The Customer Service Point of View

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by By Kathryn Stevens /

KING5.com

Posted on July 1, 2009 at 10:35 AM

Updated Thursday, Nov 12 at 1:52 PM

About the Author

Kathryn Stevens is a Regence Live Help Rep. in Tacoma, WA. She enjoys reading, writing, people-watching, and public transportation (often all at the same time). When it's not raining out, she and her husband take any chance they can get to enjoy the unparalleled beauty of the Pacific Northwest.

When people ask me what I do, I'm sometimes tempted not to mention that I work for a health insurance company. This, after all, is the industry that almost everyone over the age of 23 loves to hate. Michael Moore highlighted the brokenness of the American health care system in his documentary "Sicko," and the criticism (often deserved) has not slowed since.

But when I do break down and tell people what I do for a living, they are usually more interested than appalled. Most of the time, they have a situation to discuss--one they've been trying to puzzle out for a while and just don't know who to ask about it. They've been trying to get a claim paid for their daughter's ER visit, or they know they have two insurances but can't figure out which is primary, or why it even matters. I know the feeling.

Before I worked in this field, I didn't have the slightest clue about how health insurance worked. I equated the whole claims system to a giant roulette wheel that absorbed and then shot out claims in a blur of confusing numbers and inconsistent outcomes. Now, I see the claims system for what it is: a cooperative effort between human and computer processors; a channeling system based on coding and policy rules--much like the careful "if-then" equations in mathematics.

In most complicated claims situations, what is really lacking is information. Unfortunately, high schools and colleges do not offer "Health Insurance 101" courses and our parents didn't teach us the common pitfalls of American health care the way they warned us about bad posture and busy streets. But there are ways to learn this system, and that's where people in my field come in.

I spent the last year of my life working in a world called Customer Service. And my favorite part of the day, without question, is any opportunity I get to teach a member about how their plan works. I could spend half an hour explaining what a pre-existing condition waiting period is, why we send out incident reports, or what "maintenance therapy" is all about. My reward is the newfound understanding and confidence that members have at the end of a call. I know they are now more prepared to use their health insurance coverage wisely and to their advantage. After all, it's your health care--why not understand it like you do your auto or life insurance policy? The results of that knowledge are immediate and rewarding.

Currently, I work as a Live Help representative, chatting online with members about their insurance coverage. And, since you're reading this online, if you have questions about your insurance, Live Help is probably a great resource for you. You can also click on "My Navigator" and view your claims and benefit information. Or you can go to "My Advisor" to research care options for a loved one or news articles about topics like   or  . Need to know how to find a gastroenterologist in your town? Have questions? Click the "Live Help" icon to start. We're here, and we have answers for you. All it costs is a bit of your time. And it's worth it: Understanding your health insurance coverage is truly invaluable.

After people ask me what I do for a living, they invariably ask me if I like it. My answer? "Absolutely!" Every day, I get the chance to learn the ins and outs of one of the most complex industries in the world, and to pass on that knowledge to the members I chat with every day. But the customers are not the only ones who ask questions: I've learned the valuable lesson of asking the questions too. When it comes to insurance knowledge, I don't take anything for granted. So, drop me a line and we'll chat.

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