It’s Going To Be A Long Morning, Evening, Whatever

, , , , , , | Right | January 10, 2019

(I work at a local insurance company, at the call center that provides transportation for people on medicaid and medicare — people who have insurance through the state due to low income, disability, or old age. Transportation is strictly for medical appointments so that people can utilize their insurance while also staying healthy and bringing our costs down by avoiding ambulance and ER visits. This is a story my coworker told me about.)

Coworker: “Hello! Thank you for calling [Company]. My name is [Coworker]; how can I help you?”

Member: “Where is my cab?! I had a ride today!”

(My coworker checks her account and sees she has a ride for 10:00 pm tonight. Notes from previous rep say, “Member insists it’s an 11 pm appointment.”)

Coworker: “Okay, ma’am, it’s a 10:00 pm pickup tonight.”

Member: “Nooooo! My appointment is at 11:45 pm this morning! I don’t need no f****** 10:00 pm pickup. WHERE IS MY CAB?!”

Coworker: “It is scheduled to come tonight. When is your appointment today?”

Member: “11:00 pm.”

Coworker: “So, tonight.”

Member: “No, you’re f****** r*****ed! 11:00 pm this morning!”

Coworker: “I’m sorry, I keep hearing pm. Do you mean am?”

Member: “It’s this morning. I called yesterday.”

Coworker: “I understand that, ma’am. The issue is that you keep saying pm when I think you mean am, and I have notes here saying you did this yesterday.”

Member: “It’s one one zero f****** zero pm.”

Coworker: “So, just so I’m clear, you’re saying pm, as in this evening, as in afternoon.”

Member: “No! My surgery is before lunch!”

Coworker: “So, if I get you a pickup in the next 5 to 20 minutes, would that work?”

Member: “Yes, I want to be a couple minutes early.”

Coworker: “For your 11:45 am appointment, correct?”

Member: “I said pm, sir…”

Coworker: “So, no ride right now?”

Member: “Just send me that cab that y’all f***** up.”

(My coworker did end up setting up the cab ride, even though we have a policy against same-day-rides, as we call them. Also, before people start claiming senility or dementia, I would like to note the member was 47.)

Health Care(less), Part 4

, , , , , , | Healthy | January 5, 2019

In the spring of 2000, I came down with a cold that lingered nearly two weeks, then got weird. I went to see the doctor and she ordered several tests to be done at the hospital next door to the office building.

It was there that I was told that one of the tests she wanted done — a pulse oximeter reading — required pre-approval from my insurance company, which would take about three days to go through the process.

When I told my doctor about that, she was furious. It was a fairly simple test, but her office did not have the necessary equipment. Once she had a break between patients, she marched over to the hospital and spoke to a friend who worked in the emergency department. She then brought my husband and me through the back hallways to her friend, who placed a clip that looked like a clothespin on my finger. In a couple of seconds, the nearby machine showed the necessary data and I was finished with the test in less than five minutes. I was never billed for it.

It turned out that I had pneumonia. I was sent home with the needed prescriptions and instructions. I was back to normal in a few days.

The next time I went to that doctor, she told me that the office had acquired their own equipment.

It’s now eighteen years later, and her office has several of them. I noticed this morning that you can buy one online for about the price of two fast-food hamburger dinners. And the insurance company had wanted three days before approving the procedure!

Health Care(less), Part 3
Health Care(less), Part 2
Health Care(less)

I’m Currently Paying Zero; Can You Do Better?

, , , , , | Working | January 3, 2019

(This is an actual conversation I had on the phone.)

Me: “Hello?”

Representative: “Hello. I’d like to help you save money on your car insurance! Is this a good time to talk?”

Me: “I don’t own a car; please take me off of your list.”

Representative: “But I can save you a lot of money on your insurance.”

Me: “No, you didn’t listen. I don’t own a car; therefore. I don’t have or need car insurance. Please take me off of your list.”

Representative: “But I can save you a lot of money.”

(We repeat this whole thing way too many times. Finally. I am furious.)

Me: “LISTEN TO ME! I have a medical condition that makes it impossible for me to drive a car. That means that I do not own a car. That further means that I do not have or need car insurance. Do not call me again!”

(I hung up. Literally one minute later they called back! Luckily, it was a different rep who actually listened.)


Welcome To Private Healthcare!

, , , , , | Healthy | December 21, 2018

(I’ve recently had to change my health insurance, and I’m still getting used to its quirks. I realize that one of my medications can’t be refilled on this insurance without a Prior Authorization — “PA.” Basically, the insurance wants my doctor to formally request that I be allowed to take it, because it’s a name brand that’s relatively expensive. My doctor sends the PA request in a few days before I have an appointment with him, and I don’t hear much else about it until I go into the office, where my doctor seems irritated.)

Doctor: “So, I wrote a letter to your insurance company for the PA. Actually, I wrote them two letters. They won’t fill your prescription.”

Me: “What? I thought the point of the PA was so they’d fill ones they normally wouldn’t?”

Doctor: “Generally, but sometimes they deny the requests because they want you to try a generic first. When I sent the first letter, they replied with a denial and said that you were required to at least try [Generic #1] or [Generic #2]. The problem is, they contain [certain progestin], which interacts with testosterone.”

Me: “Which is what I’m taking [Medication] for in the first place?”

Doctor: “Yes! So, in my second letter, I told them that if they couldn’t approve [Medication], I needed anything from a long list I gave them, but specifically any variation that did not include [certain progestin]. And they absolutely will not budge. They sent me a list of more options, and every single one of them contains it.”

Me: “Um. Okay. What does that mean?”

Doctor: *looking like he wants to kill someone* “It means your insurance company won’t let you take any medication except for the kind that will only make your problems worse.”

This Tita Gets Her Cable Set Up In Time To “Eat Bulaga!”

, , , , | Right | November 30, 2018

(I work at an inbound call center for a health insurance company.)

Me: “Thank you for calling [Company]. My name is [My Name]. With whom am I speaking today?”

Caller: *yells at me in a foreign language*

Me: “Ma’am, would you like me to get a translator on the line for you?”

Caller: “Yes, please!”

(A few minutes later.)

Me: “Okay, ma’am, I have the translator on the line.”

(The translator introduces himself. The woman is still yelling but now having a conversation with the translator.)

Me: “Um… can I have your member ID number for verification purposes?”

(The woman says something to the translator.)

Translator: “She says she doesn’t have one; she wants to know what channel the Filipino Channel is on.”

Me: “Can you tell her she’s calling a health insurance company in Massachusetts? And that she needs to call her cable provider?”

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