Friday, February 22, 2008
[customer service] CareFirst Forgets Their First Name
Today was one of the days we saw a major company's contact center operations take a giant step back. Listening to those are sad -- especially when so much attention is being made of customer satisfaction.
During a routine call to healthcare giant CareFirst, a customer service representative told me that my provider had been paid for multiple claims I was being billed for by the provider. Interestingly enough, CareFirst's own computer system showed my coverage as lapsed because I had switched from one group to another, and the old group's coverage still showed on the record.
"That's IT's problem," said our rep, whom we call Cheryl, since that's the only name she provides.
No, actually, it's the company's problem, but what do we do about this bill?
Well, says Cheryl, it's your doctor's fault.
[Stop when you sense a trend developing]
But I want to speak with a supervisor. Cheryl says that doesn't happen because there are none. Apparently Cheryl, whose supervisor uses the name Ms. Taylor, is working by herself tonight. All of CareFirst's 3 million policyholders are apparently being cared for by Cheryl tonight because a supervisor can only call back within 24-48 hours. That's an awesome responsibility.
Later, we get force-transferred (that's what call center reps call the process when they transfer your call without permission). We have to give Cheryl credit though. She forced us into a provider queue for doctors and hospitals. With no id code to enter, we couldn't go anywhere. No buttons transferred us out and without a code, we couldn't get connected to anyone.
The only choice? Hang up.
The First Company, the one originally known as CareFirst, apparently meant healthcare, not customer service care.
As consumers you don't have to accept that kind of behavior when it is inflicted upon you. In our case, a letter is already on its way to "Interim CEO" David D. Wolf. This will allow Mr. Wolf and his team in Owings Mill, Maryland to relieve Cheryl of her awesome responsibility in supervising the company for the next 48 hours.
Mr. Wolf will also presumably fix "the IT problem" and "my doctor's problem". Because this happened to a Consumer Help Web person (and we were fair to say this was going on the web), we won't list CareFirst under our pending complaints, nor will we put a negative one next to their score in our databases.
Yet.
We'll keep you posted on what happens, however, to this real life case study where we can freely use the customer's name and experiences. Our demand letter to Mr. Wolf is very simple and requires that CareFirst update its computer systems to show our family's updated coverage and rescind the letter sent to our doctor demanding a refund for money they already paid him.
A simple resolution request laser-targeted to the senior executive gets results. We get those results and help hundreds of consumers. If this happened to you, let us
help you resolve your complaint too.
Labels: call center, CareFirst, customer satisfaction, David Wolf, healthcare
Monday, February 04, 2008
Smoking Cessation Drug May Cause Problems [health]
The U.S. Food and Drug Administration is warning consumers using a medication doctors prescribe to help people stop smoking may cause behavioral changes, depression and even suicide. The federal agency said that Chantix is effective in helping people kick their cigarette habit but may pose serious mental health issues.
Chantix has been approved for use since May 2006 and amazingly enough can block the effects of nicotine in a smoker's brain if the smoker resumes smoking. That effect reportedly enables people to avoid smoking because neurological effects are neutralized. Now there is concern that Chantix also causes serious neurological effects beyond blocking nicotine's effects.
The FDA is working with Pfizer, Inc (
NYSE: PFE) to create a patient guide and to change the medication's labeling so that warnings about the drug's use are more prominent. "Health care professionals should closely monitor patients for behavior and mood changes if they are taking this drug," said Dr. Bob Rappaport of the FDA in a statement.
Consumers were also cautioned to tell their physician about any history of psychiatric illness or changes in mood or behavior after using the drug.
Labels: Chantix, FDA, healthcare, Pfizer
Tuesday, April 10, 2007
Medicare Advantage Plans "Unfair", "Inflated", Says AARP
The consumer group representing people aged 50 or older and their spouses came out swinging this week against the government's proposed Medicare Advantage rates.
“AARP believes inflated payments to Medicare Advantage plans are unfair and fiscally irresponsible. Congress should ensure that traditional Medicare and Medicare Advantage compete on a level playing field,” said AARP Director of Government Affairs David Sloane.
Last month, the independent Medicare Payment Advisory Commission (MedPAC) found that reimbursements to Medicare Advantage plans are 12 percent more than reimbursements to Medicare’s traditional fee-for-service program. All taxpayers and all Medicare members—not just the 18 percent of Medicare members enrolled in private MA plans – are funding these inflated payments.
“Right now Medicare payments clearly favor the MA program over traditional Medicare, which is unfair to the majority of beneficiaries who participate in the traditional program. The federal government should be financially neutral with regard to Medicare reimbursement,” continued Sloane.
Medicare Advantage plans were supposed to provide the same benefits as fee-for-service more efficiently—not at greater cost to the program. In the past, they were able to provide extra benefits to beneficiaries through the greater efficiencies achieved by managed care (e.g., care coordination, negotiated prices, provider networks). Today, because of the excess payments to the plans, they have no incentive to achieve these efficiencies.
According to the nonpartisan Congressional Budget Office (CBO), the federal government could save $65 billion over five years and $160 billion over 10 years, if Medicare Advantage plans were paid at the same rates as traditional Medicare providers.
Labels: AARP, healthcare, Medicare
Friday, March 09, 2007
White House Creates Task Force For Combat Vets To Streamline Benefits
President Bush announced that a new task force headed by Secretary of Veterans Affairs Jim Nicholson will be launched to help streamline the paperwork and other processes combat veterans must go through to receive benefits.
Nicholson is a Republican partisan who served as the RNC's national chair from 1997 through 2000. Despite never being elected to office, he has held numerous leadership positions, including an ambassadorship to The Vatican. The 69 year old Iowan is a West Point alum who served in the Army for thirty years, including combat duty in Vietnam, where he won a Bronze Star among numerous other medals.
The task force's mandate is to accomplish the following in 45 days:
* Identify and examine existing federal services that currently are provided to returning Global War on Terror service members;*
* Identify existing gaps in such services;
* Seek recommendations from appropriate federal agencies on ways to fill those gaps; and
* Ensure that appropriate federal agencies are communicating and cooperating effectively.
Public perception of the care combat veterans is receiving has fallen in recent weeks in the wake of a scandal at well known Army hospital Walter Reed Medical Center. Brigadier General Michael Tucker was transferred yesterday from Fort Knox to lead the embattled healthcare facility. Tucker, who served in Iraq, will oversee all operations of the military hospital, which is scheduled to be merged with Bethesda (MD) National Naval Medical Center in 2011 as part of the costutting base closure bill signed in 2005.
Labels: healthcare, VA
