Continuing the discussion from Anyone from Middle Georgia or Macon?:
Wasn’t quite sure what category to pigeon hole this under, but eventually decided to go with “Self Advocacy” since the description seemed to be a good fit.
When I read stories like Dana’s, I am never quite sure how to respond. I have the type of a personality that tends to not let things go. Also usually … not always by any means, but I think fairly often … the more argumentative the person on the phone gets the calmer & more politely insistent I tend to become. So usually I can eventually punch through when a bureaucracy is making idiotic statements such as an insurance company claiming they don’t cover Lantus.
But I think it may also be that so far I have been very lucky and that I have never actually been truly challenged. So I thought I’d toss this out there to see if anyone else had suggestions to offer on how to work with and prevail over a PITA bureaucracy.
What do you do when nonsense is repeated as though it actually makes sense? How does one gain traction against stubbornly persistent institutional absurdity? 
Anyone?
LOL @irrational_John. I also apologize for always only coming here when I am highly upset or emotional. I was very careful while on the phone to not become upset with the person. Having the Benefits person on with me did help. The Caremark person who answered the phone did seem to have an “attitude” right from the beginning so I felt at a disadvantage and that is why I asked “calmly” to speak with someone else. (honestly, I was calm). I found it odd, that even after giving them both my new Caremark ID # (which is on the Card so I can see where that wouldn’t be enough), then both my and my husband’s SS #, she insisted on our stupid current and former address because we had just moved over 3 times in the same month. I was embarrassed because I have been experience memory problems. Another reason why I am very anxious to find a physician ASAP. She didn’t recognize my new address, even thought the Service Center person who was helping me from the same company (Caremark) had it. Then at first, I mispoke and started giving her an address from several years ago, when I also had Caremark. But eventually, I did give her the correct address from Texas from two months ago. She still said it was wrong, AND it was not. She was being extremely billigerant but the other woman, a manager I presume asked me the name of the medication, after all that stupid round and around about my address and said, “no, your RX plan doesn’t cover that, or Levemir”. Then, gave me yet another 800 number for my doctor to call (which I no longer have a doctor thanks to my new sucky medical coverage) and plead my case for long acting insulin. Sigh. I understand that you folks don’t have much advice so don’t feel bad. I am beginning to sink into a really bad hole here of hopelessness. Everywhere I’m turning, I end up at “O”. I am not a strong-willed person but I really want to be. I just wish someone who can help me would.
When dealing with irrational officialdom I remain calm, but don’t waste much time on the first responder, I just ask to speak to their superior. I also ask for the conversation to be recorded. If I still get no help I tell them they have messed up and I want this matter resolved immediately or I will take the whole thing further. They don’t like having to deal with your local sitting politician (don’t know your term for this), it takes time, costs money and is bad publicity. Also as PhoenixBound has suggested in another thread, if medical, you could threaten to take it to the FDA. LOL or the local newspaper. I can just see the headline to the article, Diabetic Woman Refused Insulin by XXX Insurance Co.
I have an app on my Android Phone that automatically records calls based on a number of choices in the app: 1) all calls, 2) calls to/from numbers NOT in your contacts, 3) record none. You can also set which contacts you want it to always record. During a call that isn’t being recorded, it’s easy to start a recording manually if necessary. You can also easy stop recording a call that was either automatically or manually set to record. I have it set to record using the second option I listed. The app is called AUTOMATIC CALL RECORDER. It’s free and it works well.
You live in Australia, don’t you, Pastel?
Just wanted to clarify because, for most situations in the U.S., talking to a politician is usually a lot further down the line in the problem resolution process. While our insurance companies are regulated to some extent by the government, most of them are private businesses and not run by/for the government.
Or at least that’s what I think I know …
When you write to or go to see a politician about a situation here, they usually write to the company or government department concerned and ask for clarification on the issue. This involves either a private company or government office in a lot of extra work, writing a report which is factually correct and explaining their stance. That is how it happens both here and in the UK. I don’t think it matters if they are government or private. Surely your politicians have some power they can use if resolution fails? And yes, I do live in Australia. I get all my diabetic supplies at a very low price through an organisation I joined… I pay an annual membership fee of around $A30 for this benefit. From reading about your medical insurance companies I realise that the system here saves an awful lot of hassle.
