I used to wonder what I did all day long

Discussion in 'The Watercooler' started by slsh, Mar 28, 2007.

  1. slsh

    slsh member since 1999

    I never realized how much time I spent on the phone - not chit-chatting with- friends, but making appointments, doing staffings, the neverending calls from therapists/Residential Treatment Center (RTC) staff, and of course the endless waits to speak with- insurance company and various vendors. Now that I work and have to account for my time, I know how I used to spend my days. So much for bon-bons and soap operas...

    I finally got the giggles today, and the smug know-it-all (not) who happened to be at the other end of the phone was none too pleased. Long story short, Boo's wheelchair is about 5 years old and needs some replacement parts. After a ridiculous conversation with- vendor who for some reason has not kept records of the parts they used when they *built* the doggone thing or of the parts that break annually, requiring a visit to our home to figure out what to order, get script from MD (are you *kidding* me??), then pre-cert with- insurance (wrong), then order parts, then take my son's chair for who knows how long to do the repairs (not going to happen)... I called the ins co to take care of this pre-cert business because while I know we have to pre-cert before getting a new chair (due to customization, the cost is equivalent to a nice car), we do *not* have to get pre-cert for repairs. I thought this would be a simple 2 minute call. Silly me.

    Mr. Smug, who works in the pre-cert department, informed me that vendor must submit work order with codes so ins co can decide *if* they need to pre-cert. I said, no, actually that's not the case - this is repair, not a new chair, so I just need to get from him verification that pre-cert is not necessary. He was adamant that he had to have the billing codes. In other words, they pre-pre-cert to decide if a pre-cert is needed. Which is when I got the giggles. *Then* he made the mistake of telling me that I obviously don't understand what a pre-cert is. I was just howling at that point, thanked him, and hung up.

    I started my adult life doing medical billing/insurance. Not only that, I have been dealing with- HMO/PPO paper chases for 16 of Boo's 18 years. I *know* what I'm talking about here.

    Long story short, I finally got confirmation that no pre-cert is necessary (from a nice guy in member services who *I* got giggling after I told him for the tenth time that he was a genius and a saint among men, LOL). After dipstick vendor showed up to look at chair (OMG, hold me back), without the most important part that I *know* for a fact is generic and is sitting on their parts shelves, I fired them and found another vendor who promised me he will at least keep a list of the frequently broken pieces. And I just had to call Mr. Smug's supervisor because... I hate being treated like an idiot. I totally admitted to her that I had probably not helped the situation by laughing but that one must appreciate the theater of the absurd when it happens. I also suggested that perhaps Mr. Smug should: a) be fully aware of the policy provisions of husband's company (Smug works on a phone line that is exclusively for husband's company - not a lot of different provisions to understand) before he starts spewing ridiculousness and b) if Mr. Smug feels a subscriber "doesn't understand" pre-cert, perhaps he should do his job and explain it rather than dismiss said subscriber as a lost cause. Supervisor could have been trying to placate me, but she did get the concept that there is no pre-cert for replacement parts. There is a "notation" now in our file that medically necessary replacement parts (ie anything besides a new seat cover because Boo wants a different color) do not require pre-cert.

    Time down... almost 3 hours. Practical end result? Bupkus. Zip. Zero. Nada. No parts, no repair. Do have the glimmer of hope that new vendor will be a common sense kind of guy but... impossible to be hopeful for too long given past experience.

    Tomorrow's task? Fighting with- Residential Treatment Center (RTC) affiliated hospital who is billing us for group therapy because they have repeatedly failed to obtain (you guessed it) pre-cert, *and* dealing with- mental health insurance company who refuses to speak with- me regarding said bills because thank you is over 12 - a gross misunderstanding of HIPAA and IL statues on their part. I'm guessing at *least* 3 hours. :smile:

    on the other hand - thank you's home for a visit until Sunday.... :hypnosis: Maybe I *should* let insurance talk to him. :rofl:
  2. judi

    judi Active Member

    Sue - I vote you let the insurance company deal with thank you. That's what I decided to do for my son's last hospitalization. He told them to "f-off" in those words and golly, they think he is "nuts" so they are closing the collections.
  3. Wiped Out

    Wiped Out Well-Known Member Staff Member

    I think it's great you were laughing-I probably would have been crying. What a go around.
  4. kris

    kris New Member

    <span style='font-size: 14pt'> <span style='font-family: Georgia'> <span style="color: #663366"> please, aww please, sue, let the insurance co talk to thank you while he's home :rofl:. it will make for a wonderful story to tell the grands!

    you have the patience of a saint!

    </span> </span> </span>
  5. timer lady

    timer lady Queen of Hearts


    Inane phone conversations bring out the giggles in me as well. And I absolutely hate having to "train" someone how to do their job.

    I'm glad you can see the absurd in this situation - I'm kind of cracking up here. My sense of the absurd is pretty healthy. :rofl:

    by the way, if you put thank you on to deal with mr. smug - please record the conversation; would love to hear the outcome. I bet you get everything that is asked for ASAP :smile:
  6. busywend

    busywend Well-Known Member Staff Member

    Another vote for thank you picking up the responsibility of dealing with Boo's medical phone calls. Makes complete sense to me! LOL!!!

    You are very patient!