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I despise insurance - 9/13/2008 9:56:32 PM
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csl7037
Posts: 1762
Joined: 3/24/2008
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Dh just started a new job and I can't even find anywhere anything that tells me where to take my child to the dentist. I had FITS with the stupid insurance he had at his old job and this is no better. They use the same retarded voice prompt system and I truly think they don't want you to know who to call or how to use your plan. After being so frustrated with the plan and with my last dentist (who I could never get in to see), I fell way behind in our checkups - me and the kids. I cancelled the last appointment I had for ds because I took dd and didn't like the lady. Then dh took this new job and I have known for a couple months I need to try to figure this out but have desperately dreaded it. Now poor ds has a cavity that he just told me hurts on Friday and today seems to be absessed - his whole cheek is swolen and I'm so upset. So I'm trying to figure out who I even need to call on Monday. I'm so angry and this is always what this does to me anytime I have to deal with this nonsense.
Am I just this dumb? Does anyone else have any clue how their stupid policies work? I guess it has just made me crazy how many times we've had to change policies the last couple of years - but every company is as bad as the last. The only member of this family who's insurance is even usable is the DOG! I wish I could get that company to insure my children.
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RE: I despise insurance - 9/14/2008 9:48:35 AM
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Szaftoo
Posts: 813
Joined: 4/13/2005
From: So. Calif.
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Have you tried the "provider locator" on the web site? Most companies have a site where you can find doctors and dentists in your zip code.
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RE: I despise insurance - 9/14/2008 11:42:20 AM
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Mrs.Wifey
Posts: 5079
Joined: 4/12/2005
From: The Gorgeous plains of Colorado
Status: offline
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Yeah, I always use the provider locator on the website, much faster.
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RE: I despise insurance - 9/15/2008 3:28:10 PM
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MrsTracy72
Posts: 1800
Joined: 2/28/2007
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Dental is so much different than health insurance because you can get the straight insurance that allows you to go anywhere, an HMO which is usually VERY limited, or a set spending amount per person AND they tell you where to go. I would just take the card to the dentist you want to go to and have them check benefits, or better yet, call the dentist and give them the info on the card. They either have the info in their computer systems anyway, or when they call, they get to talk to real live people.
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RE: I despise insurance - 9/16/2008 8:29:50 AM
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monamie
Posts: 1083
Joined: 1/26/2006
From: OK
Status: offline
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I despise insurance as well, but from another perspective--which I'll explain in a minute. The voice prompt systems they use are pretty useless, and as others have said the websites are a little more helpful and there should also be a handbook that list participating providers.
And you also have the option of calling providers and asking if they are in network with your particular plan.....which is where I come in. That's part of my job at our office. We deal with the same frustration that plan members do. After going through a seemlingly endless voice prompt phone system, we reach a point where we can ask to speak with customer service. Then we get to speak with "Bob" in India or Pakistan or..... We struggle to understand one another and each of us has to repeat several times what we're trying to ask or convey. We're finally able to verify the patient's eligibility and level of benefits. Then after several weeks, we receive payment and an EOB (explanation of benefits, also sent to the patient) and it's nothing like what they TOLD us they would pay. That's so frustrating. Especially when I have to go back to a patient and explain that the insurance didn't pay as much as they told us they would and the patient has to shell out more $$$$. I really hate that.
_____________________________
Unforgiveness is the poison we drink hoping others will die.
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RE: I despise insurance - 9/16/2008 10:57:05 AM
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MrsTracy72
Posts: 1800
Joined: 2/28/2007
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Monamie, I once read somewhere that if you are on the line with a call center in India and you tell them that you want a manager, they are trained to transfer you right away with no questins asked and usually you end up with someone back in the states. I know that has worked before with me with Dell and with another company. But when it comes to tech support type things, I totally love India. Those people ROCK!!!!! But I can see your point with the insurance verification. That I don't think should be outsourced to someone outside the country. Insurance laws and all the tricky things that go with benefits I think are better left to people here. But that is my opinion and I am not going to change the world so I just thought I would give you my manager suggestion and maybe it works the same way with you. It never hurts to try.
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RE: I despise insurance - 9/16/2008 11:25:49 AM
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monamie
Posts: 1083
Joined: 1/26/2006
From: OK
Status: offline
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I've had to do that before--ask for a manager or to speak to someone in the US specifically. Especially on a disputed claim.
What's funny is that once when I did that, I got a rep from the deep south. Adorable accent, but it took almost as long to iron out the details!!!! 
_____________________________
Unforgiveness is the poison we drink hoping others will die.
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RE: I despise insurance - 9/16/2008 9:50:20 PM
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MrsTracy72
Posts: 1800
Joined: 2/28/2007
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But I am willing to bet you had a delightful conversation. I love getting call centers from the deep south. Those people are sooooo friendly.
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RE: I despise insurance - 9/17/2008 7:07:23 AM
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monamie
Posts: 1083
Joined: 1/26/2006
From: OK
Status: offline
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You're right! Makes me feel like we're sitting down to visit over tall glasses of sweet tea.
That is worth mentioning though---language barriers are one thing, but I have never gotten a rude foreign customer service rep. The rude ones are all homegrown here in the US.
_____________________________
Unforgiveness is the poison we drink hoping others will die.
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RE: I despise insurance - 9/18/2008 12:58:39 AM
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MrsTracy72
Posts: 1800
Joined: 2/28/2007
Status: offline
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That is because the reps in other countries are trained to escilate the call to a manager as soon as things seem to get hairy. Especially the reps in India. Usually that manager is in the US and if not, by the third time you get snarky with one of them, you will most definately end up with a person in the US. I read that somewhere they are not to let the customer be upset because they want the business to keep using them so they want you to be as happy as you can be. I even sat on the phone for an hour once learning Hindi a while ago. It was fun, but I only remember Namaste. I think I spelled that right.
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