As a parent of a child with a chronic illness, I can tell you that dealing with medical billing can feel like a full-time job. Recently, I’ve faced a series of frustrating billing issues with my son’s specialty pharmacy—problems that are all too familiar to those in our situation. Endless phone calls, insurance complications, and the relentless need for documentation can consume my days. Some days, it genuinely feels like I’m glued to the phone or the computer, and sometimes, I am.
For those who might not understand the complexities of managing health care for a child with a chronic condition, I’d like to share a glimpse into my morning. This particular call was my fourth attempt this month to fix a billing issue regarding a month’s worth of medication received over three weeks ago.
I dial the pharmacy and wade through a series of prompts, hoping to reach the billing department.
On hold for 8 minutes. Not too bad compared to my last call, which started with a 20-minute wait.
Customer Service: This is Jamie in billing. How can I assist you today?
Me: I would like to speak to a billing manager, please.
Customer Service: I’m in billing. I can assist you just as well as a manager.
Me: We’ve tried to resolve this issue multiple times, spending hours on the phone. I really need to speak to someone who can address this without me having to repeat everything.
Customer Service: Alright, let me transfer you.
On hold for another 2 minutes.
Automated Message: Thank you for calling. Are you a new patient, existing patient, or provider? Please press 1 for new patient, press 2 for existing patient, press 3 for provider.
I press 2.
Automated Message: What is the phone number associated with your account?
I enter my number.
Automated Message: Please hold for our next available patient care advocate.
On hold for 5 more minutes.
Customer Service: Thank you for calling. This is Taylor in billing. How can I help you?
Me: I need to speak with a billing manager, please.
Customer Service: I’m in billing.
Me: I understand, but I need someone who can resolve this issue.
Customer Service: Okay, let me transfer you.
On hold again for 2 minutes.
Automated Message: Thank you for calling. Are you a new patient, existing patient, or provider? Please press 1 for new patient, press 2 for existing patient, press 3 for provider.
I press 2.
Automated Message: We’re sorry, your order cannot be completed through our automatic refill service. Please hold for our next available patient care advocate.
On hold for 2 minutes.
Customer Service: Hi, this is Alex in billing. How can I help you?
Me: May I speak with a manager, please?
Customer Service: Let me transfer you.
On hold for 15 minutes.
Customer Service: Hi, this is Casey. Can I get some information to pass along to the manager?
Me: Sure.
Customer Service: Is this account for you or your husband?
Me: My son.
Customer Service: Can I have his last name, please?
Me: Doe.
Customer Service: And his first name?
Me: Jason.
Customer Service: Can I have his date of birth?
Me: It’s 01/01/2015.
Customer Service: Please verify your zip code.
Me: 12345.
Customer Service: I’ll get the billing department on the line right away.
Me: I’ve already spoken to several people today. I need a manager.
Customer Service: I need to connect with them first. What’s your name?
Me: Melissa Johnson.
On hold for 5 minutes.
Customer Service: Ms. Johnson, I’m still waiting for a rep to pick up. Do you want to continue holding?
Me: I’ve already been on hold for nearly an hour. What other options do I have?
Customer Service: I have the same number as you for billing.
Me: I spoke with Jamie last week, who is a resolution team lead. Can you connect me to her?
Customer Service: Let me find her.
On hold for 1 minute.
Customer Service: She’s not available, but I’ll try to reach a supervisor. Can you hold?
Minute 42:37 on this call. On hold for 5 minutes.
Customer Service: Ms. Johnson, I apologize for the wait. Are you still there?
Me: I have no choice. I’ve already invested too much time.
Customer Service: I’ll keep trying to reach Jamie.
On hold for 9 minutes.
Customer Service: Hello, how may I help you?
Me: I can barely hear you.
Customer Service: Sorry, I can’t adjust the volume.
Me: Are you a billing manager?
Customer Service: No, I’m a member of management.
After explaining my situation, they finally admitted that a billing request was submitted last week, but no further details were available. The representative would reach out to the original contact and check on the status. The medication in question costs nearly $400,000 annually, and I refuse to order more until this is resolved.
It’s a long and tedious process, but hopefully, it will eventually lead to resolution. If you’ve ever wondered why parents of children with chronic illnesses seem to be perpetually busy or frazzled, this post sheds light on our reality. We often end up spending an inordinate amount of time dealing with healthcare logistics instead of enjoying the simple moments of life.
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Summary:
Managing health care for a child with a chronic condition can be a daunting task filled with frustrating phone calls and unresolved issues. This article highlights the challenges parents face in navigating medical billing and insurance, showcasing the time-consuming nature of these responsibilities.
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