurance doesn't cover immunization. That is very odd and I don't recall that was the case when I reviewed the policy. I checked with HR and HR verified that immunization is covered so I called the Insurance company back and told them that I'm confident that shots are covered; however, they still insisted that on their paper work it showed that immunization is not covered. I asked them to fax me a copy of that paper but they said it's agaist their policy. With my 3rd phone call, I asked for the Supervisor right away and they put me on hold. When the claim person came back on line she still didn't give me the supervisor and tried to understand why I'm upset. I told her the whole story again for the 3rd time and she said
Insurance Lady: "Maam, immunization is covered under out policy. I'm going to resubmit the claim."
Me: "If it is then why did the other two folks I spoke to earlier told me that it's not?"
IL: "The policy was now written clearly so newly trained people may interperted differently."
Me: "The last guy said he's confident that it's not covered because immunization is not covered was highlighted in red!"
IL: "Red highlight means there has been a change not necessarily that it's not covered."
Me: "Precisely the reason that I want to speak with your supervisor so that he/she is aware of how frustrated it can be when I get different answers from different people. I don't want to do this again with my next Dr. visit."

IL: " Maam, we made a mistake and I will send an email to the account manager so that they will rewrite the policy to make it easier to understand"

It's unfortunate that this lady gotten the wrath of Sam eventhough she was the most helpful one of all 3 that I spoke with today. I actually thanked her at the end for resubmitting helping me out. I don't have the warm and fuzzy that I'm home free yet.

3 comments:

Bullseye said...

Cable companies p1ss me off too ... add the credit card companies and other compaines who's support people are in India. I can barely understand what the h3ll they're saying.

Bullseye said...

Seems like I can't swear on your comments ...

Sam said...

I may have put up the filter for swear words. You got your point across.