Wednesday, April 23, 2008

Insurance Companies

I work in a doctor’s office and so I deal with insurance companies all the time. I don’t like them. Some insurances are better than others but that depends on where you work and what type of plan they offer. The frustrating part comes when you have to change insurance companies.

The cost of our insurance went up and they were offering less bang for the buck (larger deductible, higher copays and more out of pocket expense). Our insurance agent suggested a switch. That’s great – no deductibles for pharmacy, smaller copays, less out of pocket expense and smaller deductible. Sign me up. Here’s the problem. We couldn’t get an identification number or our insurance cards by the first of the month. It came around the middle of the month. If you don’t have to go to the doctor or get medication this is not a problem.

It was for me. We needed new prescriptions for Tom’s medications. Using a mail order pharmacy is the way to go because you get a three month supply for the price of one month. He ran out of medication and the first order takes fourteen days to get processed and the doctor’s office didn’t get it sent on time. Yes, I know, I’m starting to rant a little bit.

I had to call the doctor’s office again and ask them to re-fax the prescriptions because the mail order pharmacy doesn’t have it on record. I have to ask them to then fax a month supply to our local pharmacy so that he will have his medications.

I don’t like insurance companies. I don’t like switching. I don’t like that with some companies you have to have your doctor’s office call because certain medications they deem not necessary have to have prior authorization.

Let’s make the doctor’s office staff work even harder then they already do by having them call the insurance company, go through the millions of menu options before they can speak to a human being who then has to transfer them to another department to get prior authorization because someone at the insurance company dictates what doctor’s can prescribe.

Okay, I know, now I have to go and repent for my ranting and raving. But I’m feeling much better now.

Stay healthy.

Nadine Z. 2008

23 comments:

Brenda said...

I don't think it's wrong to rant sometimes. I've definitely had a lot to rant about lately...we've just had to leave our church of 15 years...the poopoo hit the fan to put it mildly. So, get it off your chest move on...speaking to myself here!
On a lighter note, I've just rec'd my first award and want to pass it along to you. If you've already rec'd it, just know that I was thinking of you!

Lavinia said...

Hi Nadine....I am not familiar with the dilemmas and frustrations you write about in today's blog....I wonder if that is because I am up in Canada or because I don't work in a doctor's or insurance office.

I am familiar, however, with the frustration of endless menu options before being able to speak to a human being. Sometimes just hitting the zero button will allow you to bypass all the choices and get to a real live person.....

Or, if the phone system is one that asks you to speak and say what you are calling about, I always just keep repeating "agent" or "customer representative" and eventually the phone system gives up trying to understand me and passes me on to a real live person.

Perserverance pays off. I have a long, long, long history of phoning and writing companies who have given me cause to complain about their service/billing. Of course I am always pleasant and polite, but nonetheless firm in what my expectations are requests are.

In closing, I am glad that I don't have to deal with the public in my job...try as I might, I don't think my patience stretches that far....so I applaud those who do and do it well:)

p.s. I hope those medicines you are waiting on come fast and soon!

Ann(ie) said...

I hear this daily. I hesitate to admit it, but I am an Insurance Agent and I sell Health Insurance. (**Ducking and wincing**) Seriously, I so get it and you deserve to rant. It's maddening these days for all involved. I wish it were an easier process for people. The hardest part is turning someone down and telling them that they get to go to the high risk pool the state offers and pay out the nose. Or telling me just to front their rx that cost $500 bucks a pop. It rough out there. Our system is just broken. The claims that come in are astronomical and the premiums in turn are sky high for people. I do hope that I make it a little less painful for people when they call me b/c I totally know where they're coming form. Fair rant!!! grab a glass of wine. ;) xo.

Linda said...

I just found your site and had to leave a comment...

I'm a nurse and I can't tell you how much time I waste each day with pharmacy's and insurance companies...just like you said...getting voice activated prompts and taking FOREVER to talk to a real person...if you ever do!

and

don't get me started on the whole prior authorization thing! Ok Ok, I'm ranting now too!

Toby Parsons said...

Hi Nadine,

I go through this every spring at insurance renewal time. We are self employed, so pay our own premiums. Totally gone are the days when they covered everything for a decent premium cost. Every year I think this is the last year we can afford insurance. Every year, we pay more with less coverage, higher decuctable & co-pays, etc. Just like you said. It makes me crazy! My poor insurance broker listens patiently while I rant and is really, super nice and sympathizes, but obviously, can do nothing about it. We are paying around $900 a month now. It is astounding!!!! to say the least. It is 'okay' to rant about this. It (the insurance rat race) is 'not' right! The only saving grace (no pun intended), is that we know God. We have Him to turn to and to trust in. :) Thankfully! :)

Keshi said...

I hate all Insurance companies. Liars.

Keshi.

elizabeth embracing life said...

I think the only thing that frustrates me is that my oldest son is dropped at the beginning of each year. He is in college, for four years people, but htey drop him and we have to, each Jan 1st show that he is still in school. Okay no big deal, we can do this, but here is the STINK!!!! He is home from school over Christmas and goes back after the 1st week of January. So all his dental, and dr. appointments are scheduled that first week, when he has been dropped. Sheesh!!! Why can't this be easy.

Anonymous said...

That's very interesting.

Susan said...

I think we all share the feeling about the companies that have the rotating number system and you can hardly ever talk to a REAL person, whether it's insurance or whatever.

Nadine, I went to our Chrisitian bookstore yesterday to pick up some thank you gifts for our VA family. "The Shack" was at the check out stand and I remember you, and another blog friend, saying how good it was and picked it up. I read the forward and 1st chapter last night. THANK YOU so much for recommending it. I LOVE a good book and both my husband (who I always read the books to) and I are already captivated and yes I was in tears a few times just during the forward!!! What a powerful writer.
Susan

Scarlet said...

I am so glad you took the stage on this one. I used to work for an insurance company and I KNOW what you're talking about. It's frustrating when there's a change, and the change is usually not for the better, causing more problems than before. I'm going through that now with my daughter's braces. Not fun.

Anonymous said...

Having experienced the American system now, I appreciate the Canadian way of healthcare so much more. Hope all goes well and you get what you need :)

Jill said...

I am dealing with that exact same thing this morning - getting an Rx preauthorized - ugh!

Knit-Wit said...

Ranting can be very theraputic.

Our auto insurance is going up because we are paying off our debt too fast. Apparently that makes us a risk. There's only one word for it - stupid.

Our health insurance also won't cover certain allergy medicines that they deem unnecessary. I thought doctors who took years and years of medical school would know more about what is necessary than some suits. Again.... stupid.

Emancipation of the Freed said...

Hey Babe:

Thanks for battling this nasty giant on my behalf. What would I do without you?

I love you!
Tom

Art said...

At best insurance is a necessary evil!

Elle*Bee said...

I feel your pain. I don't work for an insurance co. or a doctor's office, but I'm the one (in our family) "in charge" of dealing with all things medical.

We pay, in my opinion, a crazy-high premium, but our insurance company has been very generous with what's covered and what's not (actually, there have been very few things NOT covered).

Our prescription plan is something completely different. High premiums for less and less coverage. I agree with knitwit. IMO, the doctor should have final say on what's appropriate for the patient instead of having to defer to what the pharmacy plan deems 'standard'.

Don't even get me started on homeowner's insurance. I live in Louisiana where it's always been goofy, but since Hurricane Katrina, it's a real mess!

Damselfly said...

Ah, health insurance. I doubt there are few people who can say they've never had problems with it or can say they actually enjoy it. ;)

Dawn said...

That is definitely one of my ranting subjects! Right now I am trying to find something I can halfway afford when I retire and before Medicare kicks in. I could work 8 hours a week at the university and keep the sub-standard insurance policy I have now. I can take the policy offered by the retirement fund, but it is unbelievably expensive! I have to come up with something soon. It is very frustrating! I really dislike insurance companies, too.

Strider said...

I let Ann handle all the insurance crap. She is so patient. This is the same story with us....Rx by mail. After awhile, you get use to planning ahead. Certainly convenient and a cost saver for someone....just not us!

palmtreefanatic said...

Insurance companies can be so FRUSTRATING to deal with! especially because they know they got you! Insurance is very important to have as medical bills are out of this world! Lord knows I didn't think I would be adding to them when I fell and twisted my ankle up! ( sigh) one never knows! I ma grateful for the coverage we have but I agreee as all things it just keeps going up!

We all need to rant about this matter to get it off our chest! As long as you feel better now its all good Nadine;)

Jen(n) said...

You're such an awesome wife!! You are always taking such good care of that man of yours.

Megan Borders said...

I am with you! I worked at a recovery center and did some insurance billing... oh my goodness, NO FUN AT ALL. It's so difficult to speak to a human with all of their automated stuff. I would almost end up in tears some days.

Shionge said...

I must admit I don't have much confidence at all when it comes to claiming from insurance company.

Having said that though, the claims for all the medical expenses incurred in America was duly settled by my travel insurance so I am indeed very thankful for their speedy action.

Coming back to Singapore with all the follow-up treatment and having to pay first before claim I am totally disappointed with my company's insurance company....I have about $3000 outstanding since December 07 and yet to see my money ;(