Saturday, July 25, 2009

The Jobby Job

So I managed to work almost 20 hrs of OT this week. I've never done that in my life. However, I am caught up on all my work. Crazy, eh? Which should tell you there...we got that much work all the time...that even 60 hours a week wouldn't keep you caught up. LOL. But I did get a wonderful email on Tuesday morning from a son aka Power of Attorney for one of the insureds, it said GREAT SERVICE! He was so surprised that he faxed in the bill on the 13th of this month and got his check in hand by the 20th. I love being praised for good work! And it made my day, so in the end, it was worth it. Plus I got some phone comments from two other people...about how impressed they were with me, how helpful I am. So it lets me know I'm doing a good job. Mind you, I still hate being on the phone. However I do have to talk to the insureds or their family. But at times, I just want to tell their dang POLICY!

Seriously people...I've worked for medical insurance companies and processed claims for PPO plans, HMO plans...even Medicaid and Medicare. And in the midst of it, taken calls from providers and members/insureds. Its seriously not the insurance company trying to deny and not pay. If your policy states something, we have to process it that way. Believe, I don't enjoy denying peoples claims on purpose.

But also...there are seriously a lot of people out there right now trying to get over and fraud the insurance company as well. Like some of the policies I work right now for long term care...they pay a personal caregiver....thats someone who is NOT a licensed nurse and usually a family friend or family member. And these people be lying to get that money. I mean seriously, its rediculous...and they get mad because they have to provide proof of payment for us to reimburse them. Its crazy the stories and things we hear from people.

My advice for people, seriously just sit down and read over your benefits and coverage. Thats with any insurance policy. Know what you have.

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