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Ok, so. Let me start by saying that I'm fully aware that sometimes the amount of moolah you get back on an insurance claim is not always that great. Spent $500 at the dentist and only got $100 back? Yeah, that sucks.
However. The company I work for has it plastered EVERYWHERE - "Please call your insurer prior to receiving any treatment to confirm how much you will get back, to avoid any suprises!"
The company makes this reaaaaally clear. it is even printed on the back of their MEMBERSHIP CARD that they have to take to any appointment to be able to claim.
So one thing I hate hate HATE is when customers call in and try and be smarta*ses about.
For example. I have taken 5 calls so far today. 3 of them have gone as follows:
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Me - Hi, *opening spiel, how can I help?
SC - Yes, I just got a letter back saying I only got back $200 on my dental claim, I spent $780, quite obviously that's incorrect so I'm calling so you can fix this and pay the rest of my money to me today
Me - Ok sir, one moment please, I'll just have a look at the claim and check what was paid
SC - Yes, and can I say that this is pretty poor service. If I hadn't of called you then you would have gotten away with it, wouldn't you?
Me
- I need to have a look at the claim before I can say anything further sir, one moment thanks
*So I look, and sure enough, he was paid the exact correct amount*
Me - Thanks for waiting there sir. Ok, so I've checked the claim and you were paid the correct amount
SC - Sorry, what was that? Quite obviously I wasn't, is there anyone else there who can come to the phone to get this fixed? perhaps someone who isn't new?
Me
- Sir I can assure you that I am not 'new'. The rebate you were paid is correct.
SC - You're making me very mad young lady. Why do I bother paying for insurance when I get nothing back, huh?
Me - I'm sorry sir but what you paid was correct. For future reference, you can always call the company to check what you will get back before you get any work done, as per the instruction on your card and in your member guide...
*CLICK, as he hangs up on me*
__________________________________________________ ________
Me - Hi, welcome to *opening spiel*, how can I help you?
SC, in a sarcastic tone - OHHHH! An actual PERSON! Oh what a nice surprise!
*NOTE - aside from our intro button selection to take you through to the right area, you always speak to a real person here, so I don't know what the cr*p she is on about*
Me
- Hi there ma'am, so how can I help today?
SC - OHHH, so you want to actually HELP me?
Me - That's what I'm here for ma'am. What was your enquiry?
SC - Well I sent in a claim, and I got it back, and it was shortpaid! I'm wondering if there is anyone there capable of doing anything at all right?
Me - Ok, lets have a look
*Once again, the claim was paid 100% right*
Me - Hi ma'am, thanks for holding there. We've just checked your claim and it was actually paid correctly
SC, in a snotty tone - UM, I think you'll find that it actually WASN"T
Me - Okay. I'm sorry you aren't happy with the rebate, but it was actually paid correctly.
SC - So you're telling me that I only get $50 back out of my $60 phyisiotherapy sessions?
Me - That's correct
SC - That's pathetic!
Me - Okay
SC - I think I'm going to shop around, what do you think about that, huh?!
Me - Okay, that's your choice ma'am. I would probably just double check the rebate on physio with other funds before you cancel though, if you want, only because our rebate is actually one of the highest in the industry. But like I said, it's your choice
SC - Yes! I'll move to a fund that doesn't have pathetic rebates!
*CLICK*
__________________________________________________ ______
Me - Hi, *opening spiel*, how can I help you?
SC - Yeah, you guys stuffed up my claim
Me - Ok sir, let's take a look
*I bring up his dental claim and once again, ding ding ding! We have a winner! A claim that was paid perfectly right*
Me - Hi sir, thanks for holding. Ok, so I can see here that you were paid the correct amounts
SC - NO. I went to the dentist last year and had the EXACT same work done and it was ALL covered. You paid this incorrectly, I demand it be fixed TODAY
Me - Sir you were paid the right...
*interrupts me*
SC - Do YOU pay the claims?
Me - Me personally sir?
SC - Yes, that's what I asked, do YOU sit there on your ass all day and pay the claims?
Me
- Well no, no I don't...
*talks over me again*
SC - Then I suggest you stop wasting my time and go and get me someone who knows what they're talking about!
Me - Sir I may not personally pay the claims, but I do know what I'm talking about. We're here in the call centre to take all customer enquiries which means we are trained on every aspect of this business. When a claim is assessed it is sent to us with full assessing notes, so that if a customer was to call, we would be the ones to explain why it was or was not paid and the reasons for that
SC - I'm sorry, are you deaf? I told you to get me someone who knwos what they're talking about. I'm not wasting my time talking to someone like you
Me - Ok sir, that's fine. I will see if a manager is available. One moment please
*Our centre manager was sitting next to me, so he popped on the phone. This is what went down*
Awesome manager - Hi sir...yes...yes...okay...okay well Tilly has already advised you that what you were paid was correct...okay...mmmhmmm...okay...right...okay well yes I am a manager and yes I am also telling you that the claim was paid correctly. Okay...mmmhmm..okay, have a good day sir
Awesome manager, to me - He just wanted to hear it from a manager
Me - What an a*shole
However. The company I work for has it plastered EVERYWHERE - "Please call your insurer prior to receiving any treatment to confirm how much you will get back, to avoid any suprises!"
The company makes this reaaaaally clear. it is even printed on the back of their MEMBERSHIP CARD that they have to take to any appointment to be able to claim.
So one thing I hate hate HATE is when customers call in and try and be smarta*ses about.
For example. I have taken 5 calls so far today. 3 of them have gone as follows:
--------------------------------------------------------------------------------------
Me - Hi, *opening spiel, how can I help?
SC - Yes, I just got a letter back saying I only got back $200 on my dental claim, I spent $780, quite obviously that's incorrect so I'm calling so you can fix this and pay the rest of my money to me today
Me - Ok sir, one moment please, I'll just have a look at the claim and check what was paid
SC - Yes, and can I say that this is pretty poor service. If I hadn't of called you then you would have gotten away with it, wouldn't you?
Me
- I need to have a look at the claim before I can say anything further sir, one moment thanks*So I look, and sure enough, he was paid the exact correct amount*
Me - Thanks for waiting there sir. Ok, so I've checked the claim and you were paid the correct amount
SC - Sorry, what was that? Quite obviously I wasn't, is there anyone else there who can come to the phone to get this fixed? perhaps someone who isn't new?
Me
- Sir I can assure you that I am not 'new'. The rebate you were paid is correct. SC - You're making me very mad young lady. Why do I bother paying for insurance when I get nothing back, huh?
Me - I'm sorry sir but what you paid was correct. For future reference, you can always call the company to check what you will get back before you get any work done, as per the instruction on your card and in your member guide...
*CLICK, as he hangs up on me*
__________________________________________________ ________
Me - Hi, welcome to *opening spiel*, how can I help you?
SC, in a sarcastic tone - OHHHH! An actual PERSON! Oh what a nice surprise!
*NOTE - aside from our intro button selection to take you through to the right area, you always speak to a real person here, so I don't know what the cr*p she is on about*
Me
- Hi there ma'am, so how can I help today?SC - OHHH, so you want to actually HELP me?
Me - That's what I'm here for ma'am. What was your enquiry?
SC - Well I sent in a claim, and I got it back, and it was shortpaid! I'm wondering if there is anyone there capable of doing anything at all right?
Me
- Ok, lets have a look*Once again, the claim was paid 100% right*
Me - Hi ma'am, thanks for holding there. We've just checked your claim and it was actually paid correctly
SC, in a snotty tone - UM, I think you'll find that it actually WASN"T
Me - Okay. I'm sorry you aren't happy with the rebate, but it was actually paid correctly.
SC - So you're telling me that I only get $50 back out of my $60 phyisiotherapy sessions?
Me - That's correct
SC - That's pathetic!
Me - Okay
SC - I think I'm going to shop around, what do you think about that, huh?!
Me - Okay, that's your choice ma'am. I would probably just double check the rebate on physio with other funds before you cancel though, if you want, only because our rebate is actually one of the highest in the industry. But like I said, it's your choice
SC - Yes! I'll move to a fund that doesn't have pathetic rebates!
*CLICK*
__________________________________________________ ______
Me - Hi, *opening spiel*, how can I help you?
SC - Yeah, you guys stuffed up my claim
Me - Ok sir, let's take a look
*I bring up his dental claim and once again, ding ding ding! We have a winner! A claim that was paid perfectly right*
Me - Hi sir, thanks for holding. Ok, so I can see here that you were paid the correct amounts
SC - NO. I went to the dentist last year and had the EXACT same work done and it was ALL covered. You paid this incorrectly, I demand it be fixed TODAY
Me - Sir you were paid the right...
*interrupts me*
SC - Do YOU pay the claims?
Me - Me personally sir?
SC - Yes, that's what I asked, do YOU sit there on your ass all day and pay the claims?
Me
- Well no, no I don't...*talks over me again*
SC - Then I suggest you stop wasting my time and go and get me someone who knows what they're talking about!
Me
- Sir I may not personally pay the claims, but I do know what I'm talking about. We're here in the call centre to take all customer enquiries which means we are trained on every aspect of this business. When a claim is assessed it is sent to us with full assessing notes, so that if a customer was to call, we would be the ones to explain why it was or was not paid and the reasons for thatSC - I'm sorry, are you deaf? I told you to get me someone who knwos what they're talking about. I'm not wasting my time talking to someone like you
Me
- Ok sir, that's fine. I will see if a manager is available. One moment please*Our centre manager was sitting next to me, so he popped on the phone. This is what went down*
Awesome manager - Hi sir...yes...yes...okay...okay well Tilly has already advised you that what you were paid was correct...okay...mmmhmmm...okay...right...okay well yes I am a manager and yes I am also telling you that the claim was paid correctly. Okay...mmmhmm..okay, have a good day sir
Awesome manager, to me - He just wanted to hear it from a manager
Me
- What an a*shole
)
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