Sunday, July 5, 2015


Is reading
A lost art?


WHEN I WAS CREATING technical manuals for the Navy, I was told that I should write to a fifth grade level.

Keep It Simple (Stupid) - writing to the KISS principle.

Now, trying to communicate with AvMed customer service representatives I am discovering that even fifth grade may be too advanced.

AvMed, as probably most insurance providers, has different co-pays for different providers and different venues.

My plan, with which I am generally satisfied (providing POTUS doesn't chop any more out of the allegedly protected Medicare budget) has two levels of co-pay for specialists: $10 and $30. Before POTUS messed with Medicare it was $5 and $25.

POTUS, for the acronym-innocent, stands for President Of The United States.

I needed an appointment with a specialist, but I had forgotten the co-pay rates. I'm sure the provider would have told me, but like the Coast Guard and Boy Scouts, I wanted to "be prepared."

I sentr my question -"What are specialist copays?" - to customer service, a/k/a Member Services. I also sent an email to the person who is supposed to be my personal contact with AvMed.

My personal contact was Out Of Office (OOO). Apparently no one covers for her when she's away on vacation, sick leave, or for whatever reason. I'm sure her absence was justified. As a risk management practitioner and former customer service manager, I know that is NOT how to run a customer service organization; someone must cover for absent personnel..

Member Services responded telling me I needed to inform it of the provider's name in order for Member Services to give me an answer to my query which, I remind you, was simply "What are the two co-payment levels?"

I know that English comprehension is not (effectively) taught in our schools.

Grammar? Forget it.

I'll admit I'm a slave to spell check; knowing my limitations I run spell check frequently as I compile my thoughts and always after I make a change - those gremlins always manage to sneak in when a minor change is made.

But - I thought - I asked a very simple, straight question: What are the AvMed specialist co-pays?

With the exception of one year, I have been with AvMed since 2010. The benefits provided by AvMed have been OK - it did cancel the PCP that saved my life, something I still resent, but it came through for me when I needed AAA surgery. (As with most Medicare dental plans, AvMed's plans - two different sub-insurers - leaves a lot to be desired.)

I spent a year with Humana which, thanks to PCP capitation and some fresh off the boat PCPs, caused me to come running back to AvMed. Humana's customer service is no better than AvMed's; perhaps that's because once a person signs up for a plan, the person is "stuck" with that provider for a calendar year. Given a captive client, why bother?

I don't mind having to get referrals from my PCP - he knows who is good and who is not quite so good. I also like knowing my complete medical history is in one place. My current PCP may not be the diagnostician my previous AvMed PCP was, but, like my other AvMed PCP, he listens and he gets me referred to specialists when we - he and I - think it necessary.

AvMed is a pretty good insurance provider - just don't expect any service form Member Services.

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