I recently had the "opportunity" to make a call to my healthcare insurance, code-named "1.4 billion to the former CEO," and after wading through about three or four false reasons for a refusal to pay a claim, we finally determined that the reason a claim had not been processed was because the computer would not accept an online claim, but only hard copy. This wasn't the only mistake the computer had made, for what it's worth, in this case.
So I asked the rep. whether anyone in the company could override the computer to accept an otherwise valid claim. It didn't seem fair to make my doctor and I do the work for the company, after all.
She couldn't, but forwarded me on to another representative, and the other representative seemed to be very helpful, but admitted that she, too, couldn't override "Hal." However, apparently people at the next level could, and she was forwarding the case to that level.
So if you're dealing with a healthcare company (especially one known for backdating executive stock options) about a claim that ought to be paid, make sure that you don't just leave the matter with the first person you talk to. Rather, make sure you get to the level where they actually have authority to override the computer.
I bet, on a side note, that there are some managers out there wondering why their call center employees have low morale. If any of them are reading this, one factor might be that you've given them no authority to do their job.
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1 comment:
That's customer service, period. When they "couldn't get our phone working" when we moved 2 miles last year, I literally spent about three hours on the phone (bye bye, prepaid cellular minutes) before I finally found the person who could actually do something other than follow the looping menu and transfer me to the next person. In the meantime, on three separate occasions on three different days, I was told the problem was "solved" (translate, we followed the procedure the computer told us to follow to solve the problem) and I should have service within the same working day.
Finally, at the point that the frustration I was experiencing became audible to the call center person, I got transferred to someone who was actually able to trace the problem -- the original person I'd set up the change of service with erroneously told me I could keep my phone number, whereas I was actually located in a different service area than before. So, they were repeatedly trying to hook up a number that simply wouldn't work.
When I got through to the person who was actually able to determine this, it took less than half an hour to resolve the problem by assigning me a different phone number, and I actually did get service overnight.
You're exactly right -- the system isolates the individual reps from the ability to solve the problem, and makes the customer pay for the "efficiency" of that method by making him be the person who has to track down the rep who can actually help him. The reps evidently are not merely unable to solve problems themselves, they're not even provided with the knowledge of where to go to get it solved, until you get far enough up the chain.
I found it particularly itneresting that I must have stumbled up on a good rep, because at one point, even as the problem was on its way to being solved and I was on the phone with her and the more proficient person simultaneously, the more proficient person started warming up the song about "why our system caused this happen" and the other rep politely broke in with, "but this isn't getting her phone working, which is what she needs."
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