Post by kjs on Aug 8, 2019 10:04:31 GMT -6
This thread is just a bit of venting, pretty much how “customer service” now days – does not match how I seem to recall it being just a few years ago.
Back when I was fresh out of college and I just taken my first job (which is in the computer science industry) – I was a young Computer Programmer and one of my duties was to assist on the customer service trouble supporting lines. Now, these trouble supporting lines are not that easy to handle; since the vast majority of the callers are very irritated with whatever issues they are having. Now those like me receiving those calls – actually had training classes to teach us how we were to respond to yelling, and cursing and what-not. We were also trained to always support the customer, by returning phone calls, ensuring the customer was happy with the resolution of the issue – a day or two later.
I share all that information above – simply to show how I understand the “customer service department” of any organization should be run. Maybe, I am simply out of date and customer service areas really treat clients like is described below … thus my reason to vent…..
As many of you know, I am not as healthy as I once was. Since the beginning of this year (2019), I have had numerous hospital stays; numerous outpatient procedures done (usually more than 4 hours); and just plain doctor/clinic appointments. With all of this going on; needless to say I was missing a lot of work hours. I did try to make up most of the hours by working longer or on weekends; but even that additional work started to take it’s toll on my health. It was recommended I return to short term disability status and possibly even long term disability (if it goes beyond 12 weeks I could lose my job). Any rate so I started the Short term disability process at the end of June 2019 and the first day my leave of absence started was July 8th.
Now, one of my biggest failings to that I am a worrier. I second and third check items – just in the attempt to ensure everything is moving ahead smoothly. So when I found out who my short term claim handler was and his phone number – I called him to ensure he had received the paperwork that was requested (which had to be faxed from a medical facility). Went to voice mail and I left a detail message with my numbers. Never heard back, so I called the next day. Never heard back so I called the next day. The fourth day I called (which happen to be the Monday after the weekend – which they were not open) I basically said if I do not hear back from you by noon today (Monday) – I would be calling back and raising it up to a higher of level – like his supervisor.
He calls back finally (around 11 – I think) and angrily informs me (no he did not yell) tells me he has the right to investigate as long as he needs and since the policy states I have to be out 30 days before any benefits will be paid – I should just wait. I said fine by me; but at least return a message saying it is in progress – rather than ignore multiple voice mail messages. His reply was that I should not expect him to drop everything – just because I called. I said I do not – but I do expect a return phone call within 24 hours of the voice mail. He then “almost yelled” saying “Fine, I will do better return phone calls. By the way, your doctor’s office filled out the forms wrong – so everything is invalid until they are corrected. I said ok, and have you notified them (the doctor’s office) about the problem? He said NO, you have to do that – I said but I was told specifically all the forms had to be filled in and sent by them – I could not touch them. How am I or they to know there is an issue unless you tell them or me? Well, I am telling you now. So I ask specifically what was the problem, so they could fix it. I was told they had not filled it out completely and had not put a return to work date. I said the return to work date is easy; it is cause they do not know the when time – since they have several testing procedures they wish me to go through to try to figure out what is causing my complications. He said – well Testing procedures are not covered under this policy. I reply but testing procedures and doctor’s appointments mean I miss work time and one of the “essential duties” is a 40 hour work week…. So please explain how and why testing to determine what is going wrong – is not part of those essential duty hours. Sounds like you need me to transfer to my supervisor. I said thank you – waited for the transfer to take place – then “click” Line went dead. I immediately called back – went to voice mail – called back again – went to voice mail.
Called back and went through different process to raise the issue. Ended up speaking to Debbie a supervisor; explain the whole problem and was assured she would take care of it.
Let it rest – since I was told it would be taken care of. (back around 7/19/2019)
I get it – this is an insurance company and while they are happy collecting their premiums; they are reluctant to pay out claims. But the problem is; jumping through hoops to get the short term approved is causing additional stress on me – which I do not need.
So I started the phone call process again today – and I get a call back two hours later… which was a big surprise. Basically, told I have been approved for Short term through 8/27/2019. I said thank you for getting it approved – but who authorized that “end date” – it did not come from the doctor’s or me? Well, that is just the date that has been approved for – it can be extended if needed. I said it is needed since they still have not figured out what is causing my complications and many more testing and clinic appointments are needed. Well, those are not covered under this policy. I reply but your own documents state that a forty hour work week is an essential duty and I cannot do that. Well, you need to talk to my supervisor. I said fine – please do not hang up on me – he said wait for the transfer. After listening on the phone to music for about ten minutes --- “CLICK” and the line went dead.
I saw red…. I immediately called back – took it up the escalation chain (waited 15 minutes for them) then talked to someone about it. I was told – “SORRY” more times than I could count. Assured I would hear from the case worker’s supervisor and also have another case worker assigned. We will see if all of that happens.
So I do not know – maybe I am over-reacting…. After all the short term is approved until the 27th at this point. BUT part of me just thinks of the time when I “worked the help support line”. If I would have done anything like what has been described above. I doubt I would have had a job.
Just Saying …..
Weigh in – let me know what you think …..
Well, no I haven't, honestly, but but you told me I wouldn't yet. Yes, we know, but the insurance wants to know so they can authorize the next treatment(which was two days away)(also, if they don't, I can keep the appointment to discuss alternative treatments). Do you want us to go ahead and schedule in hopes that they authorize it? Well, yes, I guess so.(This is done in Denver. I live 250 miles away). So I arrive and find out the insurance still has not authorized, would I be willing to sign a waiver saying I will cover the cost in case the insurance does not? How much is it? Oh, a little over $10k. ?!?!?!?!? 
" src="//storage.proboards.com/forum/images/smiley/superangry.png"> Um, no! (WOW). So no treatment for that day. We talked about alternate treatments like Aimovig, but that would be treated like prescription through the insurance. Ok, how much? Usually a treatment costs around $600-$800, but your insurance covers it, except for you co-pay($45). OK. That was in June. Haven't heard a word since.
