Why Does it take at least three calls to get a non-idiot?

Reading the Comcast thread made me think of another issue I often have that I really hate. What I hate, and this is almost everywhere not just Comcast specifically, is that it almost always takes at least three calls before you get somebody who is halfway knowledgeable about anything.

It seems like most CSRs at most companies see what's in front of them and, even if it doesn't make any sense at all, try to justify it.

Been dealing with this with my insurance company and a hospital and end up having conversations like this:

ME: What's your contracted rate for that service?

HOSPITAL: $530.

ME: But you billed me $875.

HOSPITAL: Right. That's the full rate.

ME: Yes, so the insurance company should've applied the negotiated discount and paid the contracted rate, right?

HOSPITAL: Right.

ME: But they paid the full amount you billed?

HOSPITAL: Right.

ME: And so since they paid the wrong rate, the 20% of that that's my responsibility is also wrong. So this bill you've sent me is wrong?

HOSPITAL: No. It's correct.

ME: But I pay 20% of the contracted rate. You just told me that they overpaid their share, so the 20% has to also be incorrect.

HOSPITAL: No. It's correct.

ME: So the full rate is $875. The contracted rate is $530. The insurance company mistakenly paid you $700, which you acknowledge is too much, but because they mistakenly overpaid you, you want me to overpay you, too? My 20% of the contracted rate is $105, but you want me to pay 20% of the full rate, which is $175, which is what you've billed me.

PAUSE.

HOSPITAL: The amount we gave you when you were discharged was just an estimate.

And the whole thing starts over again. The mental gymnastics these CSRs put themselves through in order to justify what is obviously a mistake is incredible.

Same story with the insurance company who insisted that the full rate was the contracted rate for two calls until finally the third rep we talked to pulled it up and almost immediately said "This is completely wrong" and resubmitted it.

The only exception to the three call rule that I've found is Sprint, but only because it takes at least ten calls to get someone who can fix whatever they've screwed up.

 

It was only a week ago that I finally got the refund for the overpayment for my 2 year-old daughter's birth.

I can't imagine they would've let me get away with owing them money for 2 years, but they seemed to think that was perfectly cool for them to do it (and even during the last week before they finally paid, I would get a call saying they weren't going to pay. And then someone else would call and ask for my mailing address so they could send a check. And then someone else would call and say they weren't going to pay because it was their policy to keep such overpayments, etc.)

 

Unfortunately, sometimes it's impossible to get past the few couple of lines of defense. My most maddening conversation yesterday was with a supposed "supervisor". I kept asking to talk to the specific person who would know the answers I was seeking, but she flatly refused to put him on the phone.

I eventually called their corporate headquarters, asked for the legal department, read them the definition of "mail fraud" and "insurance fraud" and suggested they carefully consider what they're doing before taking their next step. But that didn't solve anything. I'm still looking at a bill for $300 total when the hospital actually owes me about $250 that they required me to overpay before they would do the discharge.

I was ready to go to Small Claims for the refund from the last hospital, and I let an administrator know that. I can't imagine any court agreeing with the "policy" of just keeping any overpayments as if it's a tip or something.

Our insurance company contracts with the health providers only give them something like six months to file a claim. Amazingly, some places don't do so within the time period (and some never do at all, apparently not interested in collecting money for their services). According to the contract, the health care provider is not allowed to come after us for those denied claims, but some of them still do.

 

Ain't that always the way.

 

Just by happenstance, I saw this video today from one of the TED conferences that kind of touches on some of this:

http://www.ted.com/talks/barry_schwartz_on_our_loss_of_wisdom.html

 

Chances are, she's going to hate me when she gets to be a teenager no matter what.