Have I ever in my life spoken the way I did just now to a customer service rep? Well, no….this is a first. But after 15-20 years of advocating/begging/negotiating for my multiple special needs child, I have lost it. You see, I recently had this beautiful honeymoon from that job as said child moved away for a time. And, he had gotten better and few needs were acute. Well, now he needs this major surgery that we have been waiting for him to fully grow up for. We pay a fortune for insurance on the health marketplace exchange. Well, this company literally has NO PROVIDERS in this speciality on their list. Except for ONE “ghost provider.” That means they are kind of “pretending” to have a provider or two when they have none.
Well finally they told me to “call around and find a surgeon who will take him, ” then we’ll consider bringing that provider in network for your son. I finally found someone and they told me to call the insurance company and demand their price. So that’s been several weeks ago. Every time I call literally every time I get the same lady who cannot process nor speak English, claims to have “no notes” in the system for the million conversations I’ve had with (mostly) her. Then, after an hour of waiting on hold, and losing thousands from my home business while I CANNOT OPERATE IT….I have to hang up and nothing was finished…and then start all over the next hour, or the next day.
Came to find out this company has been sued for having “ghost networks” and either they’ve paid fines, or they’re still doing it, or both. Meanwhile my son is having serious complications that THEY KNEW WOULD HAPPEN because of this denial of care. I just got off a call with the same runaround and I finally just gave up.
Maybe I need to call the insurance commissioner or a lawyer? I’m just at my wits end and having trauma about all the years I spent doing this all day long………..I had almost forgotten how it dominated my every waking minute. No wonder my life’s been so peaceful until recently!
Any advice is welcome; maybe just venting?
submitted by /u/dooeyburger
[link] [comments]Have I ever in my life spoken the way I did just now to a customer service rep? Well, no….this is a first. But after 15-20 years of advocating/begging/negotiating for my multiple special needs child, I have lost it. You see, I recently had this beautiful honeymoon from that job as said child moved away for a time. And, he had gotten better and few needs were acute. Well, now he needs this major surgery that we have been waiting for him to fully grow up for. We pay a fortune for insurance on the health marketplace exchange. Well, this company literally has NO PROVIDERS in this speciality on their list. Except for ONE “ghost provider.” That means they are kind of “pretending” to have a provider or two when they have none. Well finally they told me to “call around and find a surgeon who will take him, ” then we’ll consider bringing that provider in network for your son. I finally found someone and they told me to call the insurance company and demand their price. So that’s been several weeks ago. Every time I call literally every time I get the same lady who cannot process nor speak English, claims to have “no notes” in the system for the million conversations I’ve had with (mostly) her. Then, after an hour of waiting on hold, and losing thousands from my home business while I CANNOT OPERATE IT….I have to hang up and nothing was finished…and then start all over the next hour, or the next day. Came to find out this company has been sued for having “ghost networks” and either they’ve paid fines, or they’re still doing it, or both. Meanwhile my son is having serious complications that THEY KNEW WOULD HAPPEN because of this denial of care. I just got off a call with the same runaround and I finally just gave up. Maybe I need to call the insurance commissioner or a lawyer? I’m just at my wits end and having trauma about all the years I spent doing this all day long………..I had almost forgotten how it dominated my every waking minute. No wonder my life’s been so peaceful until recently! Any advice is welcome; maybe just venting? submitted by /u/dooeyburger [link] [comments]Read Morer/HealthInsurance