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So I get a call from a client from the 2015 enrollment stating that she had major issues with the carrier she had this year and opted to go with another carrier for 2016.
She stated that she called HC.gov and the rep told her she could switch to this other carrier in her area. Client is a heavy useage consumer and mentioned having a neck surgery pending in January.
I asked her if the Navigator looked up Dr and scripts to which she stated no. So I asked if it would be ok for me to review the carrier and her app on HC.gov to which she stated yes.
In reviewing her application the Navigator failed to set her as smoking status. Didn't look up Dr.'s or scripts.
When I told her that her plan was going to be $ 221 per month vs. the $ 96 she was quoted by the Navigator she hit the roof accusing me of trying to put the screws to her. I tried to explain the error but this client just flipped out.
I tried to move on to the Dr. search part which I eventually was able to do. In searching for her Neurologist I found he was out of network for the new carrier that HC.gov set her up with. This was especially not good because she planned for a year to get this surgery finally taken care of. I tried to explain it to her and I realized I had more intelligent conversations with walls.
In the end I get another call from her telling me that she contacted the new carrier and they stated that the Neurologist was in network. She told me to cancel everything that I had done to keep her with her current coverage.
I asked for the number so I could call. Low and behold the CS agent stated he was in network but not for on exchange based plans.
I tried to call her back last night to re-explain things to her for her own well being.
Then I realized something....I've given enough to try to help this person whom clearly was going to be a problem on going and in the end a loss to to having to be heavily involved.
How many clients have you decided to just cut loose?
She stated that she called HC.gov and the rep told her she could switch to this other carrier in her area. Client is a heavy useage consumer and mentioned having a neck surgery pending in January.
I asked her if the Navigator looked up Dr and scripts to which she stated no. So I asked if it would be ok for me to review the carrier and her app on HC.gov to which she stated yes.
In reviewing her application the Navigator failed to set her as smoking status. Didn't look up Dr.'s or scripts.
When I told her that her plan was going to be $ 221 per month vs. the $ 96 she was quoted by the Navigator she hit the roof accusing me of trying to put the screws to her. I tried to explain the error but this client just flipped out.
I tried to move on to the Dr. search part which I eventually was able to do. In searching for her Neurologist I found he was out of network for the new carrier that HC.gov set her up with. This was especially not good because she planned for a year to get this surgery finally taken care of. I tried to explain it to her and I realized I had more intelligent conversations with walls.
In the end I get another call from her telling me that she contacted the new carrier and they stated that the Neurologist was in network. She told me to cancel everything that I had done to keep her with her current coverage.
I asked for the number so I could call. Low and behold the CS agent stated he was in network but not for on exchange based plans.
I tried to call her back last night to re-explain things to her for her own well being.
Then I realized something....I've given enough to try to help this person whom clearly was going to be a problem on going and in the end a loss to to having to be heavily involved.
How many clients have you decided to just cut loose?