Wednesday, November 28, 2007

Don't Give Up: A Insurance Tale

I needed to get a vaccination. I was on the fence about getting it, but decided that if it was paid for, I'd go for it.

I was not sure if my insurance would cover this vaccination, so I gave them a call. They said that they did cover it, but only until the age of 26. The vaccination is three shots over a 6 month period. Since I was 26 at the time and would soon be 27, I asked them if the vaccination was grandfathered, or covered as long as I *started* it when I was 26. The person who I spoke to said as long as I started it at the age of 26, the series should be covered. Great! I went and started it, the first bill was paid, and I went on my merry way.

Shortly after the second shot, I received a $150 bill in the mail and a notice that it was not covered. I called my insurance company, assuming that there was some administrative mistake. I got the second shot when I was 27, but they had assured me it was covered as long as I started when I was 26. The person I spoke to this time said that they do not do that, but she and her supervisor would listen to the call (as all calls are recorded) and get back to me. If the rep had misinformed me, they would cover it.

Since I called specifically to ask that very question, and I am a clear communicator, I thought that would be the end of it.

Wrong. They called me a few days later and said that I had asked about it, but the rep had told me it was not covered.

Now really, when I ask something about money, I am very clear and specific. I knew that she had told me it was covered, unless I had terribly misinterpreted what she had said. I wanted to be sure that I had not misinterpreted what she has said, so I asked for a transcript of the conversation.

I was told to request it in writing and given a name and an address. I promptly send out a request and waited.

And waited.
....and waited.

I finally got a phone call from somebody who said that I needed to request a transcript via a specific form, but the person who was in charge of those forms was on vacation, and they'd get back to me when they could. I called and asked if they could just, you know, send me a form so the person could have it when they came back. They sent the form.

So I got the form, and noticed a lot of things on it that said things like "I agree to pay the quoted fee for the transcript." Except that the fee had not been quoted and nobody, even the person who had been on vacation, knew how much a transcript cost. Apparently people don't request transcripts very often.

So I said in writing on the form that they needed to call me if the transcript was going to cost more than ten dollars. I included my phone number and e-mail addresses, and faxed the form to the number provided.

...which was apparently the wrong number. It was my insurance, and it was the complaints department, but they had no idea how and who to get a transcript from.

Let me point out that more than three months have passed since I got the bill, and to avoid having it go into collections, I had already paid my doctor's office. They said that they would refund it if and when the insurance paid it.

So another two weeks pass and they *finally* figure out how much to charge and who to send a transcript to. It was going to cost 16 dollars, but I said okay.

...two days later, I get this call:

"Hi Mrs. Frugal. While we were reviewing you phone call, we decided that we are going to cover the shot and your shot in January as well. Do you still want us to send you the transcript?"

I knew I was not crazy, and that I had been told that the shots were covered! Victory! And it only took four months of back and forth calls and faxes! It saved us $300.

Persistence pays off! If you are positive you are correct and you know they have proof (like my recorded call that I wanted a transcript of) don't drop it. Companies count on you giving up.

Edited to add: My doctor's office refunded the money I paid with no problems! One phone call and I had a check in less than a week!

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2 comments:

Ruthie said...

Dang Catherine, you rock my frugal world. :)

I wanted to ask you how you save money on feeding your bun. I've been giving ours parsley and lettuce fro the discount rack at the grocery, but it still comes out to about $2 a week. Is that about how much you spend on greens?

Ruthie

Anne Marie@Married to the Empire said...

Wow! I don't know how you kept your temper through all that! But you're right; persistence does pay off! We went through something like this with our homeowner's insurance. It was a total pain in the butt, but we got our money in the end.