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.