Monday, May 05, 2008

I Love Help Desks

[This is from a friend of mine who's a pediatric intensive care doctor...]

Just got off the phone with the “help” desk of an insurance company. 12 minutes of my life I’ll never get back. But it was worthwhile, for amusement value.

I got a letter from UnitedHealthcare (A UnitedHealth Group Company) saying that they were notified that my patient would be receiving some type of medical service. This is the type of letter that a primary care doc gets when the insurance hasn’t received a referral for some service. Since I am not a PCP, I can’t make referrals. This means that the insurance company might not pay for the child in question’s entire hospitalization, since they are expecting a referral from me, which I can’t make. For the child’s benefit, I try to clear these messes up.

The last time this happened, it took over 6 months.

This letter clearly states a phone number to call “If you have questions about this letter”. So I did. The number did get me to the right company, but that’s about where the “help” ended.

The voice prompt tree asked for the patient’s insurance ID# and date of birth, and my provider #. None of these actually appear on the letter. Each option on the voice prompt was extremely specific, there was nothing for “To speak to a representative…”, and it took 4 tries to respond to “Operator” (not that it advertised that as a choice).

The person I spoke to asked for the same info as the voice prompts. She didn’t seem to understand that her own company hadn’t given me that information, or why that made it difficult for me to discuss this letter. She asked me to look for an 8-digit number as the pt’s ID#, and seemed confused when I told her there were no 8-digit numbers on the letter. I asked her if she could look up the letter by the Ref Num that is written prominently at the top – apparently this code is need-to-know only. She did find the letter when I got her to look it up, but since there was no birth date she couldn’t verify that I was the actual doctor, so even though we were literally on the same page she wasn’t allowed to discuss it with me. I asked her how I could possibly resolve the situation if the letter didn’t contain enough information to resolve the issue? She literally told me that she couldn’t spend any more time “playing word games” with me, and had to move on to other customers on the phone.

I was laughing too hard to get her supervisor on the phone.

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