Monday, July 18, 2011

Disease Management?

The Chief and I have insurance through my company of employment. She is full time employed but we have been on my company's insurance for almost 12 years. It just makes things easier not changing insurance every so often.

My company has changed insurance providers over the years. The current company we are with now seems to be pretty good. They have a good mail order prescription service. It also has a decent coverage/benefit plan. Who knows what is covered to what extent in the plan, with all the deductibles involved someone needs a PhD in order to understand all the rules...

I think the last change to our current provider and benefits was about 2 years ago. With this change came some "new" programs. I was going to say "good programs" but I think I should leave it at "new." The one particular program that interested us was the Chronic Disease Management. The Chief has Crohn's disease. She was diagnosed about 8 years ago. Crohn's disease is a chronic inflammatory disease of the intestines. Please note chronic in the description.

Since I am the employee and main person on the insurance, my contact number is on all insurance documentation. Two years ago or so, after the last change of insurance plans, I receive a phone call at my office from Jane at Insurance-IS-Us. She wants to discuss my wife's chronic disease. I say, "OK, here is her phone number." I proceed to give the Chief's cell phone to Jane. Jane calls the Chief and, the Chief was busy at work and could not answer the phone. Jane leaves a message with a contact phone number. The Chief calls back an hour or so later and tries to find Jane. Apparently Jane is nowhere to be found at the given number. So I am wondering if this is a scam.

Fast forward three or four weeks. Jane calls me again at my office. I again give the Chief's phone number to Jane and again the Chief is busy, at work and cannot answer the phone. Jane leaves a message with a phone number and the Chief calls her back and Jane is nowhere to be found.

A month or so later, the same thing happens only this time I give Jane the Chief's office number. This time the Chief is not at her desk and Jane leaves a message. Again, no Jane anywhere when the Chief calls back. I am starting to get a little annoyed by all the calls from Jane.

This entire process is repeated at least 10 more times. I am getting close to telling them to go and pound sand and we will deal with the disease relying on published information and doctor recommendations. I don't do this because there may be something that can help control or manage the disease and I want the Chief to feel as good as she can as much as she can. By this time the entire phone tag session has lasted almost a year and a half. Also, every time Jane calls I have to give her the phone number for the Chief. Could she not put the phone number in her file and bypass me... about call 4 I ask this question. Jane replies the phone number for the Chief is in her file... so use it... but anyway, I digress.

Finally a month later, or so, Jane calls me again. I give the Chief's office number again and this time the stars align and the Chief is not busy and can answer the phone. The Chief and Jane discuss her condition and then Jane says, "I'm sorry, Crohn's disease is not one of the diseases we are currently managing. Thank you."

Click.

Really? After over a year of phone tag a 2 minute conversation and a big "Bite Me" at the end. WTF?

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