Wednesday, May 11, 2011

5/11/2011 - the bureaucratic labyrinth. . .

Whenever a new acquaintance asks me what I do for a living, I always say "I work for a health insurance company" with a sheepish look on my face, as if apologizing for my agonizingly boring career field, as if to really say, "I'm sorry that you thought you could find an interesting topic down this path; you have made a wrong turn and should promptly turn around if you wish to leave this conversation with some semblance of liveliness about you."

So of course, I envy friends who work for more interesting industries and companies, ones that solicit a "Oh, cool!" response.  For example, one friend works for a dating site that caters to gay men with a certain muscular body aesthetic; already, without hearing anything more, I know my interest is peaked.  An old friend from years ago is a flight attendant; another works for a small social media start-up company.  Even Sam works in an industry that encourages some flow of conversation.  When I was getting my hair cut for my movie extra gig, my stylist asked me what I did for work, and after I told her, she said, "Oh, that's. . . interesting," with a discernible, pitying pause.  When I noticed and mentioned that she used a line of gel that my partner's company produces, we immediately became best buddies for 10 minutes.

The most interesting back-and-forth I've had regarding my job was with a girl who apparently just had a root canal done and didn't understand why she started receiving bills for the service when her insurance should have covered it.  I listened with my you're-a-stranger-so-I'm-going-to-kinda-pay-attention-and-pretend-I-care-because-I-want-you-to-like-me-if-only-for-these-few-minutes face, because seriously, I barely even knew what a root canal was (I'm in Marketing, for crying out loud!), much less why she would be paying for one.

This morning, I helped Sam take care of some health insurance issues in the aftermath of a brief emergency room visit last year around this time.  That day, I literally ran home from work, through Financial District traffic and up three blocks of a steep uphill grade after receiving a mysterious text message from him that said, "I'm hurt.  I need help," burst into our apartment, sweaty and out of breath, and found him curled up in a ball on the floor by our bed.  The entire ordeal turned out to be an extremely painful, but ultimately harmless condition, which is more than I can say about all the bills and troubles that followed.

From insurance company mix-ups to unpaid claims to finally a balance that went into collections over a year later, Sam never even received so much as an Explanation of Benefits.  Thinking everything was settled, he received a surprise notice regarding a long-overdue bill last week, along with a hefty fine attached as punishment for his tardiness.  Knowing something about insurance companies and terminology, I said that I would try and figure out what happened. 

After an hour or so of maneuvering through the maze they (we?) call a billing department, four different phone numbers, two of which I called repeatedly, and listening to long periods of hold music, I finally emerged triumphant from the bureaucratic labyrinth, brandishing my understanding of deductibles and PPOs and in-network benefits as weapons against the surly, surely unhelpful, customer service representative. 

Before I started working in health insurance, I could not describe the difference between a PPO versus an HMO, copayment versus coinsurance.  I've always had insurance, but it remained this nebulous concept to me, kind of like math or science or reality television.  As I tried to calmly explain to the agent why I (posing as Sam) should not have to pay $10,000 to the hospital when my insurance covers most of it, I even kind of impressed myself with how much I knew to say. 

Though I still have every intention of leaving this industry eventually (sooner rather than later, which is a post unto itself), in those moments after getting off of the phone, I wanted to dance around the nearest hillside like Fraulein Maria and sing the praises of all that I've learned about insurance companies in the last five years.

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