Sunday, March 6, 2011

Outsourcing - Who's Brilliant Idea Was This?



Do you think this commercial is funny? I don't. Well, okay. It's a teeny bit funny because it's well done and because I've never had to deal with service calls being outsourced to Russia.

I’ve worked for doctors since 1987. The main part of my jobs has been to wrest money out of tight-as-crabs-asses insurance companies and weepy the-train-ran-over-my-grandmother-I-have-to-go-to-the-funeral-so-I-can’t-pay-you patients. When speaking with patients in Florida, you have about a 70-30 chance of getting someone who doesn’t speak English.  Not bad odds considering the high population of ESL residents of the state.  It does tend to get on my last nerve, though, when I call a patient or a patient calls me and the conversation opens with, "Habla espanol?" (Um, HELLO! America!)

In order for your insurance claims to be paid, they are coded with CPT (Current Procedural Terminology) numeric codes for the procedures that were done and ICD-9 (International Classification of Diseases) alpha and/or numeric codes for what your diagnosis is. Procedure codes can also have numeric modifier codes to tell the insurance company that a procedure is not related to another, is a repeat procedure, among other things. Just so you know the purpose of your health insurance carrier is to NOT pay your claims.  I believe they’ve hired the finest minds from the world’s best think tanks to come up with ways not to pay claims.  They are diabolical.

When speaking to insurance companies, your odds of getting someone that not only speaks English but comprehends the language goes down to about 89-11 because in an effort to maintain their enormous profits while increasing your premiums and decimating customer service, the largest insurance companies have decided to outsource their call centers for the maximum inconvenience of their clients and providers.

Voice (in heavily accented English): Thank you for calling United Healthcare, my name is Pam, may I have the contract number you are calling on.

I give Pam the information that I've already given to the automated system (Another thing of absolute joy! and invention of Satan) and after she gets the patient information on her screen, I tell her my problem.They’ve incorrectly denied two procedures that were performed.

Pam Reads her script, which is exactly what is written on the explanation of benefits that I have in front of me.

Me: Pam, I’ve already read that on the explanation of benefits. I’m calling to tell you that the two denied codes are separate from the primary code and the modifiers indicate that.

Pam: It says that the denied codes are related to the primary code and not payable.

Me: No, the two denied codes are separate procedures as indicated by the modifiers.

Pam: Hold please.

Holding, listening to a propaganda tape about United Healthcare and how wonderful they are.  Over and over and over. Pam finally comes back.

Pam: There are no modifiers on the claim.

Me: Pam, I’m looking at the claim and the modifiers are there.

Pam: We would need the modifiers to research and have the denied charges reviewed.

Me: Then look at the claim, the modifiers are there.

Pam: The two denied codes are related to the primary procedure.

Now my patience has come to an end.  Pam is delighted to be making .25 an hour and proud of her ability to phonetically read an English script.  I am royally pissed off because Pam isn’t the only person in India I’ve spoken to today.  Now the real fun begins.

Me: I want to speak to a supervisor. I want to speak to a supervisor in the United States that speaks English.

Pam (indignantly): I speak English!

Me: No, you don’t. You’re able to read from a script that you’ve been given and you speak THAT. You don’t understand English and what I’m saying to you.  I want a supervisor, NOW!

Pam (cursing me under her breath in her language): Hold please. “click” and I’m now disconnected.  Fifteen minutes of my life gone.  I redial the number hoping that I’ll wind up in queue with a U.S. Representative. Odds of that, 10 to one, not in my favor.

I'm not making a political and/or social statement. I have no solutions or answers. I'm just a frustrated office worker trying to do her job without getting so annoyed that I blow an aneurysm. Am I being politically incorrect and bigoted, yes. Yes, I am. It's my blog and I'm ranting. So there! Outsourcing is so epidemic that there's a TV sit-com about it. Apparently no one who's ever had to make a call for service that has been outsourced is watching it because like the commercial, they don't think it's really funny.  

*sigh* I'll be doing it all over again tomorrow.






22 blew out from under the bed:

Red Shoes said...

LMAO... I had to call some one and complain about something awhile back... and when the fellow answered the phone, he said his name was 'larry'...

I called Bullshit on that because he sounded just like my good friend at work, K.P. who is a 'Dot' Indian from India...

Larry, my ass!!!

~shoes~

nitebyrd said...

Shoes ~ That's another thing that makes me crazy, they all have very 1950's American names. I'm very tempted to say my name is Fatima or Anastasia Beaverhausen or something else as idiotic as what they are given.

David said...

The commercial is stupid and belittles everyone on either side of the phone call, and the company that is the subject of the commercial is one of the worst.

(oh, did you ask my opinion?)

just my 2 cents

Ron said...

*cheering and applauding you loudly*

You GO, Nitebyrd!!!!

Funny you should be posting this today, because not TWO days ago I had the SAME THING happen to me when I called Verizon to see why my Wifi service was not working on my laptop. And guess what? I got a PAM too! Well, not a Pam, but a Steven with the SAME accent!

OMG, this pisses me off that we have to put up with this shit.

Grrrrrr!#>@?

So yeah, I guess I'm a bigot and politically incorrect too.

But you know what?

I. DON'T. CARE.

Fab post, Sis!

X ya!

CrystalChick said...

Anastasia Beaverhausen... hahaha...love Karen Walker!!!

We have called for tech support, and after being on hold for almost forever the plain named chick with the heavy accent answers and proceeds to follow the script... throwing in a few I understand, Ma'am's, and a couple I'm very sorry about that, Ma'am's. gggrrrr

Anonymous said...

Try living in this part of the world - I once called the fire brigade because the house next door was on fire. They hung up on me twice because they didn't understand what I was saying... Then I got a local to call and they turned up an hour later - only after someone chased them into the next street and asked them to follow to the correct location!!

Needless to say the house next door was gutted - Fortunately there was no one home!

BlacknickSculpture said...

Your dead on about the 1950's American names! I spoke with a person who called himself " Ray ".

A name that when you take into consideration his accent and poor attempt at speaking English seems highly improbable.

But actually "Ray" managed to solve my problem so I gave him a pass ;)

Akelamalu said...

If you think it's bad getting someone in India you should try understanding Glaswegians! LOL

Casdok said...

Certainly is enough to make you want to bang your head!

Casdok said...

Ps - but not too hard :)

Indi said...

nitebyrd ~ I've been bangin my head for months... phoned my bank the pother week, call centre in frickin India... no one called Larry .. couldn't understand a fricken word of English at all, I may as well talk to a fricken brick wall... or bang my head against one! If they can't string a normal English sentence together I suggest they go home. Funny all the same, damned frustrating nontheless


Indi

xxx

Joker_SATX said...

Chica, is it me? Or does anyone else have a problem reading your blog. I mean, it comes up white with very light blue lettering on your blog. I am using Google Chrome as a web browser. I am going to try another browser to see what I get.

Just sayin...if it weren't for my google reader, I would be missing some pretty cool posts!

Joker_SATX said...

I guess it is me...Just so you are aware, I am now typing this via Internet Explorer and I see your page just fine. I will looking into tweaking my Google Chrome Browser, but you may be aware that anyone using Chrome may be experiencing the same things I am.

And for the record. IE is DOG slow compared to Chrome.

ZomBee said...

I wept bitterly while reading this. Finally someone who knows my pain!WHOOO!!
I do similar 8 hours a day and it is crushing my very soul.
How dare you call ME from a state in MY country and ask me if I speak YOUR language?
Oh HELL no!

Anonymous said...

OMG!
you too?
I thought that I was the only one!
I used to think that the computer help people were bad, then I got rid of my PC and have NEVER had that problem again.
My two kids have had 2
count them 2
emergency procedures..
EMERGENCY
so when I spend an HOUR on the phone with my name is Sanjet Punjapb you can call me phil...,
who tells me that claims are denied because I didn't call ahead for PRE authorization , I want TO SCREAM" HOW THE BLOODY HELL DO YOU CALL AHEAD FOR A PRE F"AUTHORIZATION WHEN YOUR CHOILD HAS BEEN ROLLED INTO THE ER WITH AN APPENDIX ABOUT TO RUPTURE OR A BROKEN FUCKING WRIST?????"
GAAAA
Thank you for letting me rant on your blog too...
( I wish I felt better...)

Fat Controller said...

Fortunately, we have been spared this particular horror as the number of Indians who speak Danish can probably be counted on the thumbs of one hand LOL

However, I work every day in an environment where NOBODY speaks English, and they all expect ME to speak their rotten language!!!

Fat Controller said...

...and your description of insurance companies is spot on, it is the same the world over. We had a case a few weeks ago where, after a very heavy winter, the snow started to thaw and this caused widespread flooding over the whole country. Many houses were flooded, with furnishings and carpets on the ground floor ruined.

The owners naturally thought they were covered against floodwaters as a result of a thaw but apparently the definition of a 'thaw' (devised by the insurance companies, of course) is when the temperature rises from below freezing to above 42º (6º celcius) within a 12 hour period. This condition was of course buried deep in the small print, and is almost impossible to achieve.

This caused such a scandal when the national news network found so many householders who had been denied cover that the big insurers eventually and grudgingly gave way, but only after they had been shamed on prime-time national TV for several nights in a row.

tattytiara said...

If you call Toyota you'll speak with somebody in your own country who speaks perfect English. And who provides worse service than Pam and Meggy combined. And will only do that begrudgingly.

Oh, I do feel your pain, honey. I've so been there.

UP said...

This has become my PET peeve!

Keep work in America, speak English, and learn to frickin' drive!

Sorry, Red Foreman moment!

UP

Danielle said...

So freaking true! Seriously, it should be illegal. You used to have to take a ton of hours learning english to become a citizen, and now, we.... ah shit who cares! Obviously not the powers to be!

Lazarus Lupin said...

The thing is your frustration plays into the insurance company evil plans. On a statistical basis a small percentage will be so p'o'd, confused and annoyed that the corrections will at least be delayed and that's more days in the bank earning interest or some other investment.

Lazarus Lupin
http://strangespanner.blogspot.com/
art and review

Pallas Renatus said...

Having worked as a pharmacy tech for a few years, I'm often amazed (and thoroughly confused) by how much more smoothly calls to pharmacy benefit providers go compared to other insurance companies.

I've never once been transferred out of the country (at least, not obviously), they're generally open 24-hours, and even though they might be dicks about denying claims to patients, usually 1 to 2 minutes on the phone with a tech is enough to clear things up.

And I really have no good reason as to why things should be so much different for us, even though you and I have probably often called different divisions of the same office.

...unless you need to deal with MediCare, of course. That's a nightmare for *everybody*.