You Must Think I’m Stupid

Sometimes I just don’t understand people who do or say things without thinking them through.  I find that a quirky side-effect of four years of law school is the uncanny ability to more quickly realize when someone is blowing smoke up my nose.  Aside from the inevitable increase in my blood pressure, it’s like a mental chess game that only I know we’re playing when I am, most times, able to point out all the holes in their swiss cheese logic.

Example 1

So my mom has been trying to get a refund from the hospital for a Shingles shot she received in September.  She was told that she had to pay for the shot up front and that as soon as her insurance paid the claim, she would get a refund.

Sometime after that office visit she had a separate issue with her foot and went to another doctor for that.  The foot doctor said that she could treat the condition with one injection and that would likely be sufficient.  However, if needed, she could com back for a second injection that would cure it for sure.  As it turns out my mom was 1) unable to get back to the foot doctor because that was right about the time my dad passed away and 2) the first injection did in fact cure the foot problem.

What do these completely separate office visits for completely separate issues have to do with each other?  I have no idea.  What I do know is that the hospital business office got reimbursed for the Shingles shot by my mom’s insurance sometime at the end of last year, but continues to hold on to her $200 because (according to them) they have not yet billed for the foot shot because they are waiting for her to go back for the second one.  She’s told them she doesn’t need the second shot and has no plans to go back for it.  That’s ok, they tell her, they’re going to hold on to the money and wait for her to need their services again.  Huh?!?

In truth, what will probably happen if they haven’t filed a claim for that first shot is that they are outside the window to submit it.  Then, what they’ll do is help themselves to my mom’s money to pay themselves even though it was their fault for not filing her claim in a timely manner.

My mom has been round and round with them for months.  They keep putting her off and making excuses.  I went down there with her in February and they confirmed that yes, they’d been paid for the Shingles shot, and at that time a refund was supposedly requested, but “it will take 20 days to process.” (Read:  We want to hold onto this for one more month so we can get more interest off your money like we do for hundreds, if not thousands, of our patients.  We couldn’t make it without the ability to make free money off YOUR money!)

Needless to say, no refund ever materialized AND, even better, they didn’t even bother to call and tell her that they’d decided against returning the money for whatever reason.  Nope, she didn’t find out that the money was still MIA until she broke down and called them again.  This is when they came up with the whole “we’re waiting for YOU to go for your second foot shot” story.  A supervisor was supposed to call and discuss this with her…2 weeks ago.

I could write a 1000 blogs about how much I hate insurance companies and how I think they are raping thieves, but no.  Suffice it to say, I’m going to have to march down there this week with my mom and start throwing around the “F” word—FRAUD and see how we can get this resolved. I just don’t see any logic to their side of this argument.  Stay tuned for updates on this one….

Example 2

I placed a printing order online on March 3.  I opted for the order to be sent standard delivery, which according to the website, meant I’d have it in about 2-3 weeks.  I’ve checked the “status” link they sent me in my confirmation email several times in the last couple of weeks.  It provides absolutely NO status except in essence to say, “Yep, you placed an order!”

Last  week I receive an email that my order’s estimated ship date was on or before March 23.  I figured we were almost at a month and so it was fair to expect the order to show up last week.  Nope.  So by Sunday, I’m slightly agitated and since customer service is closed, I opt to use their chat feature.

Turns out that while there’s someone there to chat, he can’t give me any info because he doesn’t have access to the database.  That sets me off.

Me:  If you don’t have access to the database, what exactly are you there to chat about?

Him:  Well, our products and delivery methods.

Me:  Perfect, I want to know about the delivery of products that I’ve already ordered.

Him:  I’m sorry for the inconvenience.  What delivery method did you choose?

Me:  Standard, but I ordered this over a month ago.   Four weeks to be exact.

Him:  There is no guaranteed delivery date for items ordered with standard delivery.

Me:  That’s a stupid business model.  You sell time-sensitive products and you don’t guarantee the customer will get them in time for their function?

Him:  Well, that’s why we offer rush delivery options.

Me:  When I ordered these a month ago, there wasn’t a rush.  You’ve created the rush by sitting on this order for a month.  Why should I have to pay an extra $30 for you to get these out the door when you’ve had a month already?

Him:  It’s just that rush orders get priority.

Me:  So, even though I ordered my stuff a month ago, if a rush order comes in after mine, you stop working my order and move the rush order ahead?  What, do you do standard orders in your free time?  I ordered 60 printed items.  Even if you printed 2 per day during a lunch hour, you’ve still had enough time to get these done.  It’s been a month.

Him:  I’m really sorry for the inconvenience.

Me:  If I don’t get these this week I will call back and get a refund so I can order locally.  I’m not impressed.

……

Later via email:  Congratulations!   Your order has shipped.  Below is the tracking confirmation number….

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Why is it that people, companies, entities etc. will take advantage of people for as long as they can get away with it?  Is it too much to ask for people to just do their jobs and treat people equitably?

I try really hard to be patient with people, especially those in customer service, because I worked in customer service for many years during and right after college.  So, when I lose it with “customer service” people, they’ve pushed me to that point.  I think that people are sometimes so jaded and tired of dealing with customers that they just talk and don’t even pay attention to what they say.  If you don’t have an education, can’t speak the language, or if you don’t have an advocate, you’re just screwed.  It shouldn’t be that way.  As a society, as a legal profession, we shouldn’t be OK with people getting the shaft.

I say, hold people/entities/companies accountable.   If I strive to fully resolve my own issues and those of my family, perhaps I’m making it a little easier for the next customer that comes behind me.  I like to thinks so, anyway.

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About LegalTrenches

I graduated law school in May 2012 and have been blogging about my experience as a non-traditional student since my 2L year. I live over 200 miles from my law school and so I commuted two round trips a week from the beginning. I put almost 1000 miles a week on my car. Law school is crazy. It's even crazier as a non-traditional commuter student, but I wouldn't have had it any other way! I blogged my way through bar prep and sat for the July 2012 Texas Bar exam. Hopefully some of my experiences will help out those taking the bar exam after me. On Nov. 1, 2012, I received my bar results and became an officially licensed Texas lawyer! Follow me as I transition into the legal world as a brand new baby lawyer. I'll try to keep it light and promise to keep it real.

Posted on April 3, 2012, in Uncategorized and tagged , , , . Bookmark the permalink. 2 Comments.

  1. Thanks! I have already asked my mom to contact Tri-Care (military coverage) and report this. I’ll get home from school tomorrow and see if she’s done that. If she’s called and reported and they’ve not yet done anything, at least I can make a valid threat to the hospital knowing that the insurance is working on our issue.

    I appreciate your shared outrage. Insurance companies are the devil’s spawn, that’s why stuff like this angers you (and me) so much. Righteous anger though is a good thing.

  2. Hmmm…. the thing about your mom is hell of fishy. First off, I’ve NEVER EVER heard of someone requiring payment before processing a claim through the insurance company. I’ve worked in healthcare for a very long time both on the billing side of things and on the administrative side as well as the insurance side. Needless to say, nowhere I have worked has this ever been the norm. I do know that if your mother had some problem with her insurance on the date of the visit (say when they went to verify coverage they were told she didn’t have coverage and then she had to straighten out with her insurance company) that’s a different scenario and then you have the option of either not being treated or paying up front and then getting reimbursed.

    Regardless, they’ve been paid. Not once but twice for the same service. This is highly fraudulent and I don’t know what your mother’s situation is but if she’s on Medicare or Medicaid then this constitutes the worst kind of fraud. Hospitals and caregivers are not supposed to double dip. They’re not supposed to collect payment from two sources for the same treatment. At best, this is a highly unethical practice and if I were you I would use those legal chops to threaten them with an exposé to the local media if they refuse to act accordingly. Perhaps you should also get the insurance company involved. The insurance company can threaten to stop their contract with the hospital if the problem is pervasive enough, especially if they have this practice of requiring payment up front while they wait for the insurance to process. THIS IS PREPOSTEROUS. The purpose of insurance is that it’s supposed to take care of your needs during times when you need to seek treatment. It’s not supposed to be “I pay and then they pay and then one party gets reimbursed”. Again, without the specifics it’s very difficult to determine what applies here but there is definitely something fishy going on and I can only hope that you get this resolved soon and that you don’t stop at your mother but that you expose their practices for what they are, fraudulent!

    Don’t know why stuff like this angers me so much.

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