Self Service

I hate fighting with the insurance company or anyone involved with the insurance company.

I have been getting Explanation of Benefits from AETNA with old claims on them, trips to the doctor from back in 2003 and 2004. I generally look them over to make sure the doctor billed the insurance correctly and that the insurance company plans to pay. I hate surprises, especially when I have to write a check for them.

I decided to call the insurance company and find out why the claims are sooo old. AETNA tells me that the doctors are just submitting them and that by law they have to acknowledge the claim within 15 days of receipt. I said OK, just wanted to know whose butt to chew.

Then I asked about little princess’ strep test. The doctor billed $40 for a 5 minute test with a Q-tip but the insurance company is on to them and have negotiated a fee of $9.33 for the test. Much more reasonable in my book. But I see the insurance company isn’t planning on paying the $9.33. Oh sure, they’re gonna pay $165 for the doctor’s visit and the shot to her highness’ hinney. The lady tells me “oh, that’s because of your deductible.”

I’m sorry, my must be mistaken. We don’t have a deductible, we have a co-pay.

“No dear, you have a deductible for diagnostics, x-ray and lab work as off the beginning of this year.”

How can I get a copy of where it says this?

“Please call UPS Medical Division for a SPD.”

Ok, how bad could this be? I just need a copy of the SPD (whatever the hell that is). I call and this automatic system wants social security numbers (the last one wanted Id number) so I have to dump my purse to find it. The system hangs up on me, I’m too slow to respond. I call back and this time it is voice prompted but doesn’t recognize what I’m saying and hangs up again. Again I dial 1, 800,…

I plug in the SS# and then it asks for a pin code. I can never remember what the pin code is, never! So I skip past the part where it asks if I would like a new pin code mailed to me but please remember you can do nothing until your new pin code arrives, and I try for the human on the other end. Success, a real live boy!

What’s the first thing he asks me for? The flippin pin code. I explain that I can never remember it and that their system won’t allow me to change it to something I can remember. He proceeds to tell me he can’t help me without the pin code and that Big Daddy is the only one who can call and request a new pin code. I inform him that Big Daddy doesn’t know how to use a phone, that he never even calls his mother.

I argued the point briefly before informing him that I planned to hang up and call back, navigate the automatic system, pushing buttons and having a new pin code sent without my husband or any employee on their end getting involved. “I call it self-service” and I hung up.

(and I called right back, my pin code will be here in 7-10 days, shhhhh)