UPDATE: I just received a personal phone call from Jeff Rich, the CEO of HSA Insurance, less than 12 hours after I had sent this email out at 2am on a Saturday morning, as well as a follow-up email. He has assured me that he is taking this situation very seriously, has apologized for what’s taken place and will keep me updated of progress and outcomes as they become available.
There’s poor customer service, and then there’s a complete breakdown in job competency.
Folks, I need to take a minute to talk about the exceptional insurance runaround I’ve been getting since before the holidays at the end of last year. I am not one to run up to the blog and complain about little things; you know someone had to have really, really screwed the pooch for me to take something like this to the blog.
Below is a letter I’ve sent to my insurance broker, her boss, and the executive leadership of the company for whom they work. Four weeks ago (!), I needed to switch insurance carriers. All I needed was an ID number for my son, who needs prior authorization with our new carrier to continue to receive his RSV shots . His next shot is this Monday. And yet… I just went through all of this instead, as you’ll see.
Folks can see how utterly ridiculous the amount of paperwork involved just to make a health insurance switch
Other insurance professionals see this as a case study of everything that can go wrong with poor employee training, management, and customer service
Everyone understands that job incompetency has real-world, real-time impacts on real people… like my infant son. As his caregiver and advocate, it’s my responsibility to champion for his health and wellbeing.
This, ladies and gents, is what health activism and empowerment is about: speaking loudly when we or the ones we love have been wronged and harmed.
I write to inform you of a systemic failure of customer service as a client of the HSA Insurance group. I appreciate your patience as you review the situation as follows:
On 12/20/13, I submitted my insurance carrier change enrollment packet via email to Debra redacted., my HSA Insurance agent with whom I’ve been working since 2012 for my sole proprietorship, Words Empowered (HSA account #redacted). I planned to switch from Harvard Pilgrim to Neighborhood Health Plan for a 1/1/14 effective date for my family and me. In my email to her, I specifically asked for confirmation from Debra that my materials had been received. I never received any confirmation.
The timing of this carrier change was especially critical given that my infant son, born five weeks prematurely, has a doctor’s appointment on 1/13/14 in which he must receive a vital injection for his health, the third shot in a series of five. The entire medication series costs over $14,000; we had received approval and prior authorization while under Harvard Pilgrim, but would need to submit a new prior authorization under NHP. Thus, it was imperative that we receive my son’s insurance ID numbers from NHP as soon as possible.
After multiple unreturned voicemails, I again emailed Debra on 12/30/13 and explained the need to rush process my enrollment packet. Her initial response asked only for the name on the application, something that should have been easily referenced by my name or email, both of which are associated with my account. I was then copied on an email to email@example.com with no context other than my business name and what appears to be a reference number.
Again, after multiple unreturned voicemails and emails to Debra spanning the first week of January, I was put in touch with her supervisor, Brian redacted. After explaining the situation to him, he apologized for the breakdown in communication with Debra and assured me on 1/9/14 that my enrollment would be rush processed and an ID number assigned to my son, Judah, in a timely fashion before his 1/13/14 doctor’s appointment.
That same day, Debra called me to let me know there was an issue with the PDF enrollment form file I had sent her; the forms were blank, save for my signature. I had to fill them out again and resend them to her, further delaying my enrollment processing. When I asked her point blank via email why this error was only noticed on 1/9 and not back when I sent it to her on 12/20, she provided neither acknowledgment nor apology. Brian called me later that afternoon to inform me that underwriting had missed the electronic transfer deadline for NHP for the day but that I would receive an ID number by “lunchtime” on Friday, 1/10/14.
Voicemails and emails to both Debra and Brian went unreturned for most of Friday. At 4:11pm, I received an email from Debra with NHP ID numbers… for my husband and me only. I called her immediately to notify her of the error, to which she chuckled and said, “Oh jeez – you’re kidding me. I’m going to have to call you back.”
At 4:51pm, I finally received his ID number – now with no time left to provide this information to my pediatrician’s office so they could process a prior authorization in time for his appointment Monday morning. At the end of this email exchange, I received this inappropriately flippant email from her at 4:54pm: “Could we cut that any closer.” The fact is, the eleventh hour deadline had come and gone, as there was no way I could realistically submit a prior authorization claim for my son’s medication before the close of business today.
As of this moment, I don’t know if he’ll be able to get the medication he needs on Monday. If he contracts the illness from which it’s meant to protect him (and is at its seasonal peak), he could end up in the hospital and wind up with lifelong respiratory dysfunction due to the fact that he was born prematurely. If NHP doesn’t approve it, we’ll have to pay upwards of $3,000 for this one shot alone; I have no way of knowing or preparing for this because Debra couldn’t get me my son’s ID number until 4:51pm the last business day I needed it, despite having sent enrollment materials to her four weeks ago.
This entire enrollment change was an epic failure in customer service and professional competence, as noted by Debra’s repeated missteps that could have been prevented if she’d simply paid more attention. At no point in my interactions with her have I ever felt like a client that was valued; if anything, I feel as though I’ve had the audacity to ask her to do the basic responsibilities of her job. Not once has she apologized or admitted to her repeated mistakes, even when I’ve called her out on them.
She sure had a good laugh today when she realized she did all that work and still hadn’t sent me the information I needed most, however, I’m certainly not laughing. This is not just about shuffling around some enrollment paperwork to underwriting and NHP: this is my son’s very health and wellbeing. Her repeated ineptitude and glib attitude about “cutting it any closer” has now had a direct and potentially harmful impact on my son’s health.
Her incompetence and cavalier approach are embarrassing and I find it genuinely disturbing her complete lack of attention to detail or any sense of urgency at the repercussions of her actions as they affect my child. While Brian offered me many compassionate promises, in the end, every employee of HSA has failed me with whom I encountered during a basic enrollment change.
It’s not just embarrassing for your organization: it’s downright appalling.
Enclosed please find a PDF of all email exchanges with Debra redacted since 12/20/13. These emails, and this letter, will also be posted to my website, Facebook Page , and Twitter accounts, of which I have readers and followers in the several thousands globally. I am also forwarding them to Consumerist.com , fellow healthcare professionals with whom I work as well as my many contacts within the media.
I appreciate you taking the time to review this letter and welcome the opportunity to discuss your thoughts on this matter.