Lack of Customer Service in the USA

[gemini5362]

I dont know how other insurance companies do it I just know what my insurance company does. When they pay an invoice to my physician or clinic or whomever they send me a form telling me how much they were billed and how much they were contractually obligated to pay. They note how much my co pay is and how much I owe the provider. I know exactly how much my doctor gets paid. I understand the physicians viewpoint about how many people they have to hire to do the paperwork but I also think if you have to hire 4 full time people to do the paperwork you are seeing a lot of patients and once again I know how much my doctor gets paid for every visit I make. I dont begrudge her the money she makes one little bit. She worked hard for a long time at higher education to get where she is. She has an awesome amount of responsibility and I would not even want to have to look at patient in the eye and say you are going to die in a few months and there is nothing we can do about it. I think she deserves what ever amount she can negotiate. Different parts of the country are different I am sure but my doctor actually quit working for a company and built a new building and opened her own practice. She has to work hard like any other new buisness owner but she has not had to ask if she can borrow lunch money from me yet either.

 

[CDsdad]

If it was just one person, it wouldn't be a big deal, but multiply it by tens of thousands of people. People complain about the cost of health care, but when asked to schedule an appointment 7 days further out, more complaints. I suppose the employer could have allowed one physical every 358 days, 359 in leap years. Then people would try and schedule an appointment after only 351 days, more complaints follow.

I see by your position on the issues, and your referring to your employment as "we" in another post, that you must earn a living by association with some type of insurance company, underwriter, etc... I probably could have found this out earlier in the thread, but didn't read it all.

Anyway. Insurance companies, lawyers, and banks are just like casinos. They are in business to make money. And as much as possible, and don't get in their way.

I know what I've paid in on insurance premiums, copays, deductibles, and my 20% over the past 11 years with the company I'm with. So, I'm gonna figure my company has paid at least what I have in premiums on me also. The insurance company and I are just about even, and that's after my wife having a kid and surgery herself.

I am blessed that my company provides insurance coverage and I can afford to pay my part. But I know what a hassle it is to try to get anything out of them. It's hard for me to feel sorry for them. They make more money than I ever will.

I also believe if the insurance companies had to operate on the open market, there would be more coverage options and overall costs to the patient would go down.

 

[gemini5362]

CDSdad I think you are sterotyping those groups way too much. I started using my current doctor because my ex wife worked for her and my grown kids did not have insurance. She treated them for free every time they needed to see a doctor. If there was medication that had to be purchased she tried to use some of the lesser priced medications if they would do the job. I started using her even though she was out of my network and I had to pay extra to see her. I have good insurance and wanted to repay some of her kindness.


My wife is an attorney she could very easily increase her salary if she changed the way she charged people, she charges a flat fee for the work she does. If it takes her 1 hour or it was more complicated than she was led to believe and it takes 4 hours she still charges the same fee. She tries to give people a fair price for the work she does. I assume that she must be doing that because she gets new clients by word of mouth to the point that she stopped doing some of the services that she did because she did not have time to do them. If there is work that she does not do because of time or because maybe it is a specialty that she is not as knowledgeable about she sends them to another attorney who specializes in that area and can better meet their needs.


I am sure there are lots of people with similar stories of people they know in the professions you mentioned. While there are people like you described not all of them are quite the bulldozers you make them out to be.

 

[gemini5362]

Since this post was about customer service I am going to drift back on topic for a post. I started talking about sears and said later in the post that the local office is trying to accomodate me. They are trying very hard but one person can not stop the water from flowing out of the dam if there is a 4 foot section missing out of it. That is how I am feeling about sears. My complete problem is I need to have a delivery done prior to 1pm because no one would be home later to let them in. My local store is going to have it delivered to their dock and then bring it out on a pickup. Now it seems that sears cannot get it to a store in a major city in a reasonable manner. The local manager was suprised when I called this morning and asked where my stove was (two hours before he was due to deliver it) He told me had someone come in early with a pickup and as soon as it hit his dock it would be brought out to me. He expected it before noon. I laughed and told him that it was not coming to his store today because I had just gotten a phone call from the delivery department at the central warehouse and it was scheduled for saturday delivery. He told me he would call me back and he called them. He was not a happy camper when he found out he was paying overtime and they were not going to give him the delivery he had been promised. I spent several hours on the phone with the national number talking with customer service and finally a delivery unit manager. Basically what it comes down to is this. When I tell them I have to have it before 1pm that is a request and if they cannot honor that request then they just cant. They will not guarantee me a time. Even if they have to give me another delivery date they will not guarantee it will be before 1pm. I am of the opinion that they feel they will deliver it when they schedule it and I will be there even if it means taking off from work to do that. From what I am seeing here is how their system seems to work. You purchase the item. ( I paid cash for it so it was prepaid) They set up a delivery date. 3 to 4 days before the delivery date they call and remind you that the item is coming. At this time they tell you a general time. In my case they said it was going to be an evening delivery. They give you an 800 number to call if there was a problem. I called that number and said I cant take an evening delivery. They said they would make that notation on my delivery reuqest. They also told me the night before the delivery they would call me and tell me the time when it would be delivered. The night before the expected delivery date they called and said it would be delivered between 5pm and 7pm I immediately called and told them that I could not accept delivery at that time. I was informed that no one could change the delivery schedule at this late date and asked if I wanted a new delivery date. I said sure but it has to be before 1pm they said they could request it but could not guarantee the time (sound familiar?) Let us move to today when it was supposed to be delivered. After the local manager called them and got a delivery date for tomorrow set up I called to verify it. ( I dont want to take another day of lost apointments from my second job for nothing) I was told it was scheduled for tomorrow. I asked what time it would be scheduled and was told they could not tell me that. They will call me tonight and let me know what time it will be delivered tomorrow. I spent three and a half hours on the phone today and could not get to anyone that really seemed to want to do something with a system that was so out of touch with customers. I was told by a manager however that they could not guarantee my requests because they could have other customers and they might want to have a certain time frame guaranteed also.

I am going to help these other customers out. If my stove is not delivered tomorrow before 1pm I am canceling the order. This is also going to be my last purchase of anything in sears.

 

[CDsdad]

CDSdad I think you are sterotyping those groups way too much. I started using my current doctor because my ex wife worked for her and my grown kids did not have insurance. She treated them for free every time they needed to see a doctor. If there was medication that had to be purchased she tried to use some of the lesser priced medications if they would do the job. I started using her even though she was out of my network and I had to pay extra to see her. I have good insurance and wanted to repay some of her kindness.


My wife is an attorney she could very easily increase her salary if she changed the way she charged people, she charges a flat fee for the work she does. If it takes her 1 hour or it was more complicated than she was led to believe and it takes 4 hours she still charges the same fee. She tries to give people a fair price for the work she does. I assume that she must be doing that because she gets new clients by word of mouth to the point that she stopped doing some of the services that she did because she did not have time to do them. If there is work that she does not do because of time or because maybe it is a specialty that she is not as knowledgeable about she sends them to another attorney who specializes in that area and can better meet their needs.


I am sure there are lots of people with similar stories of people they know in the professions you mentioned. While there are people like you described not all of them are quite the bulldozers you make them out to be.

I know. You are right. I'm sure there are some people with good intentions in the professions I mentioned, except maybe casinos.

I just happened to have had a conversation about my insurance with my wife this morning and am still fired up about another denied claim. I probably should have waited until tomorrow to post. I'd of been cooler then.

If I stop and think, my divorce lawyer wasn't really that bad.

My current bank is OK, no comment on the previous one. I've never had good dealings with a casino, though.

MikePA, please don't take my rant personally. I re-read your posts, and saw that you also thought lowly of delayed payments, and were candid in your explanation of your company's payment process.

Again, I think I'm blessed to have what insurance I do, and a lot have worse or nothing. And while I don't believe socialized medicine is the answer, I do believe there has to be a better solution.

 

[MikePA]

MikePA, please don't take my rant personally. I re-read your posts, and saw that you also thought lowly of delayed payments, and were candid in your explanation of your company's payment process.

Not taken personally.

 

[N80]

Then you deal with some lousy insurance companies

Oh, there is no doubt about that. We deal with almost all of them.

or someone in the organization you work for doesn't know how to negotiate a contract.

That's not the case at all. In fact, I think I can safely say that this organization is probably the best in the US at negotiating contracts and among the best compensated physicians in the US (although that has a lot to do with the current growth and economy in the south too.)

Reimbursement rates and payment times are all negotiable.

Correct, but this is a whole multi state, multi hospitals system and concessions do get made which benefit some areas (hospitals) and hurt others (small primary care clinics).

We reimburse providers and facilities weekly and are moving to real time claim adjudication so the patient and the provider/facility know immediately what the reimbursement will be and what the patient will owe. The payment will then happen overnight via EFT.

With all due respect for your expertise (and consideration for my relative ignorance in these matters), you know well and good that that applies to simple, single problem cases. A cold, a physical, a blood pressure followup, etc. But consider the patient who comes in to get their blood pressure pills but during the visit wants to have a skin tag or mole removed. It is a great service to be able to do this for the patient all in one visit. But up until recently many insurers would not pay for a visit plus a procedure on the same day. Either someone (an employee) had to resubmit, justify or whatever to get paid for both services as these were routinely rejected. Many, if not most of the time, I did not get paid for the procedure. There are countless examples of this type of thing. And part of the reason we have so much staff dedicated to this type of thing (granted, it is billing and posting) is that we are a very very busy place with 8 or 9 doctors there at once. And our patients are not 'paper' patients. They have multiple problems and needs that don't fit insurer's protocols and when I try to meet those odd and various needs they do their best not to pay me.

Could you imagine taking your car into a shop to have two things fixed but refusing to pay the mechanic because he fixed both problems the same day! Ha, the police would be involved!!!!

For a while, we had major carriers refuse to pay for mental health visits. How sick and twisted is that!

But again, before I sound too much like a martyr (someone above said they did not envy my job) let me say a few things. We (doctors) do contract with these organizations. We do business with them. So it is a bit unfair to act like this got dumped on us. Now, we don't have many alternatives, the boutique medicine is one option but is very limited. Practices in rural areas have no alternative but to accept Medicare and Medicaid. So, even though we don't like our bed partners, we are in the same bed.

Also, this system, has been very lucrative for primary care physicians who have the clout to get good contracts. Rates are inflated and the discounts are manageable. So in my case, I get good contracts, I'm in a busy practice in a growing area and I have 8 partners so we keep the office open 7 days a week but have enough coverage so that lifestyle remains good. So the system isn't hurting me and life is good, but that doesn't mean it isn't broken.

And people shouldn't forget. Doctors and their families are patients too. We get to deal with that side of customer service too.

Regarding paperwork, you can thank the government regulations, the same government some people think are not involved in regulating health care.

Amen and it is getting worse everyday. Problem is that insurers adopt every abusive policy that medicare puts out. They figure, correctly, that if the Gov can get away with it, so can they.

Well, I've got to step away from the keyboard and go work on my tractor shed. I worked last weekend so I've got today off!

See you guys Monday.

 

[dmccarty]

When I bought the City House years ago, it needed a new fridge, stove and dishwasher. The appliances had been installed when the house was built and they needed to be replaced.

I went to Best Buy which is better called Best Buy Not. After waiting hours to PURCHASE the fridge we then went through delivery issues. Long story short, I don't buy much if anything from Best Buy anymore. Looks like that will change if they buyout Circuit City.

Eventually the stove really needed to be replaced. I went to Lowes and bought it. They had it in stock, put it on my truck and I took it home. Easy.

For the dishwasher we found a Maytag mom and pop store. Unfortunately they were going out of buisiness but we got a deal on the display dishwasher. It broke after one use. But it was fixed under warrenty. Good service tho.

After we had kids, the clothes washer and dryer just could not keep up and the cost to run 'em was getting high. So back to Lowes and we bought Whirlpool front load washer and matching dryer. They had it in stock, put it on the truck and I took it home and installed them. Easy. Only problem was a loosened nut when we moved.

For the country house we ended buying Maytag appliances from a mom and pop store. Fair price and good service from mom and pop. We went with Maytag simply because the appliances had features that were not available from the competion.

Lets just say the our Maytag repairman ain't bored watching TV and petting his dog....

The dishwasher broke a week after we started using it. See a pattern? Fixed under warrenty. Then there is the design/build defect with the bottom front tray wheels. They break. They are made of plastic and with the weight of dishes and the environment in the dish washer the plastic weakens and the breaks. Mom and Pop have tried to get us replacements but they can't. Not good.

I found some parts that sorta fixed the problem at Lowes while waiting for Maytag parts to never show up. The parts I found would eventually fail after a couple of months but I got real good at fixing the wheels. Eventually I gave up on Maytag and found some bronze parts that required some modification to the rack. I think the problem is fixed. If MAYTAG had put in bronze/brass/stainless steel this would not be a problem but they saved a few cents per unit...

About 6 months back the fridge starts making this clicking noise. Kinda sounds like the water dispenser is running but its not the dispenser. Over time the clicking is staying on longer and is getting louder. Long story short Maytag Repair Man visits. Its the compressor. I had researched the problem and this is what I was afraid it would be. Thankfully it was under warrenty. The cost otherwise would have been $500 or $750 which is pretty good chunk of the price of the fridge. Ours had a 3 or 5 year warranty otherwise we would have been SOL. Warrenty's on new Maytags fridges are 1 or 2 years. There are lots of horror stories on the Internet about Maytag fridges.

This is not my local dealers fault but it is his problem. If the fridge had failed he would have brought us a loaner to use until they could get the parts to repair. Which took a week. Would you care to be without a fridge for a week? He at least has the service to help you out in the meantime but there is no way in $%^&* that it should take a week to get a part. Not in this day and age.

So, in spite of Archies good service, if this fridge blows again its getting dumped. I'm not going to drop half the price for a new fridge for another crappy compressor that will fail in a few years. So what to do? Go back to Lowes to buy a fridge. Have them put it on the truck. Use the tractor to take the fridge from truck and put it in the house. We have three french doors that open 5.5 feet. Just for such things. Put fridge in house, which has a finished concrete floor. Just for such things. Roll out the old fridge to take to Habitat for Humanity. Install new fridge.

The Maytag Repair man will be back in front of the TV with his dog though. The new fridge won't be Maytag. Archie has good service but his products ain't worth it.

Maytag got bought up by either GE or Whirlpool. Hopefully LG, Samsung, the other Asian and European companies will drive competition to improve the appliance quality.

Later,
Dan

 

[gemini5362]

Dan
Maytag was bought by whirlpool.

 

[Sigarms]

Dan
Maytag was bought by whirlpool.

Perhaps in name only.

Both Maytag and Whirlpool have HVAC lines, and I see no connection whatsoever between the two companies like Carrier/ICP, York/Coleman, Goodman/Amana/Everest or Lennox industries/Allied Air (which makes Whirlpool) or Nordyne/Tappan (which makes Maytag).

Off subject, apologies.