I don’t know how many of you have had to deal with your health insurance company very often, but if you’re like us, it’s a lot. There’s almost nothing I dread more than that call to the “representative” to straighten something out — and that something is almost always related to a “we’re not gonna pay for this” moment. Because even though I pay my part EVERY SINGLE MONTH, they never seem to want to pony up for theirs.
Since I now have a toddler running around the house who seems to employ a lot of the same policies as my insurance company, I thought I’d share with you how they’re alike.
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Coming from an insurance background I’d like to offer some suggestions:
1. Every time your are on the phone with the insurance company write down the date, time, the name of the person you spoke with and the facts of what they said.
1. a. Always remain calm and stick to the facts.
2. When you don’t get the answer you want, in a level voice, simply say “Thank you, may I please speak to your manager or supervisor.”
3. When you get the next person in the chain of command brief them about the conversation you had with the last person, using their name and why you believe your claim is a covered benefit.
3. a. Don’t forget to write down the new person’s name, time, date & what they said.
4. rinse, repeat, rinse, repeat.
In general, insurance companies will deny a claim right away because they know a certain percentage of people won’t contact them to have the claim reprocessed and it saves them a wad of cash.
So, knowing the rules of the game you can be a better player. Make friends in the claim customer service department, get the telephone extension of those people who actually listen and help you. Take the time to answer the surveys they offer at the end of the call especially when they helped you.
Great advice! With all my recent experience, I’ve figured out that thing about them denying stuff right away because people just give up.
Fortunately the deny first, pay later isn’t true in every state. I too have been in health insurance over 20 years, we know about the “bad apples”,and as an agent (now) I don’t deal with plans like that. But, very few bad apples can do business in my state for long. Most claims really are paid the first time around, and within 30 days.
The one thing I learned in my job (many, many years ago) working for a “big shot” was how not to take no for an answer, nicely. It has served me really well! But it is getting harder to deal with the companies. I love this!!
YES. That’s all.
HA! This is so very true.
Glad I found you.
How about this one:
When you ask them, Well then, who IS responsible for this? And they say, Not me.
This is one freaking creative blog post. And hilarious, too. And sadly, so true!!
My husband’s job offers 100% free health care so I’ve forgotten what it’s like to fight for claim coverage. Also, I no longer have toddlers, so this entire post was flashbacks to darker days. Scary but funny. Scary funny!
Damn! You totally reminded me that I need to call BCBS about my sons hearing test when he was born! Also, love #6 & #8 LOL
I’ve worked in Health Insurance for over 20 years and regret that your feelings are true for so many people. Like your toddler, they mean well, but that rep on the phone just doesn’t always know the best way to express her/himself. #5…Ha! honestly really is true, for both Health Insurance and children!
This is hysterical. The super serious comment about real insurance companies? Not so funny. I wish people could take humor for what it is!!
This is hilarious. And SO true! Especially them doing something sneaky every time you turn your back.