March 9, 2023
I have recently encountered numerous billing issues with my son’s specialty pharmacy, which is a common challenge for parents managing a child with a rare or chronic illness. The cycle of pharmacy errors, insurance complications, endless phone calls, and paperwork can be overwhelming. Some days, I find myself spending hours on the phone or online—today was one of those days.
To provide clarity for those who may not be familiar with this experience, here’s a glimpse of my morning, which marked the fourth call related to this issue this month.
I dial the pharmacy and navigate through several prompts to reach the billing department.
On hold for 8 minutes. This is a relief compared to my last experience, where I waited 20 minutes.
Customer Service: This is Sarah in billing. How can I assist you?
Having already dedicated three hours this month to this ongoing issue, detailing it repeatedly, enduring hold times of 10 to 20 minutes, and being transferred multiple times, I was eager to speak with someone higher up.
Me: Could I please speak with a billing manager?
Customer Service: I’m in billing. I can help you just like a billing manager would.
Me: We’ve attempted to resolve this issue several times, spending over an hour on the phone each time. I need someone with the authority to address this without further transfers.
Customer Service: Alright, let me transfer you.
On hold for 2 minutes.
Automated Message: Thank you for calling. Are you a new patient, an existing patient, or a provider? Please press 1 for new, 2 for existing, 3 for provider.
I press 2.
Automated Message: What is the phone number associated with this account?
I input my number.
Automated Message: Please hold for our next available patient care advocate.
On hold for 5 minutes.
Customer Service: Thank you for calling. This is Mike in billing. How can I help you?
Me: Could I speak with a billing manager, please?
Customer Service: I’m in billing.
Me: I really need to talk to a billing manager. We have ongoing issues, and I need someone who can resolve them.
Customer Service: Okay, 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, press 2 for existing, press 3 for provider.
I press 2 again.
Automated Message: What is the phone number associated with this account?
Again, I enter my number.
Automated Message: We’re sorry, your order cannot be completed through our automatic refill service. Please hold for the next available patient care advocate.
On hold for 2 minutes.
Customer Service: Hi, this is Lisa in billing. How can I assist you?
Me: May I please speak with a billing manager?
Customer Service: Sure, let me transfer you.
On hold for 15 minutes.
Customer Service: Hi. This is Jenna, and I can try to help you. May I collect some information to send to the manager?
Me: Absolutely.
Customer Service: Do you have an account with us?
Me: Yes.
Customer Service: Is this for you or your spouse?
Me: It’s for my son.
Customer Service: What’s his last name?
Me: Thompson.
Customer Service: Can I have his first name?
Me: Liam.
Customer Service: And his date of birth?
Me: January 15, 2018.
Customer Service: Please verify your zip code.
Me: 12345.
Customer Service: Can you hold for a moment while I contact the billing department?
Me: I’ve already spoken to several people in billing today. I need a manager who can solve this problem.
Customer Service: I understand, but I need to connect with them first. What’s your name?
Me: Jessica Lane.
On hold for 5 minutes.
Customer Service: Ms. Lane, I’m checking back. I’m still waiting for a representative to pick up to request a manager.
Me: Thank you.
Customer Service: Would you like to continue holding, or can I provide a number for you to call back?
Me: I’ve already been redirected multiple times today and spent 40 minutes on this call without any resolution. Is there anyone I can directly reach out to?
Customer Service: Unfortunately, I only have the billing number.
Me: Is it 555-1234? Because I already have that.
Customer Service: Yes, that’s the only number I have.
Me: I spoke last week with a woman named Emily who is a resolution team lead. Can you connect me to her?
Customer Service: Let me see if I can find her.
On hold for 1 minute.
Customer Service: Yes, she is a manager. Let me try to connect you.
On hold for 1 minute.
Customer Service: Ms. Lane, she isn’t answering. Let me check with a supervisor. Can you hold?
Minute 42:37 on this call. On hold for 5 minutes.
Customer Service: Ms. Lane, I apologize for the delay. I’m still waiting for a supervisor. Do you want to keep holding?
Me: I don’t have a choice—this is the usual experience. I’m now 48 minutes in. I’ll stay on the line.
Customer Service: Okay, I’ll keep trying to reach Emily as well.
On hold for 9 minutes.
Customer Service: Hello, how can I help you? [Their voice is barely audible.]
Me: I can hardly hear you. Is there a way to increase the volume?
Customer Service: No, I’m sorry.
Me: Okay, could you repeat that? Are you a billing manager?
Customer Service: No, I’m Alex, a member of management.
[After explaining everything, I held back my frustrations.]
Customer Service: I see a request was submitted last week for billing. I can check the status with the representative who submitted it.
Me: Don’t you want to collect the $35,000 worth of medication that’s currently in my fridge? You can “check with the representative”? When will this be billed, since I’ve had it for three weeks?
Customer Service: I’m not sure what happened before last week. I can only confirm that a request was submitted last week for billing. I’ll reach out to the representative for an update.
Me: And how will I know when this has been billed? My son’s medication costs nearly $400,000 annually, and I won’t place another order until this is resolved.
Customer Service: I’ll look into this. Is your insurance XYZ?
Me: Yes.
Customer Service: I have your phone number as 555-6789. Is that the best way to reach you?
Me: Yes.
Customer Service: I’ll investigate this further. Is there anything else I can assist you with?
Me: No. [Absolutely not.]
Customer Service: Thank you for calling.
Me: You’re welcome.
[Minute 58:59. Phew, I managed to get off the call before reaching the hour mark! But based on experience, this won’t be my last call.]
If you’ve ever wondered what parents of children with rare or chronic illnesses do all day, or why they often seem too busy for coffee or extracurricular activities, remember this account. We can easily spend countless hours advocating for our child’s healthcare needs.
And then we write about it.
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In summary, managing healthcare for a child with a chronic illness can be an exhausting process filled with frustrating calls and continuous follow-ups, often leaving parents with little time for themselves.