I recently had the "opportunity" to make a call to my healthcare insurance, code-named "1.4 billion to the former CEO," and after wading through about three or four false reasons for a refusal to pay a claim, we finally determined that the reason a claim had not been processed was because the computer would not accept an online claim, but only hard copy. This wasn't the only mistake the computer had made, for what it's worth, in this case.
So I asked the rep. whether anyone in the company could override the computer to accept an otherwise valid claim. It didn't seem fair to make my doctor and I do the work for the company, after all.
She couldn't, but forwarded me on to another representative, and the other representative seemed to be very helpful, but admitted that she, too, couldn't override "Hal." However, apparently people at the next level could, and she was forwarding the case to that level.
So if you're dealing with a healthcare company (especially one known for backdating executive stock options) about a claim that ought to be paid, make sure that you don't just leave the matter with the first person you talk to. Rather, make sure you get to the level where they actually have authority to override the computer.
I bet, on a side note, that there are some managers out there wondering why their call center employees have low morale. If any of them are reading this, one factor might be that you've given them no authority to do their job.
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