Actual Quotes to actual callers

[Dagger75]

Well work is ticking me off today so I decided to wast time and post on EN-World. Now I work for an insurance company and basically help people finds doctors and tell them if the doctor they already saw will be covered. yeah very fun.

Here we go........

"Sir, you can believe what you want but the doctor is still out of the netowrk."

"Will it make you feel better if I told it is covered even though its not."

"You can call this number and they can help you out or I can tell you again we don't do that here."

"Please don't call back here again."

Caller "This is difficult."
My Friend "What was difficult, the part where I asked you your name or the part where I asked you for your phone number."


I may have more, the day isn't over yet.

 

[sniffles]

Do you actually get away with saying stuff like that? I work for an insurance company too (though not health insurance) and our customer service people would get in big trouble for saying things like that to customers.

I used to handle disability claims. I didn't run into that sort of thing as much as I think you do in medical claims, but I always recall one caller who was asking me about a particular feature of his policy. I explained to him how it worked, and he told me that his employer had given him a completely different (and much more advantageous to him) explanation. When I advised him that his employer must have been mistaken, he started shouting "You're wrong! You're wrong!" and hung up on me. I wish I could have asked him why he thought his employer would know better than I did, when it was my job to handle claims 40 hours a week for three years, and his employer was some kind of manufacturing business. :\

My SO works for a non-profit agency that does special certifications for addiction counselors. He's had people call him up and ask him, "On this form, where it says name, does it mean my name?"

He also gets the people who think their employers (counseling and treatment centers) know more about his job than he does, even though he's worked there for 12 years.

 

[Dagger75]

Yeah me and my friend get away with it. Granted usally I have to resort to that thing after trying to explain the same thing to the same person as I did for 30 minutes. Sometimes the non sugar coated harsh reality of the truth is the only thing that gets through to a few people. Most calls are normal, nice and easy. I get complimented all the time and have been rewarded for how nice I treat difficult people but sometimes they just don't want to hear bad news.

I am very nice when I call someone on the phone, ecspecially a call center. These people can help you and if you are nice to them they will usally go beyond the scope of there job to help you out but you have to be nice and understand that sometimes the person on the other end cannot do what you asked them. Call centers are split up. If I had to know policy, benefit, help with billing issue and help the doctors call I would get like 4 calls a day BUT because there are seperate departments I can transfer them and get to the next person who I can hopefully help.

Follow the prompts on the phone, if you actually listen to them instead of getting pissed because you got a machine the person on the other end can help you.

 

[Vraille Darkfang]

"Will it make you feel better if I told it is covered even though its not."

Your job sucks.

I recently had to have my very last molar pulled and the Dentist (2 of them) and the Peridontal Surgeon (3 of them) all told me the only way I could avoid the long term damage of my upper molar from erupting and protruding onto the empty space was to get a Implat (a bridge was impossible as it is the last tooth).

So we send it into the Insurance company. Their (whomever) tells us, they don't cover that (whomever) has determined that ALL IMPLANTS are cosmetic procedures. So I can go BLEEP MYSELF (not that they used that exact phrase). So their whomever knows more about my dental situation than 5 profesionals who have personally examined me?

I know that's how the system works. You pay insuracne to cover you when you get sick. An insurance company maximizes profits by getting you to pay as much as they think they can get away with & paying YOU as little as they can get away with when the time comes. As that's how most companies operate, maximize revenue, minimize cost.

I've spent many hours dealing with Health Insuracne people. I try to keep my temper & be nice. But 45 minutes on hold, 4 transfers, then a hang-up makes me a not happy camper.

You must get really, really, really, ticked off people calling you on a daily basis. I have not the temper to do customer support.

(I'm not calling you some sort of SoB for working in the insurance industry. You actually have a tough job catching a lot of (Bleep) from angry people. Or people trying to actually UNDERSTAND their policy (I belive they are written in Infernal myself.

Hopefully your day improves. Or you find a better job someday.

 

[Darth K'Trava]

True, Vraille. I have a friend who was told by his insurance carrier that when he was having work done on his varicose veins in one of his legs, that it was "cosmetic" and they wouldn't cover it unless he went to a vascular surgeon who was going to carve into his leg and rip out the bad veins instead of a different, less invasive procedure, where stuff was injected into each bad vein that caused it to shrivel up and eventually close. Never mind that his doc had said that the worst leg needed to be done to keep another vessel from bursting like one did already. He'd had this for years from standing on his feet all the time, wearing tight boots back when he was more involved in KAG and Trek fandom. So, he wasn't doing this to make his legs look all nice and pretty again; it was to prevent further eruptions in his vascular system and the potential for him to bleed to death. He went with the less invasive procedure even though he had to pay alot, if not all, out of his own pocket as he didn't relish the idea of being out of work for over a month, recuperating from the other... I know I wouldn't.

 

[GlassJaw]

Ahh, customer phone support, gotta love it.

 

[Dagger75]

The thing with insurance is basically the more you know.
It may seem boring in those meeting when you get your benefis but listen and ask questions. Trust me you will have questions. You should see how long some of those Q&A goes when insurance people are asking the questions.

Know your benefits, talk to your insurance company before you do anything more major than a general check up with the doctor.

Dental and Health insurance are 2 seperate animals. Not everything done to your teeth is dental, sometime its health, argghhh headaches just thinking about it.

What you should know is that most everybody on the other end of the phone when you call your insurance would like to help you. They want you be better, they would love for the bills to be paid right away, unfortuantly there are rules and those rules suck. I would kill to bend or even break the rules but I can't. There is a lot of blame to go around on everybody. The person that could fix and make the insurance industry a fair and smooth running operation will be elected leader of the world for life.

 

[Warrior Poet]

He also gets the people who think their employers (counseling and treatment centers) know more about his job than he does, even though he's worked there for 12 years.

This is a facet of nearly every work experience, as near as I can tell. I work in a creative field (copy production for a retail catalog). But everyone's creative, right?! I mean, everyone helps their child write a school report, or cuts out magazine pictures for their bake sale flier, right? So how hard could art layout or copy writing be? Pshaw! Ain't nothin'. You say you went to school and got a degree directly related to your work? But just last week I wrote one of those holiday letters that goes out to everyone we vaguely know and tells them all about how cute it is when little Alexandra spills her Spaghetti-Os and little Nathan is learning to say Spaghetti-Os but it comes out "Pusghetti-Os!" and Bob and Deb plan on visiting Paris this year (trés fun!) for a holiday and we hope everyone in your family is doing well and Happy Holidays. So why wouldn't I be an absolute EXPERT on editing your work, even though you're the Chief Editor for the company? And listen, can you tell the Senior Art Director that blue really isn't such a great background sweep for that one outline shot on page 7. I like maroon much better. It's my favorite color.

Luckily, I'm not bitter.

Warrior Poet

Edit: Dagger75, good luck. I try to be polite to customer service when I can, as I know that can often be a really lousy job that gets little respect, both within and without a company. Thanks for helping out.

 

[Dougal DeKree]

The best I experienced in a software hotline was when a customer was yelling so loud for nearly an hour that we could hear from from several meters away. Then suddenly the guy that was trying to talk to turned on the speaker of his phone and said

"Sir, please open a window."

"What kind of window? In my terminal? Or a unix shell? Can't you be precise?!"

"A window of your office. Stick your head out and breathe deeply several times. When you feel better you take up the phone again and we try to solve your problem."

"This is outrageous! I will complain about you!" *clack* and he hung up.

The colleague in question is still working at that hotline as he explained to his boss that he only wanted to protect the caller from a heart attack