Tuesday, November 27, 2007

Healthcare in this country is crazy

I only have a couple minutes before my next thing to do, but I needed to post this story before I forget it.

I've always thought the whole healthcare industry in this country is completely insane. I've always had insurance, luckily, but any kind of interaction with the healthcare system has always left me confused/angry. And the way I figure it, I'm a reasonably intelligent person who only has to worry about himself...how much worse must it be for senior citizens, or people with tons of family obligations that leave them with even less free time than I have?

So what incident got me thinking about this stuff again? I went home for Thanksgiving this past week (which was good btw) and found I had a couple letters from Aetna. I had Aetna coverage as part of both of my pre-B-School jobs, and now here in Chicago.

So I open these letters, and each of them have information regarding healthcare claims made on my policy. These claims were processed a couple weeks ago, but the dates of service were in November and December of 2006, respectively.

The items they listed looked relatively standard, a US exam on one, and a series of normal blood tests on the other. The provider was listed as some fund in California, which seemed odd. Then there was the part where they said I owed them over $1200 for those services, because they were both out-of-network and because my coverage had been terminated before the services were rendered.

Whoa....

I fixated on the $1200 part, not even really thinking about the California element. I was livid, convinced Aetna was actively trying to go out of its way to screw me over. I've never had an insurance company make a mistake that accidently gave me more money than I deserved.

Anyway...since it was Thanksgiving, they weren't open to receive customer calls. They weren't open on Friday, or over the weekend either.

OK, so I got back to Chicago on Sunday night, and called them first thing on Monday.

The first Aetna rep I spoke with didn't quite understand what I was saying. I tried to tell him I hadn't been to a doctor for bloodwork in that time, but he didn't seem convinced. He suggested I call up my doctor's office and see what the deal was. Fine, so I called my most recent doctor and asked what the deal was with this extra $1200 in charges. They had no idea what I was talking about, because as far as they were concerned, everything was taken care of and no one owed anyone anything.

Hmmm.....let's try Aetna again...

New representative this time, maybe she would be more helpful. And this time, I was armed with some advice from the receptionist at my old doctor, who said, 'That sucks for you, make sure you document exactly who you speak to and what they say and get confirmation for everything, because they'll try and screw you.'

Good words from a healthcare industry professional.

So I'm talking to the Aetna rep, and I tell her that I'm confused, because I don't recognize the provider or the services.

She goes to get more information on the claims.

"It's for a Dr. Chien in California." she said.

"I've never even BEEN to California!" I said, which is a bit of an stretch, but realistically, I've never seen a freaking doctor in California.

"Can you get more information on the actual procedures?" I asked

"Sure, please hold" she said

I waited for a while, then she came back on the line.

"The first one was an ultrasound and a uterus exam"

Needless to say...I felt as though someone at Aetna should've been a little more on the ball before billing me for this stuff. Like maybe just looking at the file and noticing....'hey, this is a guy, he probably isn't having any ultrasounds done on him'

So with my gender as proof, the Aetna rep agreed to void the claim and work back to see who actually received the services. It didn't help that the doctor's phone line was disconnected (shocking, for someone who clearly doesn't run an efficient operation).

But they've assured me they'll take care of it....we'll see

Sunday, November 18, 2007

Zombies

I decided to take a break from plotting an elaborate revenge fantasy against my cable provider to post another update of the goings on around here.

Last night we had our awards ceremony for the cohort films. So the class is divided into 8 groups called cohorts, and each one makes a film about the school in some way, and they get judged. We got to see the five finalists for best film last night before the award was announced, and I was amazed at the high quality across the board. Apparently, we’ve got many more creatively talented people than I would’ve guessed for a school with a number-cruncher reputation.

They were all really good, it’s too bad only one could win.

But I’m glad that ours did.

http://www.youtube.com/watch?v=1QNE3qxAsoA

That’s a link to our film, winner of the 2007 Golden Gargoyle for Best Film (also winning for Best Actor and Best Dance Sequence). And since the Writers’ Strike has killed a lot of good new television, you probably need something cool to watch anyway.

If you focused really really hard, you might be able to see me in a very bit part. But you probably won’t, and that’s fine by me. I focused most of my time and energy on collaborating with the directors to create the story. Without spoiling the surprise for those who haven’t seen it, it’s a zombie movie, and it’s pretty darn awesome.

Of course there’s been other stuff going on here apart from movie-making. I competed in another case competition yesterday morning, and continued my tradition of playing the role of bridesmaid (without the dress).

So in my first case competition, the judges didn’t select us to advance to the finals, but told us they really liked what we did and that we were the last team eliminated.

I hoped this one would go better, and was looking forward to it because it was asking us to create a growth strategy for a real company, and required us to actually present it to a panel of real consultants. The last competition didn’t require a presentation.

So our team plotted our strategy, made the slides, and presented yesterday morning. And like last time, we didn’t get selected as one of the three finalists. But I talked to two of the four judges from our presentation, and they both had identical things to say;

‘We thought your presentation was fantastic’

‘You were really creative and insightful’

‘You explained things in a phased approach which clients like’

‘You actually addressed issues that most of the groups largely ignored’

‘If you had put any kind of quantitative numbers in at all as for projections, we would’ve put you through’

Our group didn’t project revenues or costs of our strategies, mainly because we had no information to base it on. Our thought process (and our critical mistake) was that it would be better to keep it qualitative as opposed to making a bunch of crazy assumptions for numbers.
So that was a little disappointing, but it was still a really good experience and a good opportunity to actually present something.

Now that’s it’s over, I actually have some time to do some other stuff, you know, like reading for classes.

Saturday, November 10, 2007

I've been parodied...or something

So I saw this video posted as a response to my Kebert Xela video...I'm really not too sure what it is, but I thought it was pretty funny to see myself turned into some kind of cartoon character.

YouTube - eMax - Jeopardy

In other news, school's been pretty darn busy now that recruiting has started.

The good thing is that midterms are over (and they went pretty well with relatively little stress), so recruiting has taken on most of my time.

I did also spend a bunch of time on this presentation as part of a case competition. Basically, a consulting firm sponsored a competition where groups of students formed consulting teams and were given the same hypothetical business problem to solve. It was good to interview a bunch of role-players and get the information. It wasn't as much fun to actually put it all together in a presentation, but we put some serious effort into it.

There were 15 teams, and apparently we came in 6th...which wouldn't have been so bad, except only the top 5 teams made the finals and got to actually present their findings. (of course presenting involved starting at 8 this morning, so there's a silver lining in missing out I guess)

It was a pretty good experience, and I'm interested to see how the next one (next week) goes. I figure I'll try to do as many as possible and try to work with as many different people as possible. That'll have to be helpful.

The recruiting stuff has been pretty much what I expected, although I never really knew what it was like to have companies actually interested in hiring you. Coming out of PSU in one of the worst hiring markets since the depression, let's just say the firms weren't banging down our door. Now it's almost the opposite, there are so many firms competing for your attention, and it's up to each one of us to figure out how to best allocate our time.

I still haven't figured out what the optimal mix is, but I feel like I'm getting better at telling my story and asking good questions. Of course, we won't really know until the winter when I find out if I succeed in getting interviews or not.