Come, lend me an ear and let me tell you the TRUE story about what happened when I started calling the BOARD of DIRECTORS of Humana Health Insurnace (Part one)
Since January of this year I have been trying to convince Humana Health Insurance that they have made a mistake by demanding refunds from my doctor and hospital, while claiming that they were not my "Primary" Insurer.
Yesterday I got a call from my local clinic saying that I now owed an additional $1900 because Humana had "sucked back" payment for a claim they had already paid from 2007 and MY HEAD FUCKING EXPLODED. It was too late in the day to do much...
BUT....
This morning I got up, then got up on my soapbox and went to work by looking up who was on the Board Of Directors of Humana and started tracking down their phone numbers and actually calling them (bad voice and all) and speaking to their administrative assistants about how screwed up things had become at Humana. Or as I put it how FUBAR Humana was and how a little old lady or man stood NO CHANCE in dealing with Humana because they wouldn't have the stamina to keep at them. Hell, I'm 47 and it is all I can do to keep them honest. (AND IT'S NOT JUST HUMANA).
GUESS WHAT... at least one of the Director's cared. I have been getting calls from various secretaries and assistants and from HUMANA's VP of Legal Affairs for the Board of Directors.
Now, I have been told that my situation has been corrected for the 8th time, but this time I actually think they mean it. We will see.
There is so much more to this story that I will explain in the future (like how EVERYONE I spoke to at Humana wanted to help, but just couldn't make it happen, from their "front line" position), but for now... take heart someone out there seems to care, even if I did have to use a sharp stick to make the point.
More tomorrow, and there is a lot more to tell. Maybe even a way I can help you out of a similar problem.
Good for you and good for you for setting a good example! Direct action takes time and stamina but it can pay off.
If more people confronted such abuses more often, there would be a dramatic reduction in abuses like that.
May 12, 2009 3:19 PM | Reply | Permalink
eds,
Thanks, don't know the ending yet, but damn someone was listening.
May 12, 2009 4:32 PM | Reply | Permalink
Problem is, eds, not everyone has the time, to. They have jobs and kids--and insurers tend to keep bankers hours. People who need the time to confront them often are out of leave to do so.
=(
May 12, 2009 8:15 PM | Reply | Permalink
I understand that. That is what "scarce resources" means, and it is part of what makes an economy run, whether intelligence, savvy, money, or time is scarce.
I'm afraid you are trying to excuse complacency -- "Oh I don't have time to deal with that..." is like Bush not paying attention to the August 2001 PDB (to make a giant but correct leap). Or it's like my housemate getting his phone disconnected AGAIN because he won't take time to pay the bill for months on end, if you want a more personal analogy. :-)
It is also part of how lawyers and other advocates make a living, taking on the "it's too hard for me to do" problems. I've done a bit of that (not to make a living) for people I know, as well as on my own behalf.
So, if it's a matter of $1000, just how many hours of time IS IT worth to pursue satisfaction, regardless of the larger view that doing it helps reduce other instances? A relative was offered $1500 for her stolen and then wrecked vehicle. She got $3500 after two months of mostly BS from the insurance company.
Finally, it is part of the cost of overhead in health "insurance" -- dealing with the devilish details in making decisions and processing data about incredibly complicated stuff too many people take too much for granted. I'm concerned about over-leveraged technology, to quote a remark I ran across yesterday from a Danish poet:
“When technology is master, we shall reach disaster faster.”
Health care except for bedside manner IS technology.
May 12, 2009 8:52 PM | Reply | Permalink
Well, it's probably not worth losing one's job over.
It probably shouldn't be. It should be more like a public utility, like electricity and water.
May 12, 2009 8:58 PM | Reply | Permalink
How does spending a few hours over a month equate to losing your job??
"It probably shouldn't be. It should be more like a public utility, like electricity and water."
That's a non-sequitur after my "Health care except for bedside manner IS technology."
Whether health care is like a utility or not has nothing to do with it being largely technology. Utilities are generally highly technological in the USA. Checking a pulse is low tech, MRI is super-high tech. Drugs are high tech both in production and prescription.
??
May 12, 2009 11:48 PM | Reply | Permalink
Co-sign on many levels.
May 13, 2009 11:31 AM | Reply | Permalink
But here's the thing, not everyone knows that multiple tries will do the trick. I've called my credit card issuer in the past to lower my rates in the past and usually they say no. But after a lot of tries, speaking to supervisors, eventually I get my way. At least until last month when "B of A" out of nowhere and for no reason is raising my rate 5%. I first called and got nowhere. But now I paid it off (their raising the rate was actually a good thing, since I had the money to pay it off and for some idiotic reason hadn't), and now I have leverage to go back and try again. And, rest assured, I will eventually have the rate back where it was. Or threaten to cancel the card. Or actually go ahead and cancel it.
So the thing is that you have to be willing to sink the time into it. But also you have to know a little about the system, who to call, where to call. Basically you need a sense of entitlement: "No one's going to screw me over!" It takes work, and you have to educate yourself.
Educating yourself usually means going online. And who has internet access? The well off:
http://blogs.zdnet.com/ip-telephony/?p=1839People who aren't educated and without a sense of entitlement, which means the poor, not only don't pursue solutions when a insurance company or credit card company does them wrong, but they often don't even know that they can.
May 13, 2009 2:54 PM | Reply | Permalink
Yes, it takes time, I said so. No, you don't have to go online to educate yourself. Yes, many consumers, no.... MANY consumers are undereducated in the "ways of the world". The school of hard knocks teaches those who persevere, research teaches those who are knock-averse or just have "better" backgrounds.
The web is definitely ONE resource mode. I don't know what population group you have in mind which cannot get web access in the USA, and which would need it and make good use of it.
May 13, 2009 11:57 PM | Reply | Permalink
In my rambling post above, I guess my point was that the poor often don't have the mindset to know that they can change things, that they can fight and win. It's a disadvantage.
May 14, 2009 11:35 AM | Reply | Permalink
Add a little critique of Fox to this story, face, and I guarantee the blog will get traffic!
May 12, 2009 3:36 PM | Reply | Permalink
♪,
I saw that. Oddly I mentioned it to my doctor earlier that morning. HONEST, I Did.
May 12, 2009 4:34 PM | Reply | Permalink
Heh
You funeee
May 12, 2009 8:16 PM | Reply | Permalink
I'm sure that's all you got out of those discussions, TheraP. And that's a shame.
May 13, 2009 11:35 AM | Reply | Permalink
Or the word "Cheney". But for some reason every time I write that word, my computer screen goes slightly green. Maybe "Fox" is the better crowd-bringer!
May 13, 2009 3:01 PM | Reply | Permalink
Glad you had the energy to fight back.
I think when it comes to healthcare reform the american people are more united than divided.
I actually think we could come together and take to the streets to make sure that we get the real healthcare reform that we need. I think it could teach us how to to take action together to fight other abuses.
May 12, 2009 3:51 PM | Reply | Permalink
S,
I have a plan... I have mentioned it to one of those I spoke with today and they didn't laugh me off the line. More soon.
May 12, 2009 4:36 PM | Reply | Permalink
Congratulations, Face! I bet the hmos and other insurers are a little nervous now what with all the talk of reforem. It's satisfying to hear about someone who fought them and won.
May 12, 2009 4:22 PM | Reply | Permalink
FDRd,
THANKS!, Not over yet... BUT things are looking up.
May 12, 2009 4:30 PM | Reply | Permalink
DO NOT LET THE BASTARDS GET YOU DOWN FACE.
Just keep fucking with them. Never stop. Hell sue them in conciliation/small claims court. Cost them money for a filing fee. Just separate the claims to reflect the highest amount allowed in small claims.
That you are getting calls, affirmations, is just tremendous. Good for you!!!
May 12, 2009 5:02 PM | Reply | Permalink
2D,
Oh it was AMAZING what happened when the mysterious director ACTUALLY called from an office far far away, I believe folks actually jumped. Much more to tell about this "little victory".
May 12, 2009 5:19 PM | Reply | Permalink
Are they covering the expenses for your head?
May 12, 2009 6:17 PM | Reply | Permalink
KtM,
No not yet, though they did mention that they might help with the carpet cleaning bill.
May 12, 2009 6:27 PM | Reply | Permalink
Love it! Going to the Directors is brilliant. Much better than the CEO who I'm sure has people to keep you away from him. Directors aren't expecting attacks from the public.
They should get more of them.
May 12, 2009 8:27 PM | Reply | Permalink
You can get a two-for.
Draft a letter with a salutation showing that it is intended to be sent to the Board (Preferably addressed to one particular member with the others cc'd.) Then send that draft not to the Board but to the CEO, saying you're giving him a chance to reply before escalating to the board. . OBTW include in the draft a sentence that says "Before writing you I sent a draft of this letter to Mr. CEO on (insert date) who replied (leave a couple of lines open to indicate that's where you'll insert whatever you were told.)
CEO's are more than capable of ignoring a letter addressed to them.Or threatening to report them to any Governmental Agency. But they detest having to respond to questions from the Board.
As their staff know.So before your letter is provided to him the ceo's admin assist will first send it to some VP with instructions that he is to draft a proposed reply.
Then your letter and the proposed reply will be sent together to the ceo.Within 24 hours, provided of course that your draft includes the space for the sent date.
Directors may well know nothing whatsoever about the company, but you don't have to know anything to grumble " don't see why it took so long to answer"
And believe me, the proposed reply will be one that takes care of your problem.
May 12, 2009 9:04 PM | Reply | Permalink
Very clever indeed!
May 13, 2009 7:44 AM | Reply | Permalink
Great advice!
May 13, 2009 2:57 PM | Reply | Permalink
Bear in mind that there's bound to be some member of the Board with whom the CEO has a difficult relationship.Even if he's picked them all, which is seldom the case.
So if he sees that your draft letter, no mtter to whom it is addressed (and it should be addressed to one person to ensure that there would be someone who felt under an obligation to take action)is cc'd to all the directors he's going to think "Oh God, that means Charlie's going to bring this up at lunch".
Because that's the way it works. The board meeting itself (whether or not it is recorded) is choreographed with the object of ensuring nothing is said that could provide ammunition for a shareholders' suit. But at lunch the zingers fly.
May 13, 2009 10:36 PM | Reply | Permalink
Good on you Face. I really hope this works out to your advantage and I hope I can remember your example of taking action when all I want to do is sit in the corner and nurse my victimness.
May 12, 2009 10:04 PM | Reply | Permalink
bs,
I assure you, you will take great pleasure in actually fighting back. Even if it doesn't work you will feel better.
May 13, 2009 6:15 AM | Reply | Permalink
I don't always agree with you but you're my hero today. Rock on, my brother.
May 13, 2009 2:37 AM | Reply | Permalink
bm,
Thanks, but how is it possible that you don't ALWAYS agree with me... I am never wrong...am I?
:o)
May 13, 2009 6:12 AM | Reply | Permalink
No, but neither am I. Sometimes worlds collide ;)
May 13, 2009 7:14 AM | Reply | Permalink
And words.
May 13, 2009 2:30 PM | Reply | Permalink
While time consuming, patience trying and taking a real effort, if more people were proactive in dealing with big corporations and with our government we might just have a chance. It's entirly possible we can actually batter them into submission.
May 13, 2009 5:29 AM | Reply | Permalink
TPC,
You are correct we can batter them into submission
if we all make an effort. I will be trying to put together an actual "Justice League" of folks like me that have the time to take on these battles.
May 13, 2009 6:09 AM | Reply | Permalink
Bravo for your efforts, Face! Well done. But, dammit, you're not supposed to be talking at all, are you? Much less shouting at Corps over the phone!
Seriously, though, in my experience this is just standard operating procedure for the insurance companies, as it is for others. Their default position is to defraud the client, and those that complain for x amount of time will get some mild compensation. It doesn't pay for them to actually comply immediately with the terms of a contract. That's the wonderful 'free market' system: screw the sanctity of the contract! There's no incentive for them to comply. Because in the free market, God forbid anyone police these markets and punish those that break the law.
May 13, 2009 7:06 AM | Reply | Permalink
Obey,
The voice might have helped... AND I made them aware that they might be getting a future bill for this conversation.
It is very much SOP for these big boys.
May 13, 2009 7:37 AM | Reply | Permalink
While the debate continues whether we should reform healthcare, we will get answers to our questions. If the reform effort fails, things will return to business as usual. I'm not taking anything away from your efforts, Face. If you had done nothing you would have gotten nothing. But you are working your tail off and seeing something for your efforts.
I will gather some hope the insurers may have learned something about trouble shooting, but I suspect they may return to their previous scheduled programming, "What problem? There's no problem. The provider returned the money to us. That's a solution to out bottom line!"
May 13, 2009 11:07 AM | Reply | Permalink
Excellent post. There is a message here:
If you sit inside a bureaucracy (as most people in this country do) and you don't do your damnedest to fix things in your little corner of the world (even if this means risking coworkers' wrath), then do not be surprised when others feel the same way and stonewall you when you are in need of human judgement.
If you don't have the authority to do something, then get the issue moved up the chain to where someone can... but be an advocate for the issue.
That's the only way to get human judgment back in the equation. Bureaucracies are set up to prevent human judgment. Fight back from the inside!
Corporations are made of people...and people is us.
May 13, 2009 11:30 AM | Reply | Permalink
ct,
You are correct as people settle in to that culture they eventually just "settle in" and begin a long slow march to acceptance. I hope to figure out a way to introduce a new drummer to their long slow march.
This was the first part of my "evil" plan.
Ever notice how evil backwards is LIVE?
May 13, 2009 11:58 AM | Reply | Permalink
And "IF" is in the middle of LIFE.
May 13, 2009 12:06 PM | Reply | Permalink
Bravo! If you lived in New York State, the State Insurance Department could have done this for you. The insurance companies fear them.
By the way, treating other people as you have been treated is how the private insurance companies plan to reduce the cost of health care. Don't think for a minute they will give up their company-paid golf club memberships, company cars, private planes, etc.
May 13, 2009 1:05 PM | Reply | Permalink
Exactly !
May 13, 2009 8:00 PM | Reply | Permalink