#disability law or just any fucking thing. if you're here you can be on google doing research. learn more

[magdaclaire]

don't be fucking stupid and i won't call you fucking stupid

[natashalie-lumley]

Ok. This is something that maybe doesn't apply to everybody but I don't care because literally Nothing applies to Everybody. And I need to write some of this down before going to bed and having to get up for work again tomorrow

Some context: I answer phones for the Medicare department of a national health insurance agency. That means I'm mostly dealing with older people or younger people with disabilities. It also means a lot of calls about heavy topics. Which is a great lead in to my first point.

1) your member services rep is NOT your trauma dumping ground. I don't want or need to know about your shitty life, past present or future. I get so many people every day telling me they don't have any family or friends and they don't like their lives and honey I'm sorry because that does suck but I AM NOT A COUNSELOR. I'm here to answer your health insurance questions and get you off the phone.

2) similar point, WE ARE NOT MEDICALLY TRAINED PROFESSIONALS!! the number of times I've been asked "what medication should I be on" or "should I have this procedure" is higher than you think. And yes there are some people who are asking "what medications are covered" (which is a little easier to answer) and "is this procedure covered", but that's not what they Ask. Also leads in to point 3

3) we don't need to know your symptoms! We can't do anything with that information! Even if you're calling because something got denied and you want to appeal it, telling us about how you need the chemo because you're losing bodily functions or something is Not Helpful and in fact is very stressful. And no, me adding that to the appeal does not increase the chances of it getting a positive result.

4) don't ask super broad questions. A common one is "am I on the best plan" and they always seem confused when I can't just say "yes/no" to it. Each plan is just slightly different from the other, be it in the amount of dental work it covers or the medications it includes. I need to know what factors matter to you before I can tell you whether there's a plan that would work better.

5) if we say something is a Medicare rule, it means WE CANT CHANGE IT. the biggest one is the Coverage Gap, sometimes called the donut hole. (Tl;Dr is that after so much money gets spent on your meds you end up paying 25% of the cost instead of flat co-pays, which on like a handful of meds actually does save people money but usually it raises the price into the triple digits for a month supply.) Look, we know it sucks. We know that the whole system of stages is fucked. And we would LOVE to find a way for you to get your meds for free or super cheap. But as I mentioned before, we are not social workers and our resources for that are basically Google. So if we say "ok looks like the issue is [Medicare policy x]", telling us how much you need x is not going to change the fact that Medicare gets to do what they want.

6) HIPAA is a big ass deal and unfortunately it can mean making things difficult. Oh, your grandma has dementia and can't talk on the phone? Well unless you're authorized on her account or filed as her POA then grandma has to verbally come on the recorded line and say I can talk to you. Thankfully we're told that the caller can coach the member but like. It's still difficult and sometimes they're not in the same place let alone same state, and we have to say "ok so I can share certain information with you but I can't answer all your questions". If that happens, getting pissy at the rep isn't going to change THE LAW.

7) I'm sorry if you've been transferred a million times but if I can't help you because you need the dental dept, asking me questions is just prolonging both of our suffering. And yelling at me for it does nothing.

8) I don't know why other people do things. One of my absolute least favorite questions is "why did the last person I talked to tell me x and you're saying y??". Dude I don't fucking know I barely know why I DO THINGS and you want me to explain somebody else? (Also half the time the answer is "they didn't want to deal with you getting mad so they said what you wanted to hear" but I can't say that on the recording but it's true.)

9) technology sucks. I have 2 monitors and a laptop for work and I consistently want to introduce at least one of them to the business end of a mallet. Pages load slow or not at all and it's not on me so getting mad at me for taking some time helps exactly nobody.

10) those surveys at the end do have a result- bad reviews get coaching and good reviews go towards getting a raise. So even if you don't think it's worth it, if it's three questions or less maybe just take the dang thing.

11) if we're having trouble explaining something, it doesn't automatically mean we don't understand it. I get insulted at least once a day by someone intimating that if I were smarter there wouldn't be any issues and let me tell you, half the time is me remembering all of the non-advanced terms for things so I can try and break something down for you but the other half of those long pauses are me going "how to better explain the concept of co-pays when I can't break it down any further than "you have to pay for medical services".

12) if you say "well I'm going to change my plan" because we couldn't help you or something wasn't covered, please know that we are seconds from going "fine don't let the door hit your ass on the way out". We don't care, we can't care, because there are hundreds of you and it adds so much to the pile.

13) yes, a lot of us are working from home. Yes, a lot of the employees are from overseas. Yes, the costs of things suck. But if you try and engage us in any of those topics, the best you're getting is a non-committal response because and I can't stress this enough, we NEVER KNOW WHO IS LISTENING. So stop trying to get that agreement tell me what you wanted and go away.

14) if it sounds like a script it probably is. I get graded on my opening AND my closing and if I miss even a beat of it I get points off. So please. Don't hang up. Don't try and "uh-huh" every 2 seconds so we stop. Just listen and deal. Oh and please for the love of heaven, don't tell us "no I'm not taking the survey". What am I going to say to that, huh? Esp when, again, those do affect our jobs. Just say good day and hang up.

15) answer the question you were asked! This applies in both simple things (I end my greeting with "who do I get to help today" and the number of times people skip their name entirely or only give me their first name drives me up a wall) and in more complex questions. If I'm asking a clarifying question about a story you just told me, I don't need the whole story again! I just need that piece of information! You might think you're helping but really I'm sitting there glaring at the screen biting a hole through my lip in the effort to not punch you.

16) speaking of thinking you're helping, STOP INTERRUPTING. If you have something to clarify or think we missed something, keep your mouth shut and be respectful and wait until we stop talking. I hate being interrupted and so often it's something completely useless and I've actually started to very pointedly say "as I was saying" or just altogether interrupt back and say "please don't interrupt me" because "I'm sorry to interrupt but I could answer that question if you let me" was getting me nowhere.

There's probably more but I'm actually getting tired for once so I'm off to bed. The long and short of it- please remember that the person on the other end does not make the rules, does not make the decisions, and is doing their best. And also no their supervisor can't do those either because all of that is back of house and according to the internal phone book they don't exist. Sometimes you get a negative result on something and that's just life.