Wednesday, July 05, 2006

Denise, I love you

Last April my company went through one of those massive "we're changing health insurance plans" things in which we were all compelled to fill out tedious paperwork. We went from small group to large group, or some other such thing which produces no material difference in the type, quality or cost of the healthcare I receive.

So my old card went inactive and I was to receive a new card, which I did, some time in the middle of May.

My appendectomy was May 5. My old coverage expired May 1. My new coverage started May 1. But the card I gave the hospital on May 5, the only card I had, was the old card.

So I started to get lots of stuff in the mail. Automatic computer printouts about claims. Some of which told me I was "ineligible" at the time the claim was submitted.

Then all my providers started billing me, or mentioning there was a problem with my account. And they had dollar amounts with many zeros.

Last week I called Blue Cross, figured out what the problem was. The lady on the phone told me she can't change the claims, but if I call the providers and have then submit a corrected claim with the new info, everything would be fine.

So I started calling. I have one that's going to re-submit the claim. But when the CT scan biller told me the claim had been submitted under the new, correct number, yet rejected, I got concerned and called BC.

Denise answered the phone. I explained the situation, and once she had my Social security number and could see what was happening, I was placed on hold for a very long time.

She came back to tell me she was going to try to forward this case to their research department, who had the authority to move claims around and re-submit them to the correct account. I'm sure she saw how many billers I'd have to contact to fix it.

I was stunned. I've come to expect call center folk to try to pass me off as fast as they can without any regard to whether my problem was solved. Denise just found a way to fix the problem which isn't really their fault. Her Karma balance runneth over.