The Life and Times of Florence Knitingale

Tuesday, July 03, 2007

If I End Up in Hell....

....well, for one thing, no one will be terribly surprised. But apart from that, I can honestly say that I'll know where I am as soon as I see the pile of drug pre-authorization requests and the little note that says: "Ms. K, since you're so good at these....."
For those blissfully unaware, a preauth goes like this: You go to your doctor who has gone to school lo, these many years and so, hopefully, knows what is best for your condition. The doctor digs into her or his vast storehouse of knowledge and says "I believe you need type X medication" and writes you a prescription. You take it to your pharmacist who then uses a computer to tell your insurance company that they need to pay for it. And then (cue dramatic music) the cheeseweasels at the insurance company, who have a whole department on their payroll whose job it is to sit around and eat pizza and figure out new and exciting ways to avoid paying for medications (they're supposed to pay for them, of course, but they don't find the game at all challenging that way) say something like "well, we aren't at all sure we want to pay for this (like a debutate on a first date, they need a little courting and wooing...and a $120 dinner if they can swing it) so have someone from the doctor's office (yeah, that'd be me, at least until I earn my way back out of hell) call us and we'll try to figure it out." If I ever reach a real live person (questionable at best) they will then decide that they are magically qualified to practice medicine (diplomas in cereal boxes, I expect) and will tell me that the patient has to try these 12 other medications first and have them not work before the one the doctor prescribed can be paid for. Got all that? Yeah, me neither.
Thing is (like there's only one?), the recordings and the prompts and the "for this department, push this number") and so on go on for so long that by the time anyone actually picks up the phone, I'm already quite prepared to tell them in detail how I think their conception occured which never really gets things off to a good start. I think truth in advertising should apply here, because the absolutely mindless repetition of taped "Thank you for your patience. Your call is important to us, so please stay on the line and someone will be right with you" is enough to send me all the way to Batshit on an open-ended ticket. Here's what it should really say:

"Hello, and thank you for calling Soulless Insurance Company, the company with the blackest heart in the business for 50 years strong. Please listen carefully to the following options. Well, no, don't bother. Because no matter what button you press, we're going to keep you on hold until you are repeatedly smashing your head into the wall in front of you in sheer frustration. But don't worry. We'll be putting that time to good use, finding the stupidest person in the company to come talk to you. The last time we saw him, he was pushing with all of his body weight on a door marked "pull" and whimpering softly, as he had been there for about a week. We were going to call his wife to let her know where he was, but we figure if she's stupid enough to marry him, she probably hasn't noticed that he's gone. Anyhoo....good luck. The guy from the door should be with you shortly....as soon as we can teach him how to use a phone."

Several minutes later: "Are you still waiting? Geez, you don't give up, do you? Okay, look. Bill the door-pusher said he was too smart to talk to someone who actually thought someone here might help them...but the guy from facilities who speaks two words of English--"Yes" and "okay"-- is available. And he'll speak them so convincingly that you'll probably tell him the whole problem twice before you realize that he didn't understand a single word of it. Tell you what--why don't you punch in the patient's insurance ID number. It won't help--the information won't get to us and if we ever get someone to talk with you, they're going to ask for it again anyway....but it will keep you busy. Besides, you might accidentally hit the disconnect button, and we get paid a bonus if we can make you hang up without talking to anyone. We'll get more if we can get you to slam down the phone in a rage, but we'll take what we can get. Have a nice day--but know that there will be a surcharge and a high deductible if you do. Tomorrow is a holiday, so the higher holiday rates apply."

Not that I'm bitter. My boss is out of town and did, indeed, sucker me into doing preauths for her while she's gone. So far I've not broken a single phone, but the week is early.
Truth to tell, I'm feeling a bit like Mr. K was when he realized that A) the dorks who were supposed to fix our hottub apparently took the word "fix" to mean "completely mess it up so that it can't be repaired ever" B)they had no intention of doing anything about it without the expensive application of lawyers to the problem and C) it would cost $400 to haul away the old, useless hottub which is now, to all intents and purposes, a large fiberglass ashtray. Or salad bowl. He looked like this:


The old hottub ended up looking like several of these:



I think it safe to say that Mr. K would rather not pay the $400 to haul away the old hottub....anyone want to argue with the man with the wild eyes and the skill saw? No...me, neither.

Miss Gracie asked me to post another, more flattering photo of her today (Marianne, she was actually in the windowsill stretching when I tried that artsy picture...but she's concerned that I didn't catch her at her best, as she was just waking up):


Yes, she stil thinks that old plastic dropcloth is the best place to hang out in the whole world....and no, I still haven't finished the damned door. Given all the stuff that I haven't gotten done, you'd think there'd be a whole slew of things that I HAVE gotten done, wouldn't you? Yeah, not so much. I can't explain it, except to say that there is a black hole somewhere in my life that sucks time like Paris Hilton sucks up media attention. But I have accomplished this:

That's my birthday yarn from Mr. K. It is almost unbearably soft....I can't wait to wear the sweater, but I probably ought to. That inch or so I have so far isn't going to cover much.

Oh, and to those who asked, the second cat in the hottub photo (pre-skill saw and Mr. K) is actually Miss's sister, Tippy. They really are sisters, but Tippy doesn't get much camera time because she prefers to be outside. She expresses this preference by peeing on the carpets and attempting to murder Gracie. We choose to honor this preference.

Knit on...and be extra nice to whomever does preauths where you live. Bring them a stiff drink. I guarantee that they need it.

7 Comments:

  • At 8:12 PM, Anonymous jaws said…

    I have to break with "lurking" to tell you that your description of dealing with the pharmacy insurance company convinces me it's MY insurer . . . and I take some perverse pleasure from knowing I am NOT alone! I'll spare you the details, but 2 months and 14 different people later, I did prevail. Of course, now the plan year just started over so . . . . I hope things go a bit faster for you.

    Love your blog, which a knitting group friend got me reading. Thanks for the laughs!

     
  • At 9:14 PM, Blogger Faren said…

    My mother in law is in billing, so I've heard horror stories like this before.
    No, I don't think it would be a good idea to mess with Mr. K at the moment, I'll wait until he gets a chance to relax in the new hot tub!
    Miss Gracie looks so sweet!
    Good luck on the sweater!

     
  • At 11:16 PM, Blogger Charity said…

    The wild eyes and the skill saw, eh? Sounds like our guys would get on like a house on fire! :0)

     
  • At 11:23 PM, Anonymous angie Cox said…

    To think I take my prescription renewal in the Doc. signs it .I go to the chemist pay some and come home sane for another month .
    Happy 4th to you all and Puss honey you could never ,ever look bad.I want to hug all your fur-peeps all the time. Jeff is not a cat lover so we don't push for another .He seemed to think Tommy was an animal ..therefore could not have his beat chair or eat all his salmon..well really !

     
  • At 3:49 AM, Blogger Marianne said…

    Insurance companies..mostly they piss me off, I have had one really good phone experience though, remember Igneosa? Had that lady laughing, belly laughs.
    Tippy!
    Very beautiful photo of Gracie, seems that most of the Kittingale femmes are a little...well, we'll just call them little puddings. I love them all.

     
  • At 6:27 AM, Blogger Robin said…

    Amen on the Insurance thing (I've been experiencing a lot of this crap lately)...Uh-Oh on the hot tub thing--take a saw to the "repair guys"!...
    and Isn't Miss Gracie a picture of "Grace"?!!!
    Hope you have a Happy 4th!

     
  • At 1:38 AM, Anonymous MonicaPDX said…

    Try working for an HMO... Although at least it wasn't in billing. Thank god!

     

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