It was one of those drug runs, pharmacy to customer's house. To be more precise, it was 13 drugs. The reason that makes any difference is that it was also C.O.D: $405.17 to be exact. Yes, breathtaking.
I'd been to this house before. The customer/patient was a very nice woman with a bunch of health issues. The first time was last summer, and she opened the upstairs window to let me know it would take her a while to come down the stairs to answer the door and would I please wait? The second time she was already downstairs and had a helper with her. It was the same today, with the helper doing a lot of cleaning in the background.
What was different today was the bill. When she asked how much it was, she was shocked. "I don't have that much!" Her helper had already disappeared with the bags of meds upstairs where they needed to be for use. I asked did she need to call the pharmacy and check on her insurance, whether it had gotten credited.
She did reach for the phone, but dug out her insurance card and called the insurance company to demand an explanation. She informed me she just switched from Medica to Humana, and before had only had to pay $190 for the month's supply.
I sat down to wait.
She had to go through a long voicemail system with a lot of prompts, and had a problem figuring how to navigate, talking to it like there was an actual person there, asking questions like, "Why can't I talk to a person instead of a machine?" or "I can't give you the first five letters of the medication, there are 13 of them". I have serious doubts about the capability of the most sophisticated voicemail system to cope with that. Eventually she got to a point where she asked it, "Why didn't you tell me before that I had to hit '0' to get a person?"
Once she got a person she spent about five minutes expressing her displeasure with the voicemail system. While I completely sympathized with her point of view, this was my time as well as hers she was wasting. I pulled out my Blackberry and started typing dispatch what was going on and requesting getting paid for the lengthening loadtime.
Eventually she got to her point. Why was her bill so high? There was a lot of listening and asking questions, and I eavesdropped unashamedly. Apparently this was the first time in her already lengthy and well-insured life that she'd heard of something called a deductible. She didn't understand the concept. In addition she kept protesting that this was the first time she'd heard there was one in the policy. She berated the salesman who only wanted his commission and hadn't adequately explained the details.
Now at this point you might think she was a bit non-compos mentis. Hardly. She recognized me from previous visits months ago and asked about my house in Arizona. (Hmmm, apparently we'd had a bit of a chat last time. I didn't remember a bit of it.) It might also be worth mentioning that never once did she resort to swearing or any abusive language. Perhaps the designation "Rev." before her name on the check helps explain that kind of restraint.
She was finally winding down the conversation, ending on the note of needing to call her attorney and have him there when she called back, and making sure she had the proper number to avoid all the voicemail nonsense. Since she was directed to the number on the back of the insurance card again, I doubt the avoiding part was accomplished. And I didn't tell her that the attorney would cost her far more than the $300 deductible she had to pay (done now, for the year) before the co-pays kicked in.
She finally decided she had to write the check or she'd not get her medicines, so the next 7 minutes were spent in digging out the checkbook, reconfirming the amount and payee, and painstakingly writing it all out. Then there were two forms for her to sign. While she was doing that I tried to explain a bit about deductibles and how they worked. Next month should be easier, but she ought to plan that next January it would start over and she'd have another big bill.
She thanked me for my patience and I texted dispatch to let him know things were ending, finally. He was on hold with the pharmacy by this point while they probably were trying to contact this customer (no call waiting I bet) to figure out what the problem was and what was the plan? Pay? Return? Could somebody please decide so they didn't have to spend a lot of money paying me loadtime?
Yep, it's never boring.
Thursday, January 24, 2013
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