Tuesday, September 09, 2008

Sometimes I <3 The Phone

Hello, Mr. Pass, this is (redacted) your Aetna representative. Thank you for holding. How may we assist you?

I'm not sure. We keep submitting claims and you guys keep kicking them back denied.
This specific call is in reference to claim number (redacted), though it also applies a couple of times a month since May.

Let me pull up your record. One moment.

[Hold Music, Light Jazz, Piano is a bit . . . Jarring, pre-coffee]

Alright, I have your information. We can't pay on that because the condition is pre-existing.

But it isn't. I was covered through my last job. And the job before that. And a few back, actually.

You need to submit a certification of prior coverage.

I did, to the fax number (redacted) on July 30th. Would you like me to fax the receipt for that?

One moment, let me check your records again.

[Hold Music, Light Jazz, I hold the phone away from my head]

We have no record of that fax.

You should look again.

Can you re-send it?

Why, if it didn't work last time?

I really can't help you in this case unless you submit the proper forms.

Okay. I understand.

Is there anything else I can help you with?

Well, since I called you, I know what you do for a living. You don't know anything about me, though and that seems rude of me.

(uncomfortable laughter)

See, I work for [company name deleted]. I'm in Information Security. One of my jobs is providing guidance on litigation involving the Heath Insurance Privacy and Portability Act of 1996. The other things I do are less pleasant. I'm enjoying this role a lot and look forward to having you as my health care provider for the duration of this assignment.

Hold please.

[Oddly, there was no music.]

Great news! I've found your fax!

Imagine that!

I've re-submitted your claim.

And all claims back to May?

Yes. All claims back to May. You should have a new explanation of coverage and a check within 10 days. Is there anything else I can do to help?

Not at this time. Thank you for your help.

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