This Is How It Works?

I love explaining things.  I should never be a teacher, I don’t have the temperament for that.  But, sharing my knowledge is enjoyable.

Look at me, helping people improve themselves.

I try to be my modest and entertaining self while I’m doing it so that it’s fun for everyone.  No learning from rote at Galby U.

One of my favorite examples of educating people comes from my days at Meier & Frank here in Portland around the turn of the century.  Like any department store, the end of season involved big discounts.

25% off

33% off

50% off

75% off

That was just the beginning.  To keep it fresh, we would run “additional percent off” clearance sales.

It’s amazing how difficult customers made this.

Everyone know how math works?  Yeah?  You would think so.  Alas.

The reason why I’m not a teacher is because when people would read these sale signs, the fixture would be signed at 50% off and we’d throw a topper on it that said, “TAKE AN ADDITIONAL 25% OFF”…we weren’t shy about promoting great deals like this in our store.

me-and-lil-chris
Me with bad hair and Lil Chris

 

Watching someone’s lips move as they read the signs to themselves became a warning to me to be somewhere else to avoid the impending frustration.  One of my most favorite co-workers, Little Chris, had the temperament for those conversations…bless her heart.

But, until I learned how bad the unwashed masses could be at math, I gamely engaged customers about all the great deals they were holding.  Only to be met with, “Right?!?  75% off!”.

Looking back at the 50% off fixture with the “extra 25” topper on it, I chuckled and replied, “Pretty close anyway” before realizing they weren’t being funny.

Oh, the humanity.

So, I’d explain the difference:

$100 x 75% = $25, right?

Agreed.

Moving on to example B:

$100 x 50% = $50, right?

“Yes, but the sign says it’s and extra 25% off.  50 + 25 = 75!” I would hear from the beaming face before me, with all the patience of someone dealing with an idiot.

Irony.

“Yes, so back to our $100 question…50% off is $50, and then – as the sign says – you take an extra 25% off of that.”

$50 x 25% = $37.50, get it?

Usually they didn’t.

After witnessing one of these exchanges – when I had reached the point of avoiding those intellect travesties – one of the other Sales Managers in the Men’s Department pulled me aside and told me how much she missed the “This is How it Works” signs, and then told me about how they had columns where you would find the price and then it would break down the whole thing for the customer.  Because we were still using flip phones back then and they didn’t have the handy dandy calculator that the smart phones have nowadays.

I thought this was amazing and asked her why we didn’t still use them.  Her response was something along the lines of “It makes customers feel stupid”.

Really?  Because you can’t read English or solve a fairly simple math equation.  We certainly had our nerve.

Meier & Frank’s solution to avoid making their customers feel stupid, was – in and of itself – pretty stupid.

From a financial standpoint.

From a customer service standpoint, big win.  Amazing.  We began hard-marking each sale item and changed all of the verbiage on our signs to read, “Price Marked is xx% Off Regular Price”.

The cost of printing all new signs for all – I dunno – 50 stores?

Huge.

The cost of labor to do tens of thousands of markdowns each week?

Huger.

So, suddenly, no more math at Meier & Frank…just reading.

The reason I told that story is because I think I became the customer in a recent situation.

Back in August, I had to see a doctor in a semi-emergent situation.  Rather than going to the ER at 9:00 on a Saturday night, I went to Zoomcare.  It’s a great set up, you go online, see the menu of locations, providers and their open appointments, book a time:  presto, cured.

screen-shot-2016-10-04-at-2-23-44-pmIt’s where I went when I injured my sciatic nerve getting out of this guy’s bed.  Guess who my doctor was?

Yeah, buddy!

Woof!

By the way, even after I met him – I’m pretty sure that he plays for my team – I couldn’t stop thinking about the fallout from an inter-office romance between Doctor Hottie and Doctor Jennifer.  If they got married, she would be Jennifer Lawrence!

It’s really amazing that no one has snatched me up, isn’t it?

So, here I am, single and taking myself to see Doctor Hottie on a Saturday night.  I’d completed my patient profile on line and they just needed to take a copy of my Insurance Card when I arrived and I was good to go.

Except

This is my life we’re talking about here, so the soft authorization they attempted to verify my insurance came back “Coverage Terminated”.

Naturally.

I was given the option to self-pay.  Well, it wasn’t an option…it was self-pay or the highway, so I chose to pay for my office visit out of pocket, confident that everything would come out in the wash on Monday.

Plus, it was only $145 for the office visit.  Seemed like a good deal and they would credit my card for the difference once my insurance coughed up its share.

Two weeks later, I call to check up on the situation.

They had done nothing.

“Could you?”, I ask.

“Well, it says your coverage was terminated when we run it through.”

“Given any thought to calling?”

“No, I can do that…it’s no problem.”

I had actually already called them and verified my coverage, so I was just waiting for them to catch up.  I amused myself with the notion that this peppy young woman in the Zoomcare call center had parents that were probably customers of mine at Meier & Frank.

She calls me back a couple of minutes later – which impressed the hell out of me! – and said that it was all taken care of.  They were billing the insurance customer for my visit and I would have a credit of…” I can hear the math, as she calculates my refund “$240.80! And it should process to your card in the next couple of weeks, depending on your bank’s policy for crediting funds.”

Wait, wait, wait…something is wrong.

Of course.

“Ok, well, I think there is an error.  My office visit was $145 and my co-pay is $25, so i am thinking my refund should only be $120, plus whatever part of that $4 prescription you filled for me.”

She inhales, and I imagine her thinking, “Here we go…again!”

But then she says, “Well, this is how it works” – priceless – “when we can’t verify insurance at the time of your visit.  You pay the self-pay price of $145 for your office visit and then, once we verify your insurance, we bill them for our actual cost of an office visit – which is $301.”

“Well…that seems crazy.  I’m glad I don’t have your jo”

“Wait!”, she interjects.  “The insurance company only allows $150 for an office visit, so my number is wrong.  They are reimbursing us for $125, so your balance will be $20, since you paid $145 in the clinic.  How would you like to pay that?”

That didn’t sound right.

I chose this moment to practice my silence.

“No…hold on…that’s not right either.  Maybe I should have someone call you back?”

An adult?

“That would be great” I say, again telling her that I don’t think I would want her job.

The short of it is, I owed my $25 co-pay and was being credited back for $124, which included the reimbursement for the self-pay price of the office visit and the $4 for the prescription.

It could have been much worse.

Still, I couldn’t help asking for clarification on the pricing once I got the billing specialist on the phone.  “Why is self-pay pricing less than insurance pricing?  I would think it would be the same.”

The answer made my head hurt.

It all comes down to two things.  I think:

A) Zoomcare offers a discount for people who are self-paying to keep healthcare accessible to everyone.

Everyone?  I think that’s still pretty unaffordable to a lot of pocket books…about 10 hours of work for someone making Oregon’s soon-to-be-minimum-wage of $14.95.  I’d hate to face that on the week rent is due if that were me.  But, still…it’s a nice gesture on their part.

B) If someone has insurance, they are billed $301 for their visit, which is their standard office visit pricing.  Unless, the insurance carrier has a contracted price with Zoomcare – which my carrier did, $150 – and then that is what they are charged.  If the insurance company doesn’t have a contract with Zoomcare, then they are charged $301 and the insured pays their co-pay plus whatever percentage they are liable for when using an out of network provider.  Usually 20-30%, I was informed.

Oh.

My.

God.

I’m sorry, that’s truly an insane system.  Who’s against socialized care?  Jesus.

Best part?

I went back for a follow-up visit a couple days later on August 31st.  Being proactive like I am, I went ahead and told them they would need to call for the approval on that visit, too and self-payed the day of my visit.

Everything was a-ok.

But I still haven’t gotten my reimbursement for that visit.  I called on September 14th and was told that they had just set the wheels in motion on the 12th.

Really?

Can I please have a job where it’s ok to suck at my job?

She assured me that once they received their reimbursement, my card would be credited – say it with me – “in accordance with your bank’s policy”.

It’s October 4th.  I’m gonna have to call these yahoos again.

Because that’s how it works.

This Is How It Works?

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