In case I forget.


What a difference an Allied Moving Van can make.
October 17, 2006, 1:18 pm
Filed under: Dr. Neuro B, Dr. PCP, Texas Comprehensive Epilepsy Program

Something strange has happened. I’ve had the same medical insurance for ages. It used to be that I’d have to have a shot of bourbon before I called them for anything because they were rude, stupid, unhelpful, full of attitude, and generally undeserving of good holiday gifts. This went on for years. Every tiny little claim resulted in multiple calls to get them to cover it.

Then, about a year ago, something changed. They started just….paying claims. Occasionally they would kick something back and I would have to call them. BUT. When I called, they were polite. They were helpful. You could hear the smile in their voices. These call center people had become something of an advocate for me, helping me understand terminology, giving me leading information that caused me to ask the right questions.

Case in point:

Epilepsy Protocol MRI, ordered by Dr. Neuro B, for who I had a referral from Dr. PCP.

Facility charges: $2,749

Insurance adjustments: $1,099.60

Insurance payment to provider: $1,154.59

Patient balance: $494.82

Problem: $494.82

I knew I had done everything right. I had the referral. I had an in-network provider. I had the provider get a pre-authorization for 100% coverage. And now I have a bill for $500. So I call MegaInsuranceCompany.

I got to talk with Craig. He first said, “That’s you co-insurance payment.” I said, “I don’t have co-insurance.” He said, “Let me dig some more.” Then he said, “It looks like you didn’t have a referral.” I said, “I had a referral from Dr. PCP to see Dr. Neuro B, who ordered the test at an in-network facility. I have a Managed Choice plan and this should have been covered at 100%.”

THEN Craig said, “I’m sorry if there has been a confusion. Would you hold please while I research your benefits?” I, thinking yeah I’ll hold for $500 say, “Sure.”

A few moments later Craig comes back on the phone and says the mistake is theirs, that they mis-coded the claim, that he had “validated” it and sent it through for rush payment. He apologized for the inconvenience and THANKED ME for calling so he could fix it.

Then we chatted a little bit…he said it was snowing. I said No Way! He said, Oh Yes. In this rural northern state bordering Canada, it is snowing. I told him how pleased I am with the service I’ve been getting from his company. He laughed and said he hears that all the time. He said that MegaInsuranceCompany had moved a year or so ago from Huge Multi Million Residents City to Middle of Nowhere Rural State and that everyone there is nice. He laughed and said, “In the winter we can’t help but be nice we’re just so happy to have another human being to talk to!”

So…they key to good customer service is to establish your call center in the middle of freaking nowhere. The citizens are happy to have good jobs available. They don’t spend an hour in rush hour traffic commuting to a huge smog infested city where it costs $20 a day to park their cars. The citizens in Nowhere are community oriented, they live at a slower pace, and they still think being helpful and polite is a good way to go.

If I ever leave the Gulf Coast, I think I’m moving to Frozen Land by Canada, just because the people are nice.

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1 Comment so far
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Hi all. Cool site Google
Thank.

Comment by coehyday




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