Dude, Pay My Claim

Part of: Debating Health Care

I really don’t like dealing with my HMO. If I asked for a show of hands for all those who find interfacing with their health insurance company a pleasant experience, I would probably get the same response I would if I asked the same group if they enjoy sticking a needle in their left eye.

When my family must interact with our HMO/PPO, this task falls to me, since I have a little more patience, being in the business. My wife did try to call one time. I begged her not to, but she insisted, saying we should share this burden. I reluctantly agreed, gave her the number, and walked upstairs to change. I came back down 10 minutes later, and she was sobbing into the phone, yelling "I don’t want to speak to a supervisor, I just want an answer to my question!" That was the last time she volunteered for that duty.

I really don’t have much trouble with customer service at our PPO. When I was in college, I sold books over the telephone. You know, the kind that once they start, they never stop coming? We had little flip charts: If they say no, go to chart 2, if they say no again, go to paragraph four on chart 3. If they say yes, get their info, etc. I lasted one half of one shift, and never went back, but it gave me enough experience to imagine how my PPO probably works.

I call the toll-free number, and keep hitting zeros until I am queued up. I listen to the Muzak version of Christopher Cross’ “Sailing,” and I am connected to my rep, Ted. This is one of the largest health organization’s in the country, and I get...Ted. I always get Ted.

CSR: Thanks for calling. How can I help you?

Me: This is Rick Vassar, My member number is—

CSR: Dude, it’s me, Ted. What’s happening?

I began to think that Ted was the only one who works there, and my suspicions were validated the day I unknowingly and accidentally hit the prompt to speak to someone in Spanish. I was put on hold, listened to some song by Carlos Santana, and just before the guitar solo, I hear:

CSR: Hola, como le puedo ayudar?

Me: Uh, this is Rick Vassar, my member number—

CSR: Vato, soy Ted.

Me: Ted, I don’t speak Spanish, can you help me?

Continued on the next page Page 1 — Page 2

Article tags

Spread the word
Bookmark and Share
Profile image for rick-vassar

Article Author: Rick Vassar

Rick Vassar CPCU, ARM,is a career commercial risk manager and benefits expert. In 2009, Vassar was named the 2009 Risk Innovator for Manufacturing by Risk and Insurance Magazine.

He has served on the editorial board of The John Liner …

Visit Rick Vassar's author pageRick Vassar's Blog

Read comments on this article, and add some feedback of your own
  • No image found

Article comments

  • 1 - Mark Schannon

    Sep 05, 2009 at 11:04 am

    Great article. Funny & very much to the point.

    Given the problems me & the bride have had with health insurers, doctors, hospitals, and wild turkeys, it's hard to imagine a worse system. Even not being able to get seen by a doctor (as in those commie countries such as Canada & England) is preferable to being seen by one who hasn't the time or interest to differentiate cancer from a canceler sore.

    In Jameson Veritas

  • 2 - Arch Conservative

    Sep 06, 2009 at 4:15 am

    Today Van Jones. Tomorrow Barack Obama.

  • 3 - Joanne Huspek

    Sep 06, 2009 at 9:09 am

    Frying pan, fire, frying pan, fire...

    Tough choice.

    I have health insurance, am not happy with the outrageous deductible, but the only reason we have it is for the worst case scenario. But you're right, it's no fun dealing with the companies.

    Of course, it's no fun dealing with the PO or the DMV either.

    Like I said, frying pan, fire...

  • 4 - Spelling Nazi

    Sep 06, 2009 at 9:37 am

    Of course, it's no fun dealing with the PO or the DMV either.

    Or Medicare.

  • 5 - Mongo

    Sep 06, 2009 at 10:39 am

    According to a CNN poll last fall, 59% of Americans think the government could do a better job than their insurance company. Considering most Americans would say private companies could do a better job than government at most things, that's saying a lot.

Add your comment, speak your mind

Personal attacks are NOT allowed.
Please read our comment policy.
Please preview your comment.

blogcritics lists for May 21, 2013

fresh articles Most recent articles site-wide

fresh comments Most recent comments site-wide

most comments Most comments in 24hrs

top writers Most prolific Blogcritics for April

top commenters Most prolific Commenters in 24 hrs