Service With A Sneer: Or Check Your Brain at the Door

I'm not sure which frustrates me more: the notion that a company that once provided excellent customer service has taken a nose dive over the cliff of corporate indifference, or that because of their changes, I can't do my job according to the requirements of my position.

But I find myself in the S.S. Catch-22, sailing on a sea of inefficiency, between the proverbial rock and a hard place.

As I wrote in an earlier blog, I work for a medical billing company. One of our local Blue plans is changing their customer service strategy, and now requires that all routine inquiries be handled over their computer site. This site is one of the few we're currently using at the office. And it's a great site; it generally answers most of my questions when I work that section of my monthly report. But it doesn't answer all the questions I need to complete my job. And therein lies the problem.

It used to be that we could call up and ask the questions that couldn't be answered by the website. Now, we're just told to use the site and if we have any problems to call the site techies and they "will walk us through" our inquiries. Most of us know how to use the site, but some insurance groups, such as some out-of-area groups, won't come up; and we don't have access to some of the information that we need.

I understand the needs for work and cost efficient behind the insurance companies decision to promote the use of their website. I love the website! But their inflexibility with inquiries outside the website's efficiencies is downright maddening! And in the long run, this inflexibility will only perpetuate problems and create more work for insurance company, as well as my coworkers and me, and all other medical billers.

Because with limited information, I have limited options. For instance, we had received a denial stating the insurance company needed information from another medical provider to process our bill. So I called them up to see if they had received that information. I was told to use the website to ask them to review our claim again. I even asked to speak with a supervisor, but was not able to obtain this simple bit of information.

Now, all I was asking was if the information was received; no other details about said information. And, if my question had been answered and the information had been received; I could have asked them to adjust the claim for payment and the problem would be solved. If the information had not been received, I could have called the other provider's office and alerted them to this omission (information they also certainly need to know!), and again the problem would be solved. And was just asking for some common courtesy and common sense. What I got was a prime example of corporate facism at it's most pigheadedness.

Now, I must keep up requesting adjustments each month until the information is received; and if it is never received, our doctors won't get paid.

Oh, they did say that if we gave them the name of the other provider, they would call the office and request the information. So in my website inquiries, I gave them the provider's name and phone number. But I'm a bit skeptical about this offer of service. After all, I found more than 12-20 or more such cases on the day of the conversation; and I worked that part of the report for 5 days! And I'm just one biller working for one doctor's group. Even if they send letters instead of making phone calls, that's thousands of contacts; and a virtual quagmire of inefficiency that will drag on for months. This cost-cutting measure could end up creating costs in the long-term.

And in time, this inflexibility and inefficiency will affect the company's image and popularity. Such rigidity does not foster new ideas or growth, and disaffected customers may choose to take their business elsewhere. After all, you can find bad customer service anywhere, and maybe save money too! Bad customer service is bad business.

And, I still can't do my job the way I'm supposed to; and solve the problems with a few phone calls as I usually do with the other insurance companies. So, I've had to sent notices to our patients to alert them of the problem. This is usually our last resort, after a few phone calls turns into a number of phone call with no results.
I'm hoping our patients call in to complain about the notices so we can explain what the insurance company is doing, or rather not doing, on their behalf. Because I know they will listen to their members. That's what we pay those every increasing health insurance premiums for!

So, friends, if your doctor's office calls you or sends you a notice asking you for information, or to contact your insurance company; please know that we're only trying to get your claim paid. Sometimes we just need to ask for some help; from you, another doctor, or even an insurance company. If everyone works together problems can get solved quickly. And if one party in the agreement doesn't cooperate, problems stagnate and go unresolved.

So, as I said in my previous medical insurance blog, be proactive about your medical bills and claims. Make the phone calls and get problems resolved. Then maybe the insurance companies will get the message that you expect them to do their jobs.

And isn't sad that we need to ask a service company to provide service?