To really foul things up...

[NW-Bound]

True.

...There was no excuse for the time it took for them to fix it. I say fire the damn programmer.

Come to think of it, it's not a single programmer's fault, but the process or a whole department. Fire them all! Off with their head. Bring in the next guy.

 

[EastWest Gal]

I'm not doing Medicare, but when it comes to insurance, I completely ignore doctor bills. I wait for the EOB and pay what it says on there. Doctors are always billing more than they should get, so I just ignore them. At first I'd call them on the second notice, but each time they said they were not in the business of turning people over to the credit bureau for waiting a few months for the insurance company to catch-up. On my daughter's braces, I argued with the insurance company for 6 months. The ortho office was chill with me not paying in the mean time, as long as they knew the argument was still underway. If it's like a year old, they may sell the debt to a collection agency, though.

My husband paid one of my medical bills online as he always does. He received a refund for the amount he paid. He was confused but never figured out what went wrong. It turned out he missed that his and my account numbers are different. So my bill was never paid. We were never notified. So they send me to collections over an $85 bill. And it was a balance bill (illegal as we were in network). That was before ACA insurance. We now pay a copayment and we end up paying a lot less than my old company plan. Funny, we're with the same insurance company.

We were also a month behind on insurance premiums even though we had set up autopay. The insurance company "forgot" to bill us in April. I even called them about it. They finally fixed it this month by billing for two months at once.

It's by design that doctors and hospitals overcharge. That way every insurance company pays a discount. Cash paying patients have to negotiate a rate. It's a very stupid system and I spent an entire career in that stupid billing system. Yikes!


Sent from my iPhone using Early Retirement Forum

 

[rbmrtn]

Another part of the problem is just the process itself. There are third and fourth level parties involved. The provider claim goes through a clearing house ( or two ) before it ever reaches the insurer. Any error along the way and it goes back to start over. Any computer upgrade or outage throws the whole thing into chaos. It can take 3,4 6 months for claims to be settled.

I pay mine online and the when I go to the payment tab it leaves the insurer site and goes to emdeon ( big clearing house ). Sometimes my statements are there, sometimes not. Sometimes they skip a month then bill for two.

 

[travelover]

I'm not sure it really does much, but I record every non-personal call that comes in or goes out. Even if it's excellent customer service, I figure I'll record 'em all...they do!

If I get in a situation where I think they're snowing me, I ask them their name again and have them repeat what they said. If they say they can't do something they should be able to do, I state what they should be able to do and have them confirm they can't do it. Then I say something like, "like you, I record my calls", and most of them are smart enough to know the transcript or the call itself might end-up on the VP of customer service's desk, or maybe on the Internet, if it's entertaining enough.

So it might not do any good, but it makes me feel better when they're giving me the run-around.

In my experience, they will agree to do something to make you happy, then just not do it. When you call back, the next rep will also agree, but not do it. And on it goes as long as you want to keep calling. So called "supervisors" are not much better and are "in a meeting" whenever you call back for and ask for them.

 

[MRG]

Another part of the problem is just the process itself. There are third and fourth level parties involved. The provider claim goes through a clearing house ( or two ) before it ever reaches the insurer. Any error along the way and it goes back to start over. Any computer upgrade or outage throws the whole thing into chaos. It can take 3,4 6 months for claims to be settled.

I pay mine online and the when I go to the payment tab it leaves the insurer site and goes to emdeon ( big clearing house ). Sometimes my statements are there, sometimes not. Sometimes they skip a month then bill for two.

+1

My last assignment was around one of the third parties. What an evil system, thing was supposed to be mothballed, unfortunately a new customer signed up for the promise of this system will do exactly what you need it too. They threw megabucks at the thing trying to make it work. Biggest issue the development team had no idea what it was supposed to do, or experience with the technology to make it work. I'm not a DBA but in my experience seldom do queries that join 22 multiple million row tables together perform decently.

Yes when claims didn't adjudicate properly they waited. Sometimes for a very long time.

 

[sengsational]

In my experience, they will agree to do something to make you happy, then just not do it. When you call back, the next rep will also agree, but not do it. And on it goes as long as you want to keep calling. So called "supervisors" are not much better and are "in a meeting" whenever you call back for and ask for them.

That's my experience too. But for the next rep, at a strategic point in the call, I tell them that I've heard that one before, in fact I have an audio recording of the unfulfilled promise, just like I have an audio recording of this call. I'll sometimes say that if I can make this entertaining enough, I'll post it on the internet, tweet-out the link, and see if we can get it to go viral! Me and Abdul, Internet stars for a day.

Again, makes me feel better to have a tiny bit more leverage, but I probably don't get any better treatment, maybe worse, since the company obviously doesn't care about their reputation if they treat customers by not fulfilling promises.