Coventry Conversation: Lucinda, LaShounda & Lucretia

Joe Moore

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Lucinda:

Lucinda: Adventra Freedom, May I help You?
Me: Yes, I am Joe Moore and need some help to get a client his medications.
Lucinda: Is this an existing client?
Me: Yes, I enrolled him in March 2008 in Freedom 5, everything worked fine until today and he went to the drug store today and his drug card quit working.
Lucinda: You know, we changed our drug plan to Medco this year didn't you?
Me: No, I did not know that.
Lucinda: Let me transfer you to Medco and see what is happening.
Me: Thank you Lucinda you have been very nice.


LaShounda:
LaShounda: Medco, may I help you?
Me: Yes, this is Joe Moore in Morristown, TN and I have a client whose card has quit working, can you help me?
LaShounda: Are you an agent?
Me: Yes, I am agent # XXXXXX, and this client's Medicare # is 123-45-6789-A, his birthday is 01-01-41, and his address is XXXXXXXXXXXXXXXXXXXXXX.
LaShounda: Yeah, I found him, what you say the problem is?
Me: Well, he can't get his medications, his card has quit working after January 1, and I am trying to help him.
LaShounda: We mailed him a new card January 3. When did you say you took this application?
Me: In March, 2008.
LaShounda: How you do this? We not start taking applications until November 15, 2008.
Me: Well, he stayed in the plan from 2008 until 2009, it worked fine and he wanted to make no changes.
LaShounda: You say you are an agent? I can't tell you nothing. Have the man call in and we will tell him how to get his medications.
Me: But, he has Alzheimers, he cannot call you, and has no clue what is happening. He has been getting his medications for 9 months and suddenly his card quit working, what is wrong? I am not asking anything except asking you to help get this man's medications.
LaShounda: HIPAAsays I can't tell you nothing, tell him to have his wife to call, and we will give her the information.
Me: I am not sure she would understand, she is not exactly a brain surgeon, but can you call the drug store where he is trying to get his drugs?
LaShounda: Nope, we don't do outbound calls, and I can't tell you nothing.
Me: What can I do? This card just quit working. Look, this guy has been in this plan almost a year, I simply want to know what he can do to get his medications.
LaShounda: The reason his card don't work is because he did not re-apply in 2009. He should have re-applied November 15th. He missed his chance to reapply, and he may be out for a year. I don't know why we mailed him a new card January 3rd, he should have applied after November 15th. He can't do that, he had to re-apply for 2009.
Me: Why?
LaShounda: Cause we had a new year start in 2009, and he had to re-apply.
Me: Let me talk to your supervisor.
LaShounda: I don't have a supervisor.
Me: Where are you located?
LaShounda: I'm in Dallas, where you say you were?
Me: It does not matter where I am, who the hell do you answer to if you have a problem, and lady, you are about to have a hell of a problem?
LaShounda: Well, when I have a problem with a client or agent, I talk to our team leader.
Me: Well, could I talk to your team leader?
LaShounda: Yeah, but she gonna tell you the same thing I did.
Me: I'll take my chances.

After about 5 minutes, here is,

Lucretia:
Lucretia: This is Lucretia, may I help you?
Me: Yes, I have a problem with an existing client getting his drugs. Can you help?
Lucretia: Yes, LaShounda has told me the problem, and we can call the wife and the Drug Store and give them the new number to get this client's drugs. Is there anything else I can help you with?
Me: This is all I need to solve this problem.Do you have the phone number of the Drug Store?
Lucretia: Thank you for asking, LaShounda evidently did not get this.
Me: Well, here is the Drug Store's Number: 423-XXX-XXXX.
Lucretia: I will call the client's wife and the Drug Store within the next 15 minutes, so the client can get his medications. Is there anything else I can help you with?
Me: Yes, thank you for being so nice, but can you put LaShounda back through whatever training she should have had. I don't think it sunk in. She should be solving problems instead of creating them.
Lucretia: Thank you for calling Medco, Sir. I will take this up with LaShounda, she has the authority to call the Drug Store and the client's wife to rectify this situation, but she may not realize this.

The moral of this story, Lucinda and Lucretia will help agents. AVOID LaShounda at ALL costs. If you are directed to Medco, immediately ask to talk to Lucretia.

About an hour later, I called the client back. Lucretia had called her and called the Drug Store, and the client's medications were able to be picked up.

What a simple solution to a simple problem, Lucinda and Lucretia really gave a damn. LaShounda wanted me to think she had it all together and was in control, when really she was nothing more than a bumbling ***.
 
Joe, she doesn't get paid any more to help people than she does when she's no help.

Goes with my theory that EVERYONE should be on some type of commission or incentive pay. The world would be a better place.
 
Joe, she doesn't get paid any more to help people than she does when she's no help.

Goes with my theory that EVERYONE should be on some type of commission or incentive pay. The world would be a better place.

Scott,

LaShounda may be part of the "Bailout" package.

She doesn't at all belong in customer service.
- - - - - - - - - - - - - - - - - -
Joe, she doesn't get paid any more to help people than she does when she's no help.

Goes with my theory that EVERYONE should be on some type of commission or incentive pay. The world would be a better place.

And I agree with you 125%.

Wait until you see my dialog with a client at WalMart yesterday, it may beat this one. This has not been a great week, so far.
 
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I spoke with local coventry today about this. The pharmacist has to run the card under Medco and not caremark. If they run it under caremark it will not work.

I called customer service and got the BIN#, PCN and group number for my clients just in case...
 
I spoke with local coventry today about this. The pharmacist has to run the card under Medco and not caremark. If they run it under caremark it will not work.

I called customer service and got the BIN#, PCN and group number for my clients just in case...

LaShounda must not be in your local office.
 
I liked the story and see the point. Lucinda Lashounda Lucretia ??? Sigmond Freud would have a field day with your narritive. Still excellent work. Bravo.
 
I spoke with local coventry today about this. The pharmacist has to run the card under Medco and not caremark. If they run it under caremark it will not work.

I called customer service and got the BIN#, PCN and group number for my clients just in case...

I spent the better part of the day trying to resolve similar problems. I found out that the bin# of 610014 is Medco's ID, and also the issuer # of 80840 is Medco. The pcn for a MAPD is MedDPrime, and the GRP is specific for the carrier. In Coventry's case it is CVTYMED. For Care Improvement Plus it is CARERx01. This information seemed to help my CIP client, but not my Coventry client. It appears that Medco has problems assimilating the data into the client database. They may "see" the client but have their benefits wrong, or NOT "see" an active client and deny any coverage. I can't find a consistent problem.

It didn't help when Coventry told me that the bin# should be 640014 (wrong).... and putting me on hold for over an hour. Calling Medco is a waste of time... their CSRs know less than the so-called "Broker Service Unit" CSRs. None of them can fight their way out of a paper bag. I have had more help from friendly pharmacists than carrier reps. That may just be the luck of the draw...

My phone has been tied up for two days over clients unable to get their meds or being charged a different co-pay than they should. Both Coventry and CIP changed from CareMark to Medco... hang on, the fat lady hasn't begun to sing.

What a mess!! Add to this the fact that some new applicants don't know if they are enrolled... etc. etc.

But we are "overpaid".... Stark says.
 
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Lucinda:

Lucinda: Adventra Freedom, May I help You?
Me: Yes, I am Joe Moore and need some help to get a client his medications.
Lucinda: Is this an existing client?
Me: Yes, I enrolled him in March 2008 in Freedom 5, everything worked fine until today and he went to the drug store today and his drug card quit working.
Lucinda: You know, we changed our drug plan to Medco this year didn't you?
Me: No, I did not know that.
Lucinda: Let me transfer you to Medco and see what is happening.
Me: Thank you Lucinda you have been very nice.


LaShounda:
LaShounda: Medco, may I help you?
Me: Yes, this is Joe Moore in Morristown, TN and I have a client whose card has quit working, can you help me?
LaShounda: Are you an agent?
Me: Yes, I am agent # XXXXXX, and this client's Medicare # is 123-45-6789-A, his birthday is 01-01-41, and his address is XXXXXXXXXXXXXXXXXXXXXX.
LaShounda: Yeah, I found him, what you say the problem is?
Me: Well, he can't get his medications, his card has quit working after January 1, and I am trying to help him.
LaShounda: We mailed him a new card January 3. When did you say you took this application?
Me: In March, 2008.
LaShounda: How you do this? We not start taking applications until November 15, 2008.
Me: Well, he stayed in the plan from 2008 until 2009, it worked fine and he wanted to make no changes.
LaShounda: You say you are an agent? I can't tell you nothing. Have the man call in and we will tell him how to get his medications.
Me: But, he has Alzheimers, he cannot call you, and has no clue what is happening. He has been getting his medications for 9 months and suddenly his card quit working, what is wrong? I am not asking anything except asking you to help get this man's medications.
LaShounda: HIPAAsays I can't tell you nothing, tell him to have his wife to call, and we will give her the information.
Me: I am not sure she would understand, she is not exactly a brain surgeon, but can you call the drug store where he is trying to get his drugs?
LaShounda: Nope, we don't do outbound calls, and I can't tell you nothing.
Me: What can I do? This card just quit working. Look, this guy has been in this plan almost a year, I simply want to know what he can do to get his medications.
LaShounda: The reason his card don't work is because he did not re-apply in 2009. He should have re-applied November 15th. He missed his chance to reapply, and he may be out for a year. I don't know why we mailed him a new card January 3rd, he should have applied after November 15th. He can't do that, he had to re-apply for 2009.
Me: Why?
LaShounda: Cause we had a new year start in 2009, and he had to re-apply.
Me: Let me talk to your supervisor.
LaShounda: I don't have a supervisor.
Me: Where are you located?
LaShounda: I'm in Dallas, where you say you were?
Me: It does not matter where I am, who the hell do you answer to if you have a problem, and lady, you are about to have a hell of a problem?
LaShounda: Well, when I have a problem with a client or agent, I talk to our team leader.
Me: Well, could I talk to your team leader?
LaShounda: Yeah, but she gonna tell you the same thing I did.
Me: I'll take my chances.

After about 5 minutes, here is,

Lucretia:
Lucretia: This is Lucretia, may I help you?
Me: Yes, I have a problem with an existing client getting his drugs. Can you help?
Lucretia: Yes, LaShounda has told me the problem, and we can call the wife and the Drug Store and give them the new number to get this client's drugs. Is there anything else I can help you with?
Me: This is all I need to solve this problem.Do you have the phone number of the Drug Store?
Lucretia: Thank you for asking, LaShounda evidently did not get this.
Me: Well, here is the Drug Store's Number: 423-XXX-XXXX.
Lucretia: I will call the client's wife and the Drug Store within the next 15 minutes, so the client can get his medications. Is there anything else I can help you with?
Me: Yes, thank you for being so nice, but can you put LaShounda back through whatever training she should have had. I don't think it sunk in. She should be solving problems instead of creating them.
Lucretia: Thank you for calling Medco, Sir. I will take this up with LaShounda, she has the authority to call the Drug Store and the client's wife to rectify this situation, but she may not realize this.

The moral of this story, Lucinda and Lucretia will help agents. AVOID LaShounda at ALL costs. If you are directed to Medco, immediately ask to talk to Lucretia.

About an hour later, I called the client back. Lucretia had called her and called the Drug Store, and the client's medications were able to be picked up.

What a simple solution to a simple problem, Lucinda and Lucretia really gave a damn. LaShounda wanted me to think she had it all together and was in control, when really she was nothing more than a bumbling ***.
:yes::laugh::twitchy:
 
Sad but humorous dialog. I don't work in that market, just curious however, what would be the typical commission on this product you sold?
 
Sad but humorous dialog. I don't work in that market, just curious however, what would be the typical commission on this product you sold?

On MA/MAPD business you're looking at around $400 if they're new to these products and $200 if you're changing them from another one.

Some plans are paying lower than that and you can get GA contracts to pay higher, but that's about the industry norm.
 
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