...do you know what happens to liars? Do you? Because I think you're about ready to find out.
You told me the problem with the claim was a bad NPI number. You sounded very certain, almost like you were swearing you spoke the truth.
I'm glad you didn't actually swear though, because bad things happen to people who break oaths, at least if you buy all the Jesus stuff that so freely floats around this country.
I believed you because you were in a position of trust. I hung up and went to the information superhighway to look up a new NPI number (by the way, for those of you who don't know, you can look up NPI numbers in seconds online, but it requires your employer to treat you like an adult and allow you internet access. Good luck with that. You can do a lot of stuff online to make your workday easier. You might want to think about taking a tablet to work)
I put in the new NPI and......got the exact same reject. How could I not feel betrayed? I came to you for guidance Ms. Help Desk Lady, and you threw my good intentions and trust down a rathole.
I only want to get this Celebrex paid for. I'm not greedy. A little over my acquisition cost will be fine.
What I got instead was another in a long line of emotional manipulations by the women in my life. I thought it would be different with you. I suspect the real problem is you need a prior auth and you knew that all along.
Why don't women ever tell you what they really need?
So when I call again Ms. Help Desk Lady, you can toy with me once more, use me as your plaything for your amusement. Or you can do the right thing. I'm not hopeful.
I'm even starting to suspect my call isn't very important to you at all. As I rot on hold.
7 comments:
You have 3 other callers on hold, a whole page in red, an old lady at the register screaming at your tech about her doughnut hole, and then, after YOU"VE been on hold for 15 minutes you hear it: The voice of Satan telling you "I'm sorry, sir. You'll have to contact your software vender"
This one was both comical and sad (frustrating).
I was on hold with CoEd, my power company, the other night. Two issues: 1) some fucking fucktard approved the decision to play COMMERCIALS instead of classical or jazz muzack to customers on hold, which was total TORTURE; and 2) the wait time INCREASED as I waited to speak to a representative, rather than decreased.
After 25 minutes on hold, my wait time was 52 minutes rather than 38. I was homicidal by that point, but what could I do?
P.S. I sort of want to give you my ex-boyfriend's number so that you can prank call him for Rxs that don't exist....sweet, sweet fantasy...
If I can, I make sure they stay on the phone with me like I'm a 2 year old as I try to bill the claim again. I've had this happen more times than I care to admit, so now once I have an actual human, I keep them as long as possible.
I was on hold for 25 minutes with Express scripts yesterday only to get disconnected from the call while I was trying to resolve a "cost exceeds maximum" rejection. Well, I called back, sat on hold for 10 minutes and another line rings...the woman actually called me back! I was almost in tears when I picked up that call, "No insurance company has ever done this before...thank you so much..." she also didn't pretend the rejection was unfixable on her end, she resolved it right then and there. These people don't realize how fast they can make or break our day.
You went into this with too much expectation. The goal of the person on the other end of the line was not to provide anyone with any sort of help, but to decrease the professional phone interactions possible. By keeping you on hold with her an extended length of time, she couldn't allow you to call her for another situation at the same time. The trick is to hang up after 5 min. and call again, to see if you can get someone else, then demand to speak with her (his?) boss, or someone in the accounting department, and someone in the shoeshine department, someone that keeps track of the person that keeps track of NPI, etc. to tie up as many lines as possible. It may be, hmmm, what is that word, ehh? Passively aggressive, but it brings a certain sense of hubris.
Haven't you ever had the experience of having to repeat your NPI ten times and still not getting anywhere in 25 minutes? It's like they don't believe you, like maybe despite the fact that they've asked you to repeat it so many times at the first couple calls you can wake up from a sound sleep and repeat it backwards and forwards, like if you changed it or made up a few extra numbers, that there might be a hope that it would go through without another word said, like there is some chance in hell that you've finally figured out the number with which you could actually get through to the person you want to speak with within 2 minutes in one transfer?
No, the actually game plan, my friend, is to keep you on the phone, tying up the lines which slows down things in 'their' day as well to get a lunch break. Thing is, 'they' don't have a person with bulging red-veined eyes and vicious language withing 6 inches of their face. (Or, maybe, somehow, the US pharmacists have gotten into the Miss Manners gig and are now supposed to be teaching their clients how they wish to be spoken to? Yelling at customers, is not only inappropriate, but leaves one with a raw, sore throat, and a tension-headache. DM there's a new paradigm in healthcare e.g. mental health pharmacy known as 'trauma- informed' something or other and it involves saying right up front, 'this person that has come to my counter today has something wrong with them and I'll not add to their trauma'. On the other hand when you're transferred from person to person on a phone call with an insurance company, you can lose track of which trauma you're forgiving).
Take care.
Make sure you are sending the npi and not the DEA or state license. On FSI from the main menu: 3,7,1,1(enter the insurance code in question). About half-way down the first page of the insurance profile is the "Use Doctor ID Number" field. Make sure this is populated with a lower-case "n" and that the "Ql" field to the right of that is populated with "1". This is a common error that occurs quite a bit with insurances that you don't use frequently and with coupons.
I used to work for medicare, as a provider customer service lady (which recently switched handling companies to another company that has zero experience handling medicare claims) and trust me.... it wasn't your NPI number.... When I was hired they sat us down and gave us a two week training course on how to fill out claim forms.... and they specifically make it extremely difficult (I am talking if even the dot on an I is in the wrong spot, it will deny) so that claims get denied over and over and over again.... this is of course illegal, so to cover their asses, they have a "How to fill out claim form" section/video on their website so they can say they offered the right way to fill out the claim, so it won't get denied... but they are hoping you won't find it. And eventually your claim finally bounces out global/or timely filing. Go to insurance company website and type in "claim form" in the search bar, and you should find "How to fill out claim form for providers" or a variation thereof somewhere in the results, then you will see how sadistically perfect everything on that form must be filled out in order for the claim to process.
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