Probably my first call today, and my supervisors/team leads keep dropping the ball with escalations the past couple weeks so this call on top of that had me really heated. I don’t post in here very often, but I take customer service calls for an insurance company. My job encompasses a lot of tasks but most of it involves providing benefits and reviewing claims.
I’ll be SHN, caller will be UAM for Unhelpful, Annoying Man.
SHN: [greeting, get caller’s name and phone number]
UAM: “Hello, Short-Haired Nymph, I think I was overcharged at my doctor’s appointment, but I want to make sure with you guys first, and I need to know if I’m gonna have to pay that again at my next appointment.”
SHN: “Oh gosh, I apologize for that unfortunate experience, but I’d be more than happy to help you look at the claims and compare it to your benefit information. To get started, could you please confirm for me your date of birth and current address?”
UAM: [tone sounds slightly skeptical] “What do you have on file?”
SHN: [blinks] “I… I don’t know what we have on file, I don’t have your information up.”
UAM: [unimpressed] “You have zero information on my policy?”
SHN: “My apologies; what I mean is that I need this information from you in order to pull up your account.”
UAM: “I give you guys this information every. single. time I call, and I can NEVER. Get any information from you.”
SHN: “I apologize sir, I’m not sure what the issues have been previously but once I have your account up I can review previous notes and see what the problem was, but in order to do that I need your information.”
UAM: [sighs, but calms down] “Okay. Fine. What do you need from me?”
So he gives me his info, I’m able to pull up his policy, and he says he’s been calling us for three days without any help. Our notes only show one call in the past week, but the insurance company shares its name with a large chain of providers, so people often get us mixed up thinking that whatever they talk about with the hospital will be documented with the insurance and vice versa. Whatever, this is pretty common.
SHN: “Thank you for that information sir. Okay, so I see the claim here from last week, with [provider name], you said, right? Yes, I have that here now, let me take a look at the charges here.”
UAM: “Yeah, that one, I paid my copay, that one’s fine, unless you see something I don’t. But my follow-up was this Monday and I had to pay again.”
SHN, internally: I mean… that’s… that’s how it works, pal. Ya gotta pay the office visit copay every time you have an office visit. That’s. That’s literally how it works.
SHN: “I see, okay. So, we don’t actually have a claim on file yet for Monday–” [because it’s only Wednesday, dude]
UAM, cutting me off: “No no no, this was not a claim, this was a COPAY. Are you understanding me?“
…Dude, are you fucking serious?
SHN: “…Yes, sir, I understand you paid a copay on Monday. What I mean is that the provider has not sent us the information on services that were rendered, so I have nothing that I can review. However–“
UAM: “Hmph. See? Useless.” [Disconnects]
Per our policy, I have to call back in the event of a disconnect before I give my pre-close and close if I have the phone number. So I called back, and if he would have answered I would have told him that that copay still applied because it was still an office visit but that if he didn’t actually see his provider and if he was never actually in the office that there were steps to take to correct this, but he never answered.
What the hell is with these people? Help me help you, my guy.
Edit: formatting
submitted by /u/shorthairednymph
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