Tuesday, December 11

Dropping Customers: PacifiCare

Ike Piggot’s Occam’s RazR is a blog to watch for many reasons. Just one of many standout posts tells the story of how Citibank erased the last dime due from his account rather than force him to send a .10 check with a 47-cent stamp.

It’s a great customer service story and a fine example of how social media can catch people doing good. It can also catch them doing not so good.

My customer service story is a bit different, with the amount right around $1,000. That’s right. Our health care provider doesn’t want our payment for November, possibly saving us a grand.

There is catch, of course. PacifiCare would rather drop us. We found out yesterday after my partner was prompted by a past due statement that claims we did not make a payment in November.

We did make a payment in November, just without a payment coupon because PacfiCare was slow to send a new book with an adjusted rate after I moved into the 40-something column. She knew it was going up and even called to find out what the adjusted rate might be. They weren’t sure so she sent a payment anyway.

After she received the past due notice, she called again to let them know that she had sent a payment, but it apparently had not posted. In fact, she even sent yet another payment priority mail once the coupon book arrived, just in case.

The customer service representative thanked her for the call, but said it didn’t matter. According to PacifiCare, we were dropped six week ago (we just didn’t know it). So now, even if they found the payment (or both payments), our only option is to reapply, which is impossible because PacifiCare longer accepts applications from Nevada.

In other words, we were dropped six weeks ago because of PacifiCare policy and were never notified. Or perhaps more accurately, we were slowly dropped starting two years ago, ever since PacifiCare merged with UnitedHealthcare (UNH). Originally, we thought the merger might be a good thing, given the promises emblazoned on the company’s Web site.

“The health care system isn’t healthy. At UnitedHealthcare, we’re committed to improving the health care system. We aim to take what’s wrong and make it right.

We know. That’s a bold statement. But no one is better prepared to lead a heath care revolution than the strongest, most committed health care company in the nation.”

We get it. UnitedHealthcare means that if they cannot service you properly, like sending adjusted payment coupons promptly, they will drop you. And maybe, if you’re lucky, you will even find out. Amazing!

Am I upset? Not at all. Thank you PacfiCare, UnitedHealthcare, and UnitedHealth Group. Your lack of customer service has prompted us to find a better health care provider with a better plan at half the cost. We appreciate it.



Anonymous said...


I would check with the Nevada Attorney General's office. Dropping you in this way doesn't sound legal to me.

To your point: What the heck is wrong with the insurance industry? They never change; they always operate based on their bottom line; they are uncaring; and they do little to focus on people.

Rich on 12/11/07, 11:37 AM said...

Thanks Lewis,

Good advice.

We are going to see how they handle the Nov. payment, and the last medical follow up for our daughter in Nov.

Our understanding is that if they accept Nov. payment (sent twice), then we might be covered through Dec. until our new plan kicks in.

We're very fortunate that we were looking to change providers after PacifiCare's customer service diminished. Had we not already had something in the works, it might have been more difficult to be accepted by a new provider.

You are exactly right. Many insurance companies, who would be better served by being people centric, are as far removed from people as possible.

I have to admit, retroactive customer dropping is a new one on me.


Rich on 12/11/07, 11:44 AM said...

Seems we are not alone...

"UHG officials said that PacifiCare lost 315,000 customers this year, a problem which they attributed to customer service problems. They also admitted that both doctors and customers were frustrated by its efforts to integrate PacifiCare into its overall operations." — FierceHealthcare.com, Dec. 5

Hawksdomain on 12/11/07, 11:55 AM said...

Well, I don't know about Nevada, but I do know that United HealthCare is a dirty word here in Kansas. Both on the side of the patient and the side of the doctors offices.

I wish you much luck in dealing with them. :)

Kim on 12/11/07, 12:13 PM said...

Dealing with PacifiCare is one's worst nightmare come true. I called them from my hospital bed the day after my daughter was born requesting forms to add her to my policy. I returned the forms within days of receiving them, but I sent them back priority mail with delivery confirmation (because I knew from experience not to trust PacifiCare).

A month later, the hospital called to tell me that my daughter, who was born premature and stayed in the hospital's NICU for THREE months, was not covered. When I called PacifiCare, they denied ever receiving the forms.

They only resolved the issue AFTER I called their PR person and told her I planned to write an article about their practices. Any time you call, their reps need to "email another department" for answers and say they'll call you back in 3 days, which they never do.

Every interaction with them was filled with inaccuracies and false promises. If you call back three times with the same question, you will get three reps who will give you completely different answers.

They gave me nothing but grief for $1,212 per month (really).

PacifiCare is the poster child for what is wrong with our health care system today.

Sweet Tea on 12/11/07, 12:46 PM said...

Thanks Rich. I had some dealings with these wingnuts too once. If you think they're bad, though, you should try dealing with Charter Cable. What a nightmare!

Anonymous said...

nightbird says...

Long ago before mergers I had coverage by Pacificare. I was told that the things the reps who came to our company to sell them to us said were not necessarily true. Huh? After I had been laid off and had one month left of coverage it took them months to pay the doctor, I assuming that hoping I'd give up and pay it myself.

As for charter, my internet provider....three service calls to install the origional modem and three to upgrade it to wireless, and snotty customer service reps saying that they might have to charge me. The only reason Charter stays afloat is city contracts or their customers would leave en masse too

Rich on 12/12/07, 9:44 AM said...

Thank you all. I am always hopeful this will work out for the best.

Amazingly enough, UGH is claiming today that it promises to do better while these kind of instances continue. The promises have taken hold enough to give them a little stock bump. I might recommend consumer probing before UGH is released from it's past infractions.

Likewise, I have heard Charter customer service lacks as a company more times than I can count.

Really, it's not so difficult to be a better company.



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