Switching our Agency to a new health insurance provider, I was immediately impressed by the account management resources provided. Through a robust online portal, members could do everything from finding a doctor and reviewing past claims to scheduling a virtual visit.
As a member, I regularly receive messages from the company about the portal, as well as other technology, including a mobile app – all things, so the communication went, designed to make managing our account easier.
The system is so sophisticated that when an out-of-network physician checked my insurance status, I received a notification that a doctor I may be planning on visiting would cost me extra.
With all these tools available, it was a surprise to learn there was one thing I couldn’t do online – file an appeal when a claim had been denied. Instead, I was required to collect “receipts, documents or other items that might help us understand your request or better explain your situation,” and mail them to the company.
Speaking with a rep, I was told it was very important the envelope was clearly marked as being a claim because the same address was used for member inquiries (complaints), and if improperly identified would not be processed.
So let’s review – rather than allowing me to submit a claim electronically through the portal where I could seemingly do everything else to manage my family’s care, my insurance company was making me use the US Mail to send in papers which could easily end up in the wrong department and never be addressed.
When implementing self-service technology, which can include portals like this one as well as Online and Mobile Banking, the message is often that we are putting customers first, by putting them in control. But our choices, particularly related to tasks we don’t allow customers to complete, can create a second, conflicting, narrative.
In this case, the message I received from my insurance company was loud and clear – they do not want me filing an appeal. They will, in fact, go to great lengths to make the process harder, even as they use technology to make other pieces of our healthcare management easier.
It’s a message that has overridden all the other messages and has negatively impacted my overall experience with the company.