What’s A Girl Got To Do To Get An HMO To Help Her?

What lengths do you have to go to to get good coverage from an HMO? Being sick obviously won’t do it. So what about starving yourself? Well, not if your HMO is Blue Cross Blue Shield.

Patrick M. wrote in to talk about his recent experience trying to get his wife a blood test. “This is a story of poor health care and not the typical they-are-refusing-my-coverage stuff. Just poor customer service.”

And it is that. Nothing like fasting for 12 hours only to find out that your HMO never bothered to make you that appointment. His wife’s ordeal, after the jump.

So I know this might be some uncharted territory for you guys, however, I thought I’d give it a shot.

This is a story of poor health care and not the typical they-are-refusing-my-coverage stuff. Just poor customer service.

My wife and I have blue cross blue shield – so in the realm of health care, it’s supposed to be “good” (if course, this is all relative). My wife had to make a blood appointment for some blood test, she had to go through the ever large company Quest Diagnostics. Since Quest is a this national corporation that supposedly has efficiencies of scale they made her call a 1-800 number to schedule the time and location of said test. When she called the operator said there were no locations in our area. Thankfully our doctor had supplied two locations. Needless to say, somehow the operator then found said locations and made an appointment. My wife then asked if there was anything else she needed to know. The operator acted as if this was a crazy questioned. My wife asked if she needed to fast before the appointment. “oh, yea, yea, you need to, ‘um, fast for 12 hours before your appointment.” After fasting fro twelve hours my wife showed up to her appointment – or what she thought was her appointment. The local quest office did not have her down for an appointment and made her wait for over an hour till they could accommodate her.

So to sum:

National corporation does not post numbers for local offices and instead makes you call a 1-800 number where, in theory, they have highly trained operators

Said operator can not find location

Said operator schedules appointment and does not inform patient of the need to fast beforehand

Locale Office has no appointment and make patient wait over an hour

So, we are consumers and are wondering what is the appropriate level of customer service for this type of incident. Why should retailers and direct to consumer brands work to give a customer a satisfactory experience (e.g., a coupon) and not someone like Quest?

I’d like to hear your thoughts on the matter should you feel it appropriate.

The problem is, of course, that you can’t easily switch insurance providers, a lot of times. Therefore, there’s no incentive for them to try to keep your business.