There is no "care" in Health Care

Perhaps my expectations are not set properly. Are we "customers" of the health care system or financial burdens?

Over a week ago I requested a refill for my allergy medicine. This is medication I have refilled several times, but this time I received an automated notice that my prescription cannot be refilled as it needs doctor authorization. How can it need doctor authorization when my doctor prescribed it to me?

So, I call my doctor and they tell me they have to authorize the insurance company. They ask me the same questions they ask every time, have I taken this or that. Yes, I have tried it all and this is one only medication that works for me. Why would I go through all this trouble if there is a solution I can pick up at the grocery store?

A week later my allergies are getting worse and my evenings are miserable. Today I call again, the pharmacy has no update, the doctor says they sent the authorization to the insurance company and they will send a message to my doctor. I decide to call the insurance company, that's when the real fun begins.

I call the contact center at Blue Cross, go through 5 menu options and get a recording that they are in a staff meeting and to call back. They do not offer me the option of leaving a message, the automated attendant actually said they are in a staff meeting, call back and then disconnected my call. WOW, that's the worst possible customer experience.

Thirty minutes later I call again and this time I skip the menu options and get right to a person. They, of course, can't help me. They transfer me to the "pharmacy" department where I give my member id, birth date, address and describe my problem AGAIN! This agent isn't very friendly, but I'm not very friendly at this point either. She asks me if they filled out a specific form. How am I supposed to know what forms they have to send back and forth? I'm a patient trying to get my allergy medicine, not an expert in claim processing. She tells me I need to call my doctor as they don't have the authorization. My doctor told me they sent the authorization a week ago, so it's clear that I am lost in this inefficient process.

I call my doctor's office again, only to have them tell me they will send my doctor another note. That's helpful!*#! Meanwhile, my eyes are puffy, I'm sneezing and enjoying all the allergens California has to offer. I'm lost in our health care system and I'll probably go down today and pay the $123 for the prescription and put us all out of this pain.

This experience demonstrates another challenge organizations face in managing their customer experience, partnership. How does your ecosystem affect your customer experience? While the health care system may not care if I'm a customer or not, organizations focused on growth need to understand how their partners affect the customer experience and eventually loyalty. If we weren't trapped in health care options based on the selection of our employers, I would be looking for a new insurance company today.