In which mathbabe becomes insurance claims adjuster
Who knows what I’m talking about with this story.
My husband dislocated his finger sledding with my son last January, so more than a year ago, and the hospital kept sending us bills for the event.
But here’s the thing, we were covered under my medical insurance, which had perhaps recently changed policy numbers when MSCI took over Riskmetrics. So probably what had happened was my husband had given them the old insurance card, but in any case, in the the end I knew I wouldn’t have to pay since we’d definitely been covered.
The hospital called once a month or so, and every time they got hold of me I argued with them and told them to check their records. They kept telling me that the insurance company was refusing payment under any of the policy numbers I gave them.
In the end, last month, I called up the insurance company myself and got them to admit payment, which wasn’t hard since they said they’d already paid for the X-ray from the dislocation on that date. I called up the hospital and straightened it out.
So yeah, I ended up doing their job for them, and that’s both annoying and exciting because now nobody thinks I owe them $2400. In fact I did a victory dance (at work, because you always have to do this during work hours for people to answer the phone).
But why I’m writing about it today is that it’s actually really infuriating how often something like this happens, and I can’t help noticing that I always get out of it but many people wouldn’t. I’m at a huge advantage in this common situation because:
- I worked as a customer service person so I know how to talk to customer service people. Turns out you should always be polite, but never hang up the phone until your problem is solved. Just keep asking, extremely nicely, things like, “Hmmm… that’s confusing, what do you think could have gone wrong?” or “What would you do if you were me?” or if those don’t work, “Do you think you could tell me who to talk to sort this out? I’d really appreciate it.”
- I am always covered by insurance, so I never worry that they are right. This is an enormous advantage over people who sometimes lose coverage between jobs or something.
- I keep all my old paperwork. Impossible for people who don’t have an incredibly
boringstable lifestyle like mine.
- I have a job that allows me to make calls like this during work hours. Obviously huge.
- I am completely unafraid of forms and red tape. This comes from experience, but I know most people are afraid of such stuff, and that alone would probably keep most people from arguing.
I really do feel like I am relying on my professional skills in order to get my insurance to pay for setting my husband’s dislocated finger, when that should be a no-brainer. If you are inexperienced and poor, you’d probably be completely at a loss for how to deal with this situation.
I wonder how many people have their credit scores lowered by medical claims which should have been paid but weren’t due to crap like this. It’s a broken system, but it only leaks on the most vulnerable people, and I hate that.