Tuesday, March 3, 2009


An actual conversation with the insurance company:

J: "I see that you didn't cover a visit to a doctor that was covered by BCBS but a different plan from last year. Can you tell me why?"

BCBS: "Your provider is using an outdated code."

J: "Oh, well can you give me an updated code?"

J: "No."

J: "Well how do you know the code is outdated if you can't tell me the new one?"

BCBS: "Check with your provider."

J: "So you know that my codes are unacceptable, but you don't have a list someplace that gives you the acceptable codes?"

BCBS: "No."
I called another provider I saw for a similar issue, got alternate codes. Called back later that morning....

J: (I get the same rep) "So I have two alternate codes, can you tell me if they are acceptable?"

BCBS: "Yes."

J: give codes...

BCBS: "Yes, those are acceptable."

WHY oh why could he not give me that information in the first place??
I have spent hours on the phone this week following up with unpaid and misunderstood issues around insurance. I would LOVE to work on a project where we get to talk with consumers and understand what they want from their health insurance and not have it driven by corporate greed rather than real patient needs. It's really broken. We need to fix it. 


Dars said...

I had a ridiculous set of experiences with BCBS this past year... extremely frustrating and each time I hung up in tears in disbelief that these folks were in charge of my 'health'care. I'm a young, new professional and having to deal with insurance for the first time has been intimidating and upsetting. I ended up avoiding my 'providers' and sat in line with everyone else at the local Urgent Care and city clinic.

Janna - Customer Experience Guru said...

Sorry to hear that. It really is astonishing how little those in charge of managing our healthcare actually know about a patient's needs. Ridiculous that you had to avoid your provider altogether.