Health Insurance

How competent are health insurance companies?  I ask because I'm amazed at ours and wonder if they're all the same.

Our health insurance is with a company I'll call X.  Up until last December, X had been doing reasonably well.  In December they refused to pay for a doctor's appointment.  I called, "Oh, sorry, we misfiled it."  Fair enough, I thought, anyone can make a mistake.

But X misfiled the claim a second time.  I called again, wading through what felt like hours of nasty on-hold music and "Your call is important to us, but we can't be bothered to talk to you" messages.  The claim was then misfiled a third time.

By now it was four months since the original claim, and there was a second unpaid claim floating around.  Clearly I was getting nowhere fast.  Hubby went for an alternative route: complain to the benefits department of his company, who can then jump up and down on X on our behalf.

So X starts giving Ms Benefits the runaround too.  Finally she has enough and sends an email I'd love to have seen to her counterpart in X, and her counterpart's boss.  This resulted in a groveling call from X to Hubby, and a fax number, name attached, with a promise that the claim would get to the right place this time, because it had never reached its destination before.  Yeah, right.

Meanwhile, X has called my doctor and told them it never received the claims, could they be refiled please?  Doctor's receptionist asked how they could have misfiled something they never got, she and I having talked at my latest appointment, which had darn well better get paid first time.

So the claims have been refiled, and we wait to see the result.  Is this normal for a health insurance company?

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