Working with the public means you come across many faces, attitudes, and personalities. This can help the work day go by fast and also hinder it from becoming "quitting time". I encountered a patient in which English was not her first language. I informed her that I was having trouble verifying her insurance and it showed her as being inactive. Of course she was against it and started to get upset and question what I had just told her. She went on saying the insurance is through her ex husband and she had just used it at another facility with no issues. I stated to the patient I will call the insurance company to make sure. So I called Tricare to see what was going on. I gave the Tricare rep the patient's info and the response I got back was not good. The representative stated that the patient in fact did NOT have coverage and the spouse had re-married and put the new spouse's info in for coverage. Ohhhhhhh Lord it is about to get real! I'm thinking like how in the world am I supposed to say "Ma'am you do not have coverage anymore and your ex has remarried and listed his new wife for benefits." I tried explaining this the best way I could, but it did not go over so well with the patient. The patient went ballistic, crying and sobbing. She went on crying saying things like "How could he do this to me?" We were married for 38 years." "I am entitled to benefits!" "I want my benefits!" I felt soooooo sorry for her. Until things progressed and I dug deeper info the facts. Truth is yes the patient was once married for 38 years to a military serving spouse, but they divorced in early 2012. The ex spouse did in fact remarry and list his new spouse for benefits. Well there is nothing wrong with that except the patient did not know the ex had remarried or that her insurance was termed, but she just found out unfortunately. I hate it happened the way it did. While trying to calm the patient down I was able to speak with a different rep who stated the patient may be eligible for benefits, but she needed to provide basic info as well as some documents. The rep verified the patient's mailing address and come to find out the patient never turned in the info that actually had been sent out several times. The patient had not done what she was supposed to do in the time period allotted and she would have to start the process all over. It has almost been a year and you still have not did what you need to do in order for you to receive your "entitled" insurance benefits. How could you sit up here and act like you don't know anything about your situation? Yes you did just find out your ex has now remarried,but you failed to say you had started and not finished everything needed to complete the request. So why did I have to deal with all of that? I was insulted and told I didn't know what I was doing. Now in the end was all that necessary? Especially when you as the patient knew what you needed to do. I think she was just hurt about the ex remarrying, but you still need to handle your business, but I am sorry I had to be the one to tell you.
No comments:
Post a Comment