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Monday, December 15, 2008

Kafka lives

Because I’m insanely stubborn, once I’m over the gloom and shock of these idiotic bills from Blue Cross Blue Shield, I decide I’m going to call them to try to straighten things out. I figure I can handle a call a day before my head explodes. But first, before trying billing, I figure I’ll call them to ask about the “Case Management” person they’re offering to assign me to, purportedly to give me a single point of contact to help me navigate all this stuff. Sniffle – is BCBS actually starting to care about its customers and trying to make their lives a little easier?

No. The answer to that would be no. Because I do call, and a very nice woman tells me that the person they’d assign me to would help me with very useful things, like determining what treatment I need and where I should go for it, what doctors I should use. I ponder this for a brief moment (picturing myself heading off to Stan’s House of Fine Boobage for reconstruction surgery), and decide, no thanks. Especially after I ask if this person would help me sort through the maze of insurance stuff – umm, no, though they’d tell me what number to call. Thanks – I can get that from looking at the back of my BCBS card.

Onward. I decide to call to first find out about the $5000 bill that’s due to an “adjustment,” whatever the hell that is. After much time on the phone, during which I sense a few rounds of darts are going on in the background, the woman comes back noting that the dart has landed on “extra person in the room.” Huh? Supposedly there was a registered nurse in the room during surgery, and BCBS won’t pay for that, just for the doctor. This practically stuns me into silence, because what the hell do I come back with? Was I supposed to poll everyone pre-surgery to make sure that only the bare minimum of necessary people were present? Wouldn’t my doctor know who should be there?

I then decide to tackle one portion of that $5000, a bill for $355 to NW for surgery with Dr. Jeruss. I call my doctor’s office and speak to the assistant, who has no idea what the hell this is either, so she sends me to the NW Memorial billing person. Who also has no idea what this is, so she calls BCBS, and has a conversation with someone who tells her that no, the charge is because I haven’t met my out-of-pocket limit. Again, huh? This is clearly not the case. Whereupon we have the following conversation:

BCBS loon: My records show that you haven’t met your out-of-pocket limit yet, so that’s why you got that bill.
Me: But that’s not the case. I have a whole stack of bills here and I met my limit early on, probably back in July.
Loon: Well, it really depends more on when we process the bills. So you could get billed for things because we haven’t processed them as showing that you’ve met the limit.
Me: But regardless of when you process things, paying this bill would put me over my out-of-pocket limit.
Loon, speaking slowly: Let me see if I can explain this in really simple terms. Doctors have up to a year to bill us so what matters is the date we process things. But you’ll still never pay more than your out-of-pocket limit.
Me: So you’re saying that because of your delay in processing these bills that means I have to pay more than I should? Because that’s what’ll happen if I pay this bill.
Loon: No, you’ll never pay more than your limit, even if you pay that which puts you over your limit.
Me: Excuse me a moment.

I go retrieve my head from across the room, since it’s just spun free of its moorings.

When I go back to the phone, I tell her that we’re not getting anywhere and that it would be simpler if I just wrote everything down and faxed them the info, so we agree on that at least. I get the feeling that BCBS just wants to badger me into paying this bill, figuring what’s $355 out of tens of thousands of dollars? I’ll tell you what it is – it’s the principle of the thing, dammit. And it irks me that here I am with an MBA from Wharton, and I can hardly figure this stuff out. What about all the poor schmoes out there who are too sick or confused to deal with this crap? BCBS, as soon as I can figure out how to get it made, there’s going to be a Fuck (XXXX) hat with YOUR name on it.

Speaking of Wharton, I decided to actually make some use out of LinkedIn the other day, and got in touch with one of my connections, even though I wasn’t sure exactly how we had connected. Though we both have a background in B2B, and he went to Wharton, so it must have been one of those. Anyway, we’re chatting when suddenly he mentions something about “that blog of yours.” Oops. I try to keep fun/personal stuff on Facebook, professional stuff on LinkedIn, but clearly the blog snuck through. Which made me think of my mom, who doesn’t read my blog but who cautioned me against it back in the fall, when I was entertaining thoughts of returning to full-time Corporate America. She thought it might scare companies off, and I admit I did toss that possibility around in my head.

And quickly discarded it, figuring – who’s going to google an interview candidate and find my blog? Puh-leeze. But now, I care even less. Because it occurred to me, as I was having this delightful conversation with Mr. Fellow Wharton alum, who clearly appreciated the humor of the blog, that if there are people out there who would ding me because of the blog......then they’re not the kind of people I’d want to be working with anyway.

And finally, for all you naysayers who had me doubting my eyesight and my sanity, in questioning whether or not I actually saw a sign for the Quaker Steak and Lube restaurant, behold:

Quaker Steak & Lube®, voted Best Wings USA, is a family friendly restaurant with a motor-sports themed atmosphere. The restaurant has 18 Award-Winning home-made sauce recipes with a menu variety that include Buffalo-style chicken wings, ribs, steaks, salads, signature appetizers, distinct beverages and Kids Lube Cruiser meals. Founded in Sharon, PA in 1974, Quaker Steak & Lube® houses unique décor, including race cars hanging from the ceilings and motorcycles, Corvettes and gas station memorabilia decorate the walls. The Lube® began franchising in 1997 and currently has 25 locations in nine states.

This was from a press release for a Hamburger Festival, where QS&L won with its “Lubeburger.” No, seriously. My question is, how have I come this far in life without ever having even heard of this place? Much less stopping there??

4 comments:

Deanna said...

I have actually had lunch at a Quaker Steak and Lube. There is one by my parents house in FL and my dad and I had lunch one afternoon when I was visiting a few years back. It is a diner-like place with a 50s car theme.

D said...

There's only 1 thing that scares me about moving to the States: the health care system. Your stories do not help.
Hang tough and fuck em up!

consumeradvocate said...

Trying to make sense out of health insurance bills can be frustrating. Trying to determine the true price of health care services BEFORE you visit the provider is impossible. I am founder of Outofpocket.com, a community search tool to help consumers look up prices, compare what other consumers paid for similar services, and find the best value. The sites invites consumers to post/share prices they paid for actual services, to share with other consumers.

I welcome any comments you would like to share on this health 2.0 website.

Colleen said...

I love the idea of Quaker Steak and Lube. The only better restaurant name I've ever seen is the Reaper Room in Virginia. It's supposed to commemorate Cyrus McCormick, the reaper king. But seriously, would you ever want to eat at a place with such a name? I'd be sure that I'd be struck down immediately after dessert!