THERE ARE SEVERAL REASONS I DISLIKE DOING BUSINESS via the telephone. 1..Noise on hold
2. People who don’t speak my language
3. People who are not even on my CONTINENT
4. Having to explain my situation again and again as each new person pretends to care
5. Knowing in the end it will be a (s)he said-I said confrontation.
I much prefer written communications.
Email is great. It is fast, it is (relatively) free, and a complete history of the conversation can be kept together as one contiguous “string.”
Snail mail is OK; it’s slow and increasingly expensive. (I remember 7¢ airmail stamps and “penny” post cards.)
When it is in writing, there is less opportunity for “weasel wording.” No “You misunderstood” or “The issue was not fully explained.” There is proof, be it pencil, pen, or crayon on paper or digital images that can sent back and forth or printed on paper.
The main problems with email are two:
- 1. The email address of the actual responder is is hidden from the person who wants to communicate via this medium (e.g., Joe CustomerService), and
2. The email is ignored at the destination.
Even with Delivery and Read receipts, the email version of certified and return receipt mail there is no absolute proof the missive was read and acted upon. ’Course that can happen with snail mail, too, but it has proven to be less likely.
What prompts this rant?
Medicare; specifically Aetna Coventry’s Summit Medicare Advantage plan.
My Spouse has a Coventry “regular” plan via her employer.
She’s about to (reluctantly) turn 65 years young and she wants to change to a lower cost coverage (than her employer-subsidized) insurance.
The problem is that Coventry is a capitated plan. (See Medicare plans: Beware the plan is not “capitated” (http://tinyurl.com/ycmmlw42) for a explanation of “capitated.”)
While it has the providers my Spouse wants and needs, her Primary Care Physician (PCP) cannot refer her to a critical specialist. This specialist is so important to her that she is – albeit most reluctantly – prepared to give up her excellent long-time PCP to keep the specialist.
That’s just half of the problem.
IF she gives up her long-time and trusted PCP, where will she go?
She will have to call each prospective Coventry PCP to ask: Can you refer me to my critical specialist? (She already asked my PCP’s office if he could refer a Coventry-covered patient to the Spouse’s critical specialist. The answer: “No.”)
Coventry sales people cannot (or will not) tell her which PCPs can refer to which specialists.
Can I go to the hospital with which I have a positive experience?
Both the specialist and the hospital are on Coventry’s Providers’ List.
HOWEVER, the hospital’s list of accepted insurances shows the Coventry plan is accepted only at a limited number of facilities in the hospital system; not the nearby main hospital.
Trying to contact Coventry via email is “mission impossible.”
Coventry is – alas – not unique. It may be one of the worst in so far as getting a written response to a written question, but it is NOT unique.
She has called Coventry and failed to receive a satisfactory response.
Can she go to her hospital of choice? According top Coventry, yes; according to the hospital (see image above), no.
Since that discussion was on the phone, who knows what actually was said. No record.
Could my Spouse’s PCP try to get permission from Coventry to refer her to the critical specialist, even though the specialist is not on the PCP’s capitated list? According to the PCP’s referral person, “We can try.” The logic being that the Spouse has been under the specialist’s care for several months, with many more months’ care anticipated.
Still, Coventry seems better than Florida Blue. The Blue Cross/Blue Shield’s web site shows that all of her doctors are available, but when we talked with a Florida Blue representative (see Don’t trust Medicare info On the Internet at http://tinyurl.com/y8yzl4eh ) we found out that NONE of what appeared on the firm’s web site was accurate. The Florida Blue clerk with whom we spoke told us that the hospital was not on the plan’s list, yet the hospital’s list of insurance shows that almost ALL of the Advantage plans ARE accepted. Of course the hospital system’s web site could be wrong.
Even when dealing with a representative “face-to-face,” there is no guarantee the information will be accurate; they are, after all, only sales people, and likely only part-timers or new hires, depending on the “season.” The Medicare “season” starts in mid-October and ends on Pearl Harbor Day; somehow that day seems appropriate.
- I have had Medicare Advantage plans since 2010. None provide everything I want in a plan. One was capitated and limited my ophthalmologist options. Another, although not capitated, didn’t cover my specialists, and the most recent – and soon to be history -- has me traveling out of county to see most specialists. (The county to which I would need to travel has both high crime and terrible traffic, two reasons I am reluctant to travel to practitioners in that county.) The one plan that DOES meet 90% of my requirements insists on a prescription co-payment of $100 while almost every other plan offers the same medication at $0 co-pay.
Even in the heart of “Geezer County” there is no “perfect” plan, but I keep hoping and every year I compare many plans. I also compare auto and home owner plans – that’s just good business.
PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.
Truth is an absolute defense to defamation. Defamation is a false statement of fact. If the statement was accurate, then by definition it wasn’t defamatory.
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