this heart broken

I have learned another valuable lesson when dealing with insurance companies; it is not considered rude to tell them off, it is the only communication to which they respond.

Case in point: I called to get Zoe’s synergist shot refill (RSV prevention) shipped and was informed she had already received five shots this winter and they would not ship another one without several forms sent in by her healthcare providers. Did they tell me to anticipate that when they shipped doses one, two, three, four or five? No. I told them RSV season is not over and she needs the shot and she needs it on Tuesday. They connected me with a nurse who told me she was looking at the CDC website and assured me that RSV season was indeed over in Seattle (specifically) and her previous shot would keep her safe for a full 6 weeks (not the 4 weeks I thought). I called my pediatrician’s office just to check and they referred me to the clinic where she receives her shots. The clinic was LIVID! No, RSV season is not over in Seattle and it is projected to go into May this year. No, her previous shot would not give her protection for six weeks AND they had already faxed over the necessary paperwork to clear her for more shots. I was given the advice, the squeaky wheel gets the oil. I called my insurance company back and talked to a supervisor who pretended to not hear my complaint that their nurses were giving out false information. I told her in no uncertain terms that Zoe’s shot needed to be in the mail the next day. She told me it had to be approved by a medical director and that could take awhile. I said, “THAT IS NOT GOING TO WORK FOR ME, it needs to be in the mail TOMORROW”. She decided to track down the paperwork and have someone call me back. I again told her my real concern was the false information I had been given. She continued to pretend I had said nothing (do they take classes for this stuff?).

The next morning I still had not heard from the “new nurse” who would be taking care of the issue at hand so I called Supervisor back and again said, “THIS IS NOT GOING TO WORK FOR ME, it needs to be in the mail TODAY”. I got a call 15 minutes later and was told a medical director still needed to approve it but they could probably ship it Monday and I would receive it sometime Tuesday. “THAT IS NOT GOING TO WORK FOR ME” and I explained why it had to come Monday and why Zoe had to have it on time and why she has to have the first appointment of the day at the clinic. The nurse suddenly became very helpful. After more phone calls and a prescription renewal fiasco she called to say the pharmacy was packaging it and it was going out the door. Then, someone called me Saturday morning to make sure it had arrived. I got some pretty amazing service after I squeaked enough.

This entry was posted on Sunday, March 25th, 2007 at 8:27 pm and is filed under Aetna. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.