Millet, spilling the tea:
**R A N T**
So firstly, new patient leaves VM about wanting to schedule.
I call her back and she's like "I can't believe you called me back after how you spoke to me yesterday."
And I was like "? We didn't speak yesterday." and she was like "YES WE DID -(incoherent ramble)"
And I was like "Whoa, whoa hold on ma'am. Genuinely, we didn't speak yesterday. I was at home with my fiance and we own the business. No one was at our office yesterday. We're closed on Monday’s." (I still usually work Monday’s but its paper work day.)
She was like "You telling me you're not on chandler street?" and I said "we are on chandler street but so aren't several other clinics…..We're on the second floor of the organic market."
THEN She calmed down and was like "oh...I went to the wrong place..."
I was like "now that we have that squared away, did you still wish to schedule …or?"
And she asked about our prices and she was happy we are 20 dollars cheaper than the person she saw yesterday. (the person she did see also has rocky reviews and we’ve received several clients that were originally his and dissatisfied.)
She wanted to schedule, so I ask about her insurance- which if she had coverage would mean price didn’t matter xD
I ask the standard norm of questions 90% of insurances ask for when speaking to providers: "Full name, date of birth, member ID number"
She gives me the info,
I read everything back to her *twice* (because she has a thick accent and I wanted to make sure I didn't mishear.)
"Z as in zebra, G as in goat, C as in cat" and she repeated back to me "Yes Z as in zebra, G as in goat, c as in charlie"
So I call BCBS. They can't find her in the system. So they ask for her home address- I didn’t have it yet (literally never need it to make calls, and don’t receive their address until we see them in person first xD) . So I had to hang up and ask her.
I read her everything I have written. I speak slowly and make sure to annunciate and she fervously confirms what I have written is accurate (all her insurance info and NOW the home address)
I call BCBS back again.
They still can't find her, even with her address. Ugh.
So I CALL HER BACK AGAIN and let her know she isn’t listed in the system. She goes "Hmm, well I have two insurance cards maybe I gave you the wrong one! One is older. I don’t know which is which haha”
(Face palm dude) OKAY SO I TAKE THE OTHER NUMBER AND CALL THEM BACK
They tell me that I'm calling the wrong number (no I’m not) and give me a new number to call.
Despite knowing I didn’t call the wrong number, I hoped at least the other number could still help. Oh low level insurance reps and their lack of training (not their fault, that’s the industry.) The number they gave me is for Blue Cross DENTAL of TEXAS.
I’m not a f******* dentist. And this isn’t Texas, this is Massachusetts.
(mind you each of these calls has me on hold up to ten minutes before I get anyone)
So I contact HER again, and ask for photos of the front and back of both cards. (I had asked earlier but she was on the road and had to wait until she was home)
The first picture she sends me…is a distance photo of the cards. Like. She’s sitting on her couch- she put her cards on a coffee table and took a picture from the couch lmao. What. I ask her to take a close up photo so I can. You know. READ IT.
Finally the mystery is solved, the first letter is "X" not "Z" she apologizes over the phone- english is second language and got X and Z confused thought zebra was spelt xebra. Frustrating but forgiven, I understand juggling two languages can be hard.
SO I CALL BLUE CROSS AGAIN.
They refuse to tell me she has coverage unless I have an ICD number on her now.
(USUALLY a majority of insurances inform ME of what ICDs are covered and not covered. It isn’t ‘top secret information’ to find out coverage. “We cover this if the patient is experiencing severe pain” is what we hear a lot. Not cat and mouse “We won’t tell you her plan if you don’t tell us her diagnosis.”) BUT WHATEVER OKAY SO I HANG UP AND CALL HER BACK AGAIN.
I tell her the service rep is requesting to know why she wants our services, her left shoulder is in a lot of pain, which is ICD M25.512.
AND I CALL BLUE CROSS AGAIN
I give the new rep the ID, and she tells me it’s a deductible plan of 5,000 and they won’t cover until she meets her deductible- when she does she will have coverage.
Didn’t ask for her ICD whatsoever lmao. I ask the rep about that and she was like “I don’t know man, some reps here are just strange. Plans are considered public information there’s no reason to keep that a secret.”
Of course I got the smart one last. OBVIOUSLY they need an ICD to do billing, but not for inquiry of benefits on behalf of the patient.
She unfortunately has a high deductible and hasn’t come close to reaching it yet so she has no coverage for pain management until she spends enough out of pocket.
She was like “I pay 100 dollars a month just for them to tell me I need to spend $8,000 before they help me…” yeah it’s a scam. I absolutely loathe the medical insurance industry. Two trips the the ER and you’ll be all set to get covered with how expensive that is.
United States btw, if anyone is reading this confused.
long ass post probably not read at all lol