Can you believe I haven't gotten this money back yet? It's been since March 5th!

Have you ever dealt with this kind of HMO hell before?

I've talked to every manager there. Should I just keep being patient?

Ha. Patient. Get it? Because I was a patient, I have to be patient.

Har de fuckin' har.

-- Anonymous, July 21, 1999

Answers

i worked as a clerk in a small law office last summer, and spent most of the summer on the phone with annoying insurance carriers, trying to get money, forms, and information from them. they're about as annoying as pamie describes, only sometimes they're worse. made me never want to be a lawyer, or get in a car accident and need to file claims.

pamie, that sucks. but it's not just you, so don't worry - they're screwing EVERYONE over, just for the hell of it.

(hey, if you worked for an insurance carrier, wouldn't you take your fun where you could get it?)

-- Anonymous, July 21, 1999

It's bureaucracy and it's hell. And there's nothing whatsoever you can do, short of getting on the telephone to the office of the head of the insurance company and telling him what's happening. This will always work.

I've had two similar battles recently ...

1. I lost my annual season ticket, and instead of taking 24 hours to produce a duplicate for me, British Rail took nearly three bloody weeks, forcing me to shell of #50 I can ill afford on weekly travel cards while waiting.

2. I rang BT (telecom) five days before we moved into our new flat, to cancel the old phone account and open the new one. I was told that the line to the new flat was dormant (whatever that means) and that they would have it up and running within six days - so the Tuesday after we moved in.

Tuesday, Wednesday and Thursday came and went and the phone wasn't working, so I rang them back to see what the story was. The bastards told me they had no record of the order (despite obviously having a record of me cancelling the old account, as that had been actioned), and that they'd get cracking on it. That was last Friday, they can't get an engineer to our new flat until next Monday, and I've had to use my mobile all the time in the interim. Tristan had been in Canada and America for the past week and a half, so I've been calling Canada and America on my bloody mobile. I dread to think what the bill will be like.

Ooh, it makes me mad just thinking of it. Do me a favour, Pamie - blow up the office of the insurance company and score a point for all of us against those grey suit wearing, slip-on shoe favouring, pencil pushing tossers.

-- Anonymous, July 21, 1999

Uh...

I'm not surprised. Insurance companies only exist because they can pay you back less than they take from in in premiums. Therefore, when you want money, they aren't very efficient in getting it back to you unless everything is very clear cut. Go out of the mold, and you're doomed.

The best way to deal with it is keep asking for a supervisor until you reach the top and someone saying they will get it to you tomorrow. Take names, write them all down, log your calls, keep a journal of them, start taping the phone conversations if you have to (but, be sure to TELL them they're being taped, or you'll get in trouble).

As soon as you start getting flak from someone say "I'd like to speak to the supervisor." If they say they aren't available, say you'll stay on the line until they are, or else you want to talk to the supervisor's boss. Stick to your guns and you'll get somewhere.

-rich http://www.inferiority.com

-- Anonymous, July 21, 1999

A year and a half ago I had to go to the emergency room and then several places for various treatments and examinations after that. I had just graduated from college and I was no longer on my mom's insurance. However, I was able to sign up for a different kind of insurance provided by her company that was supposed to provide retroactive coverage.

I was billed by numerous treatment facilities. I did not pay these bills because I had paid for medical insurance, which was supposed to cover the expenses. The insurance company had been bought by another insurance company.

Soon I was faced with debt collectors calling me each day. The debt collectors wanted money for the treatment. I informed them that the organization that was dilinquent in payment was my insurance company, not me. I had fulfilled my part of the bargain by paying the insurance company. The debt collectors said that was between me and my insurance company and that I still owed them money.

I contacted my insurance company and they told me that I didn't exist in their records (remember, new owner). I asked them why, if I wasn't in their records, they continued to take my money each month. There was no answer to that. After several months of wrangling, sending records, establishing my existence, and ignoring debt collectors, I finally got my insurance to say that they would take care of the whole thing.

I just got a call from a debt collection agency and rather than ignoring it, I decided to call them back. They informed me that I was delinquent in payment. I explained the situation and informed them that they should really be sending collection notices to my (former) insurance company. They said "We don't do that, that isn't how it works... YOU are responsible for the payment."

OF COURSE they can't collect from an INSURANCE AGENCY!!! That would be like sueing your mother. No, instead they come after me. And in any logical, rational, common sense universe it would be immediately obvious that I have no responsibility whatsoever to pay these bills because, as I have noted, I payed my insurance company.

So now I get to contact my (former) insurance agency and start the whole process all over again. I realize that this will only serve as a slight catharsis for myself, but I would like to say (and I apologize for innocents) "FUCK YOU, YOU FUCKING RAPING AND PILLAGING PIRATES WHO HIDE BEHIND YOUR FUCKING RULES AND YOUR FUCKING LAWS WRITTEN BY LOBBYISTS ON YOUR FUCKING PAYROLLS!!! MAY YOU ALL ROT ETERNALLY IN HELL!"

There. I feel mu

-- Anonymous, July 21, 1999

Last year I switched to MCI as my long distance carrier. Eventually I decided that the deal was not as good as it had seemed and in the fall I switched back to AT&T. How to cancel MCI? Call their 800 number and try to navigate one of the most poorly designed IVR menu setups I've encountered. There is no menu choice for account cancellation. So I write them a letter requesting cancellation. Time passes (image of pages being torn from a calendar) and monthly bills arrive from MCI for a monthly base charge of $4.95. I figure I've written to them once, that's enough, but I decide to try their 800 number again. No appropriate menu choices, the best I can manage is an option that seems to be to be intended to fix incorrect call charges. I try that. The next bill seems to have a credit that in effect reduces total owed by about one month's bill. The bills keep coming, however, and the amount owed keeps increasing. Finally the total is around twenty-five bucks and they are threatening to stop supplying me with long distance service. Duh!

One of their automatic machines leaves a recording on my answering machine asking me to call them and gives an 800 number. It's the same 800 number. This time I select an option for ordering new service and I actually get connected to a live human being. I explain the situation and they promise to cancel my service.

They send another bill for the "past due" amount, threatening to turn the account over to a collection agency. Their robots leave more messages on my answering machine. I call them up, really angry, use the 800 number option for ordering new services, get a human being and launch into a rant that ends with a threat to file a complaint with the Federal Communications Commission. When I finally wind down, she tells me that their system shows that my prior call had resulted in my account being closed but that the past due amount had not been removed. She told me that she was now removing that amount and that my account was zeroed out and closed. And, of course, if I should decide to change long distance carriers, she hoped I would choose MCI. Yeah, right...

A few weeks pass... I get a bill in the mail from MCI. It is for two cents. Yes, that's right... they sent me a bill for $.02! It did not specify what that charge was for... So not only are they a telecommunications company that is unable to design a decent IVR menu, their data processing department seems incapable of writing software that understands that it is foolish to send bills for two cents. I thought about calling them up and disputing this amount but then decided that I should not have to waste my time and effort to point out their mistakes.

A few days ago I got another bill in the mail from them. I have not yet bothered to open it but I assume it is a repeat billing for those two cents. I wonder how much money they intend to spend trying to claim that I owe them two cents (which, of course, I do not)...

-- Anonymous, July 21, 1999

Jim-- I can just see them following you around on their bikes, a la "Better Off Dead"--

"I want my two cents!"

-- Anonymous, July 21, 1999

This past April, I was playing basketball and tore ligaments in my knee. I went to the health center that evening (I was still in school then) and they told me that it most likely was torn ligaments, but that the orthopedic would not be in until early tomorrow morning. So early the next morning, I get up and have my girlfriend drive me back to the health center. The orthopedic is not in, because he only comes in on Mondays from 8-11 am. So the assistant orthopedic looks at my knee and says, "Well, I think you tore ligaments, but I cant be sure without an MRI. Why don't you call your insurance and get them to authorize one. In the mean-time, make an appointment to get an MRI." No problem, sez I. So I make the calls. I explain to the insurance that I am an out of state student with an injury, and I need an MRI. My insurance says that it will take a couple of days to process the forms, but it shouldnt be a problem. I asked them if it was ok that I go ahead with the MRI. They say that that is fine, because the procedure will definitely be authorized. So a couple of days later, I get a call from the insurance saying that since I was seeking treatment at an out of area facility, it will take a couple more days to get authorization. I should reschedule the appointment for next week. Meanwhile, I'm walking around on crutches in a big ol' knee immobilizer, inconveniencing everyone I know to drive me to class, etc. And I have an appointment with the real orthopedic at school on Monday morning. So, since I cant get the MRI until after my appointment, I cancel that appointment in hopes of being able to get an MRI for the real orthopedic to look at. Well, later in the week, my insurance calls me back and says that they feel that this is not an emergency procedure and out of area treatment is unnecessary. In other words, they won't cover the MRI or the orthopedic visits that I've had. So I call them back and talk to the supervisor, explaining the situation. I'm out of area, about to graduate from school, and I'd like to get this taken care of as soon as possible. Yes, yes, they understood all of that, but there's nothing they can do. I asked if it would be easier to take care of this when I got home. She said most likely, it would be. So I waited until I got home, had surgery three weeks after that, and I ended up losing a whole summer's worth of paychecks, in addition to 6 weeks of work in the spring. ARRGGGHHH!! I hate HMO's!!

-- Anonymous, July 21, 1999

MCI update... After yesterday's posting and Pamie's chuckle at picturing MCI hunting me down for two cents, when I got home last night I decided to open the MCI bill that had been lying around for a few days. Yep, sure enough, they still want me to pay them two cents. And, they threaten, if they do not receive payment by August 9th, they will have to impose a monthly penalty charge of 1.5% of the overdue amount. Hmmm, let's see, what is one and a half percent of two cents and how many month would it take to bring the total amount of the bill up to a whole three cents? Of course, since I don't owe them the two cents to begin with...

-- Anonymous, July 22, 1999

OOg, this reminds me very much of my last tussle with my health insurance. The bill was for July 28, 1999; I just got it finally dealt with last week. Whole story: I got Lyme Disease last summer. I have a University health insurance policy that's operated by a big insurance company from out-of-state. I go to the Univ. health center, who send me to an laboratory in town to get the blood tests. The lab is owned by another big out-of-state corporation (LabCorp). The day of the bloodtests, LabCorp tells me they don't deal with my insurance co. directly, so I either have to pay right there or be billed. I tell them to bill me. I get the blood tests. I work a couple weeks, then go home to San Marcos, TX (must see Pamie sometime!) because my Mom is worried sick about my health. Come back, and find the bill from LabCorp. My payment is already overdue. I get pissed because they didn't bother to send me the bill till about a week before the payment's due. I go back to the health center for a check-up, and ask them what to do with the bill. Hey, I've never dealt with it before, and these University docs know how to deal with the Uni-recommended insurance company, right? No. They tell me to go home and deal with it. I try. I call Insurance Co. and they say not to pay the bill. I fill out the bill form as best as I can (that's what I wanted help on) and mail a copy to the Insurance Co. (I'll abbreviate to IC). Weeks pass. I get another bill from LabCorp. I call IC. They say I have to use a form from the Uni Health Center. So I go back to the Uni HC, get the form, fill it out to the best of my ability, and mail it back to IC. Weeks pass. I get another bill from LabCorp. I call IC again. I might say now that there's only one guy at IC who deals with all claims from the State of Delaware. His name is Jeremy, and he's never ever at his desk when I call, but if I leave a message he often calls back within 2 minutes. Anyway, Jeremy says there's no diagnosis on my HC form. Yes there is, I say, I filled in that blank. Well, Jeremy says, we can't just accept a student's * claim* of a diagnosis--he needs an actual diagnosis from an actual doctor. Mind you, this is a standard form provided by the IC, and nowhere on it does it say that it must be filled out by a doctor. I point this out to him, but he says they always need a doc's diagnosis. I point out the codes on the LabCorp Bill indicating I got Lyme Disease blood tests, but that's not good enough. So I go back to the Health Center. The HC nurse tells me they've "never" had a problem with students filling out the form like this before (see?! see!) but she tells me that they'll send the IC a letter with a "diagnosis code". OK, whatever. I leave. Weeks pass. I think I get another bill from LabCorp. By now they're threatening "late fees, credit damage, or legal action". I wonder what's going on. The nurse from HC calls me and tells me they *finally* have that letter prepared, and would I come by and sign a medical information release form, oh and mail it? So I do. Weeks pass. Another Labcorp bill. I call IC again. They finally send me a statement in November explaining my benefits, what my copayment is, and that they're mailing the remainder to LabCorp. Instead of waiting for another LabCorp bill, I go ahead and send them my copayment along with a letter of apology (they make you feel so bad in their bills!:"Dear so-and-so, when you were sick, we responded to your need immediately. For your services we expected prompt payment in return...."). I tell them the insurance money should come soon. Weeks pass. I go home for Christmas break on the 15th, come back on the 29th. There's another bill from LabCorp dated the 13th. Now, they've got MY payment but not the insurance's! I forget about it for a few days while I party like it's 1999. First week of January, I call Jeremy. He says they sent that check in November and he doesn't know what the problem is. He says he'll try to call LabCorp himself but "they're hard to reach". I play phone tag with Jeremy for another week. Finally and call him and suggest, maybe I should try to call Labcorp? Yeah, he says. Thanks, Jer. So I call LabCorp the next day. After a long wait, the LabCorp lady says my account balance is $0.00. Huh? Apparently the insurance check came in on December 13th, just a few hours after they sent me that last bill. Heh. So, now it's FINALLY OVER!

Sorry this is so long. But Pamie, I wanted you to know I feel your pain (to quote Clinton), and it is still fresh in my mind.

-- Anonymous, January 17, 2000

Holy cow, Jim!

I went through something similar, except I didn't change my long distance co. just my phone number. They just failed to stop the LD charges for the old number. It took me a while to figure out why I was getting 2 bills a month, and the second would be for like $3. I did get one $.56 bill. That's just weird. It costs them more to process and mail that check than what the bill is worth.

-- Anonymous, January 17, 2000