My doctor sent me a bill for $1, 300. My insurance company had denied my claim with a code 23. Code 23 means that the bill exceeded the insurance company’s contractual agreement. This could mean that the insurance company and the doctor are going to duke it out and I need to wait to find out who pays or it could mean that I have to pay. It wasn’t clear from either the doctor’s bill or the insurance company’s denial.

I go to the insurance company’s web site because the insurance company doesn’t want you calling them. They do everything to discourage it. If you ever do call, a recorded message will encourage you to go to their web site for faster service. I try finding my answer on their web site. They explain in minute detail about what they will pay for. I am sure that the author is a lawyer trying to help the company fend off law suits and not by a person interested in answering an actual person’s customer service question. After reading as many explanations as I can stay awake for, I realize I still have no idea who is supposed to pay the bill. On the plus side, if some pissy customer service agent asks whether I tried using the company’s website, and they do ask that question, I feel like I can truthfully answer yes I tried.

The doctor’s bill is due in a week or so. I am not going to pay the bill until I find out who is responsible. If you pay the bill, both the doctor and the insurance company loose interest in the answer. Unless you plan to spend hours on the phone arguing about this, never pay the bill until you know you need to pay the bill. Someone has to be waiting to be paid in order for you to get any action and it is best it is the doctor and not you. I wait a couple of days to see if I get a revised bill from the doctor with the insurance payment or directions that I am indeed responsible.

The revised bill never comes. Which is a crisis. I now have to call the insurance company’s Customer Support for an answer. This will consume a good hour of me waiting on hold, getting transferred to several other customer support agents, and explaining my story numerous time. I prepare for the call — get a few snacks in case I get hungry, find some chores that can be done on my computer while I wait and have every document I need ready for any questions I might receive. Once I am fully prepared, I make my call.

The recorded greeting directs me to the website. The message assures me that it will be faster than waiting for a customer support agent. I want to scream I have tried the website already that is why I am calling, stop telling me to use it when it was useless. I restrain myself as it is pointless to scream at the recorded greeting, I continue to listen for further instructions which brings me to dreaded phone tree.

You climb the phone tree in order to get routed to the correct person. This is rarely my experience. First, and most importantly, you have to listen carefully to your options. If you lose focus even for a second, you might miss your option. You can then find yourself listening to dead air with no way to get back to the tree or having to leap from the tree and begin climbing again. Instead of starting over, I have found randomly depressing a number sometimes connects you to a person. It might not be the right person but then they will help you to the right person. And, really, chances are you, even if you used the phone tree, you were going to wind up with the wrong customer service agent any way, so this is actually a time saver.

Anyway, I listen to my phone tree options with laser like focus because I know this was going to be a long call. I go through the phone tree options. I choose one that best fits my need and I am finally connected to a person. Step one complete.

The first Customer Service representative was perplexed. He was confused about the denial. He saw the same explanation I saw but couldn’t determine who should pay the outstanding amount. He asks me to hold. He doesn’t actually put me on hold though so I hear the whispered conversation he has with a nearby associate. After five minutes of this, and without letting me know, he puts me on hold. I know I am still connected because I begin to hear recordings again which includes a message about using the company’s website for faster service and also letting me know that the company had just won some customer service award for customer satisfaction. I find this difficult to believe. Ten minutes later the customer service agent returns to tell me he needs help from a supervisor, can I continue to hold.

I put the phone on speaker and continue with my chores. After another ten minutes, the Rep comes back on the line and tells me he has to transfer me to another Customer Service Rep at another office to answer my question because the phone tree directed me to wrong person. I am no longer a company employee and I am using COBRA to pay for my company insurance. Which seems like a pretty lame answer because I am paying to have exactly the same insurance as someone who is an employee of the company. I get exactly the same benefits as an employee. Also if COBRA employees should call a different number is the one I should call, why does my insurance card give his number. An awkward silence follows, until exasperated with the absence of an explanation, I agree to be transferred. Before the Rep transfers me, he gives me the right phone number to call in case he accidentally disconnects me during the transfer process. This is not reassuring.

The new Rep answers and proceeds to irritate me. He is way too friendly for my taste. He speaks American Bro like we are old pals and not a customer and a company representative tasked with helping the customer with a problem. I don’t encourage him whatsoever. But he is one determined dude. He spends a good five minutes trying to connect with me. He notices I live in San Diego and talks about a trip he took to San Diego many years ago. He loved San Diego. I mutter a few monosyllable answers when he feels it important to include me in the conversation but, for the most part, he doesn’t really need my participation. He is on speaker and I am doing other things and I can wait for him to exhaust his faux friendliness.

He finally winds down and asks me what my problem is. This makes me a little testy. I tell him that I have already explained it to the other Rep, didn’t the other Rep explain it to him. Maintaining his Bro demeanor, he lets me know that he just wants to make sure he has the correct information. I want to ask him to just give me the information he has because I suspect he doesn’t have any information whatsoever. But I’m pretty sure the Bro would try to bond further with me so I surrender. I explain,for a second time, my problem.

He does some quick tapping on his keyboard and then stops talking. The first time he has stopped talking since we connected. I hear the clickity clack of typing on a keyboard, an audible “this is interesting” and then he told me he was going to put me a hold for a moment. I wait. Like the previous Rep, he doesn’t put me on hold. I hear him talking to the person next to him. After about five minutes of a whispered back and forth, Bro tells me he has to talk to his supervisor and for me to continue to hold. This time he means business because I hear the recording which tells me that I can get faster service if I go to the website.

After another 10 minutes, Bro comes back on the line. “Mr. Fitzpatrick.”

I knew I was in trouble then. Nobody calls you Mr. when they have good news. He asks if he can give me a call back in a few minutes as he is still trying to determine who is responsible for paying the bill. I give him my phone number. He tells me he will call back in a few minutes. Then, because I have had problem with insurance companies and doctors not leaving messages on my recorder because they don’t know if other people use the phone and they are afraid they will be sued for divulging private information, I tell him, “that he can leave a message on my recorder if I don’t answer.” He assures me it will only be a few minutes and that he can give me an answer. He wants to give me this information directly. I tell him it is unnecessary to speak to me directly if, for some reason I don’t answer, all I need to know is who is responsible for the $1,300.

“Mr. Fitzpatrick just know I have taken a personal interest in this and I will get back with you by the end of the day.” I thank him for his help and wait for Bro to call back.

He doesn’t.

I call back the next day. I will spare you the ordeal of the recorded messages, the phone tree, and the transfers even though the original Customer Service rep gave me the correct phone number to call. I finally get a supervisor who explained code 23. She tells me that, even though the code as defined by her company means that bill exceeds the insurance company’s contractual agreement, what it really means is that I hadn’t met my deductible yet. I asked her why the company didn’t use a code that says I haven’t met my deductible instead as I would have understood this immediately and it would have saved me hours of customer service calls. She said technically code 23 is correct because the cost did exceed the contractual agreement regarding my deductible. I asked then why doesn’t anyone at her company know this. I spoke with two different reps who spoke with their associates and supervisors and nobody seemed to know this all encompassing meaning of code 23.

She gives this a think and then replies, “I will let my supervisor know.” She isn’t going to engage in a pointless argument with me over bureaucratic mumbo jumbo that she doesn’t have the answer for. She can’t do anything about it, so she lets me know that she will pass on my complaint to someone who could. I am absolutely positive she did not tell her supervisor.