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A short conversation with Blue Shield of California last month: BS: Have a question? Ask us via this very useful secure messaging form! Me: Great! Can you exp

A short conversation with Blue Shield of California last month: BS: Have a question? Ask us via this very useful secure messaging form! Me: Great! Can you explain the difference between these two arcane out-of-pocket limits that you display that are un-Googleable and nowhere in your documentation that I can never find anyway? BS: Sure! We will wait two days and then send you an email suggestively titled "a response to your inquiry" that really just contains an attached PDF with a link to a completely different portal where you have to register a new account to download an image of a scanned fax that tells you to call customer service where you can wait on hold forever to answer whatever question it was you had that we also don't remember! Yay secure messaging! Me: Wow such technology! I now very understand the difference between "out of pocket max" and "max out of pocket max"! I feel much secure that I won't go bankrupt the next time I have an incident and get treated by the wrong doctor at the right hospital! Thanks, 2022! Fin.

ethbr0 5y ago
Generally, anything not-for-profit and older than 40 years is a technological shit-show. There's neither the individual or management will to successfully migrate or upgrade at the pace required. Consequently, everything is held together with duct tape and person-hours.
- tvanantwerp 5y ago
  I worked for a 80+ year old non-profit. Their tech was definitely a shit show before I turned it around. I won't be surprised if it ends up degrades into a shit show again in a decade or so.
  - hadlock 5y ago
    Almost immediately after you left, they promptly lost the admin password, Phyllis in accounting said, "why don't we just go back to copy machines and filing cabinets, we know how those work" and they unplugged all your computers.
    - Angostura 5y ago
      This may me hyperventilate, because I've been there - except in my case I hadn't left, I'd simply gone on holiday for 2 weeks.
- dmitriid 5y ago
  > Generally, anything not-for-profit and older than 40 years is a technological shit-show. Everything new is the same. Because everything has to be disruptive innovative hockey stick growth bullshit. Here's a screenshot of tha app for a Swedish bank, Klarna: https://pbs.twimg.com/media/FHXG5bPX0AIC1oe?format=jpg&name=4096x4096 https://pbs.twimg.com/media/FHXG5bPX0AIC1oe?format=jpg&name=.... They are a bank. They offer credit cards, and fast online credit payments. And no, "Payments" isn't a list of your payments you've done throught them, that's behind two or three clicks now. It's what you owe them.
  - climb_stealth 5y ago
    What the actual fuck. If you ever come to Australia the Commonwealth Bank and Australia Post apps are two examples to restore faith in humanity. They are functional, practical, reasonably intuitive and they keep improving with actual valuable and handy features. Every now and then it still boggles my mind when I use them. Whenever there is a request for reviews I make sure to mention it. I hope the dev team is paid well because they clearly deserve it.
    - dmitriid 5y ago
      To be fair, the other bank I use, Handelsbanken, is also sane: displays all the info you need, gives you quick access to functionality etc. Not without its issues, but Klarna takes the cake :))
salawat 5y ago
Oh wow. Blue Cross hosed that? Max Out of Pocket: This is the yearly maximum accumulation that an insured individual must pay before the insurer takes on full financial responsibility for subsequent claims. This comes in generally one of two flavors: a family or individual. The individual is straightforward. If you have a MOOP of $1000, and you've paid out $1000 in copays or coinsurance after meeting your deductible on just you, you no longer owe any contribution on claims for you, for that year. However, someone else in your family on your insurance will have to have their copays/coinsurance paid until either their individual MOOP is hit, or between the two of you you accunulate enough for the family MOOP to kick in, which depending on the nature of the plan, will start covering expenses for everyone else in the family unit. Out_of_pocket_max is likely the individual MOOP. Max_out_of_pocket_max is probably a terribly named family or Group MOOP. These should not be confused with policy or lifetime maximums, which are caps to the amount of a specific benefit the insurer is willing to pay out for you as an individual period. I know for a fact places screw that all up. I spend a large chunk of time making sure things like that do not stick around.
- monktastic1 5y ago
  https://imgur.com/a/t7M2RGv https://imgur.com/a/t7M2RGv When I called, I was told that it's there to show that the OOP max for in-network and out-of-network providers isn't summed to get my total OOP max; instead it's just equal to my OON OOP max. (Of course, this plan makes it hard to go bankrupt, unlike all ACA plans. That was a bit of literary liberty.)
  - salawat 5y ago
    Ah... So they're differentiating MOOP levels they'll honor based on the provider in question. I'm guessing they probably have some funneling arrangement that recoups the extra spend they'd incur from the potentially more frequent MOOP attainment in network. Cute, but it really kinda sidesteps the concept of "Max out of pocket". I sense an MBA at work.
    - monktastic1 5y ago
Swizec 5y ago
> go bankrupt /../ the wrong doctor at the right hospital This is the real problem. If we could solve that, none of the rest would be an issue.
- Antipode 5y ago
  I thought that was already solved by the No Surprises Act that went into effect this January.
  - geoduck14 5y ago
    >I thought that was already solved by the No Surprises Act that went into effect this January. Are you serious? Is this a real act? We need an act of congress to not be surprised by health care?
    - mgkimsal 5y ago
      It seems that it is indeed real, but I suspect it will take a while before it's common knowledge and actually has teeth (but I'm a bit cynical).
alasdair_ 5y ago
This sounds exactly like my kids school district. They send an email telling you you have a "secure message" and you need to log in to see it. So you try to sign up to see the message, but can't because you don't have the password. So you try calling them and they say they will reply via email. What they mean is that they will send you a secure message about your inability to receive secure messages. So you call again and they transfer you to a number that is only open between 9am and 4pm on weekdays. So you call back on Monday and, because this is the start of term, can't get through, like, at all, ever. So eventually on Wednesday you get through and they transfer you again, only this time you manage to invoke XKCD 806 and get a real person who knows how to "reset" the password you never set in the first place. So you finally manage to log in to the secure messaging portal and look at the email. Oh, it's a PDF download. You download the PDF and see it's a physical letter that has been scanned in to the system manually (seriously!). The letter? The reason you went to all this trouble? It's a welcome letter to the new "secure messaging" platform, with instructions about how to reset your password...
- IG_Semmelweiss 5y ago
  Banking, health insurance, education I see a trend!
  - pas 5y ago
    It's not like Google or Amazon is better in customer friendliness. (Amazon at least has a working customer service where they get you a refund even if they have absolutely no idea wtf happened to your precious order.)
    - plankers 5y ago
      even when you keep making new accounts and "losing" the packages!
- yarky 5y ago
  Next time just fill out the "forgot your password" form.
professoretc 5y ago
> get treated by the wrong doctor at the right hospital! In California, this shouldn't happen. If you go to an in-network hospital, all care providers you see are required to bill you at the in-network rate.
- monktastic1 5y ago
  Unfortunately, I don't actually live in California.
- bfdm 5y ago
  Great, now just do the same thing for making all hospitals in the state (and later the nation) forced to bill at "in network" rates. then with a final step of capping the premiums paid according to income with the rest automatically covered by social programs, the USA might finally get to something sort of like a sane healthcare system.
- anonymoushn 5y ago
  Last time my wife went to a hospital in California, they delayed care by like half an hour over insurance and then didn't use it, so she got to spend a few days on the phone half a year later when each doctor who managed to visit the room for a few seconds sent us separate bills at the uninsured rate.
geoduck14 5y ago
I heard somewhere that telegraph is a legitimate form of communication for some official routes - unless they aren't specifically prohibited. Has anyone tried this? I would reallt like to force my bank to respond to my telegraphs... or pony express letters
- buttocks 5y ago
  In the US, telegram service ended in 2006! https://www.nbcnews.com/id/wbna11147506 https://www.nbcnews.com/id/wbna11147506
- dan-robertson 5y ago
  At my university there was a rumour that you were still allowed to submit your thesis in Latin. I think some people were tempted to try it but I’m not aware of anyone who did (or who pored over the regulations to find out if it was true)
  - erik_seaberg 5y ago
    I’m reminded of the unconfirmed stories of a student who exercised “Gentlemen sitting examinations may request and require Cakes and Ale,” and was given burgers and soft drinks but fined for failing to wear a sword.
    - rocqua 5y ago
      I was told this story in Cambridge by the person piloting our gondola.
      - charsi 5y ago
        It is called a "punt".
p1esk 5y ago
A short conversation with Medicare: Never happened. They never pick up the phone, and they don't have any other way to contact them after you applied for benefits. I tried for weeks to resolve an issue with an application for my father, a dozen of calls, every time being on hold for hours. Sometimes the automated system says "leave your number and someone will call you back tomorrow at a certain time". That's a lie, no one has ever called back.
- throwoutway 5y ago
  If this is what we have to look forward to when Congress eventually makes a nationwide health insurance, I’m not going to be happy
  - bscphil 5y ago
    Wait, so the two examples given are someone who can't figure out what their out-of-pocket costs will be, and someone who hasn't heard back about an application, and your conclusion is that universal health insurance, which wouldn't have any out-of-pocket costs or out-of-network doctors and wouldn't have applications because everyone would already have it ... would be a bad thing? That seems a very strange conclusion to me. Health care in the US is a mess right now, public or private, largely because of the mess caused by extreme privatization. Half of the problems people have with health care would vanish overnight if we had universal health coverage.
    - protomyth 5y ago
      I assure you the full health care provided by IHS would cause a new revolution if applied to the rest of the US population.
  - adgjlsfhk1 5y ago
    it still will be better than what we have now. medicare spends 95% of it's budget on health care. most private insurance spends 20 to 30% on hiring people to make up reasons to deny your claim.
  - 5y ago
Fritsdehacker 5y ago
Email from the dutch government: You have a message from <organization>. Log in to My Government to view. Me: logging in to My Government using DigiD, which takes some effort, like five steps between two different sites and an app, but at least seems to be secure. My Government message: you have a message from <organization>. Log in to <organization> portal to view message. Me: Logging in to <organization> portal, again using DigiD (same steps). <organization> portal message: There is a new document for you to download at My Documents in our portal. Me: Wow, I don't even have to log in again, that's great! Document is not in the list, though. O, you have to select unread documents, otherwise you only get the old ones. Sure, makes sense. Document: You student loan interest has been changed. We will send you your new monthly repayment amount soon. Me: Great, glad I spent an hour finding out what was in that document...
agumonkey 5y ago
My ex job at a courthouse, handwriting documents by pencil was about as performant as using C vs python compared to the computing system. There needs to be a large computing swipe to turn the tool back into a tool and not a straightjacket. Companies incentives are just not there.

ethbr0 5y ago

Generally, anything not-for-profit and older than 40 years is a technological shit-show. There's neither the individual or management will to successfully migrate or upgrade at the pace required. Consequently, everything is held together with duct tape and person-hours.

tvanantwerp 5y ago
I worked for a 80+ year old non-profit. Their tech was definitely a shit show before I turned it around. I won't be surprised if it ends up degrades into a shit show again in a decade or so.
- hadlock 5y ago
  Almost immediately after you left, they promptly lost the admin password, Phyllis in accounting said, "why don't we just go back to copy machines and filing cabinets, we know how those work" and they unplugged all your computers.
  - Angostura 5y ago
    This may me hyperventilate, because I've been there - except in my case I hadn't left, I'd simply gone on holiday for 2 weeks.
dmitriid 5y ago
> Generally, anything not-for-profit and older than 40 years is a technological shit-show. Everything new is the same. Because everything has to be disruptive innovative hockey stick growth bullshit. Here's a screenshot of tha app for a Swedish bank, Klarna: https://pbs.twimg.com/media/FHXG5bPX0AIC1oe?format=jpg&name=4096x4096 https://pbs.twimg.com/media/FHXG5bPX0AIC1oe?format=jpg&name=.... They are a bank. They offer credit cards, and fast online credit payments. And no, "Payments" isn't a list of your payments you've done throught them, that's behind two or three clicks now. It's what you owe them.
- climb_stealth 5y ago
  What the actual fuck. If you ever come to Australia the Commonwealth Bank and Australia Post apps are two examples to restore faith in humanity. They are functional, practical, reasonably intuitive and they keep improving with actual valuable and handy features. Every now and then it still boggles my mind when I use them. Whenever there is a request for reviews I make sure to mention it. I hope the dev team is paid well because they clearly deserve it.
  - dmitriid 5y ago
    To be fair, the other bank I use, Handelsbanken, is also sane: displays all the info you need, gives you quick access to functionality etc. Not without its issues, but Klarna takes the cake :))

salawat 5y ago

Oh wow. Blue Cross hosed that? Max Out of Pocket: This is the yearly maximum accumulation that an insured individual must pay before the insurer takes on full financial responsibility for subsequent claims. This comes in generally one of two flavors: a family or individual. The individual is straightforward. If you have a MOOP of $1000, and you've paid out $1000 in copays or coinsurance after meeting your deductible on just you, you no longer owe any contribution on claims for you, for that year. However, someone else in your family on your insurance will have to have their copays/coinsurance paid until either their individual MOOP is hit, or between the two of you you accunulate enough for the family MOOP to kick in, which depending on the nature of the plan, will start covering expenses for everyone else in the family unit. Out_of_pocket_max is likely the individual MOOP. Max_out_of_pocket_max is probably a terribly named family or Group MOOP. These should not be confused with policy or lifetime maximums, which are caps to the amount of a specific benefit the insurer is willing to pay out for you as an individual period. I know for a fact places screw that all up. I spend a large chunk of time making sure things like that do not stick around.

monktastic1 5y ago
https://imgur.com/a/t7M2RGv https://imgur.com/a/t7M2RGv When I called, I was told that it's there to show that the OOP max for in-network and out-of-network providers isn't summed to get my total OOP max; instead it's just equal to my OON OOP max. (Of course, this plan makes it hard to go bankrupt, unlike all ACA plans. That was a bit of literary liberty.)
- salawat 5y ago
  Ah... So they're differentiating MOOP levels they'll honor based on the provider in question. I'm guessing they probably have some funneling arrangement that recoups the extra spend they'd incur from the potentially more frequent MOOP attainment in network. Cute, but it really kinda sidesteps the concept of "Max out of pocket". I sense an MBA at work.
  - monktastic1 5y ago

Swizec 5y ago

> go bankrupt /../ the wrong doctor at the right hospital This is the real problem. If we could solve that, none of the rest would be an issue.

Antipode 5y ago
I thought that was already solved by the No Surprises Act that went into effect this January.
- geoduck14 5y ago
  >I thought that was already solved by the No Surprises Act that went into effect this January. Are you serious? Is this a real act? We need an act of congress to not be surprised by health care?
  - mgkimsal 5y ago
    It seems that it is indeed real, but I suspect it will take a while before it's common knowledge and actually has teeth (but I'm a bit cynical).

alasdair_ 5y ago

This sounds exactly like my kids school district. They send an email telling you you have a "secure message" and you need to log in to see it. So you try to sign up to see the message, but can't because you don't have the password. So you try calling them and they say they will reply via email. What they mean is that they will send you a secure message about your inability to receive secure messages. So you call again and they transfer you to a number that is only open between 9am and 4pm on weekdays. So you call back on Monday and, because this is the start of term, can't get through, like, at all, ever. So eventually on Wednesday you get through and they transfer you again, only this time you manage to invoke XKCD 806 and get a real person who knows how to "reset" the password you never set in the first place. So you finally manage to log in to the secure messaging portal and look at the email. Oh, it's a PDF download. You download the PDF and see it's a physical letter that has been scanned in to the system manually (seriously!). The letter? The reason you went to all this trouble? It's a welcome letter to the new "secure messaging" platform, with instructions about how to reset your password...

IG_Semmelweiss 5y ago
Banking, health insurance, education I see a trend!
- pas 5y ago
  It's not like Google or Amazon is better in customer friendliness. (Amazon at least has a working customer service where they get you a refund even if they have absolutely no idea wtf happened to your precious order.)
  - plankers 5y ago
    even when you keep making new accounts and "losing" the packages!
yarky 5y ago
Next time just fill out the "forgot your password" form.

professoretc 5y ago

> get treated by the wrong doctor at the right hospital! In California, this shouldn't happen. If you go to an in-network hospital, all care providers you see are required to bill you at the in-network rate.

monktastic1 5y ago
Unfortunately, I don't actually live in California.
bfdm 5y ago
Great, now just do the same thing for making all hospitals in the state (and later the nation) forced to bill at "in network" rates. then with a final step of capping the premiums paid according to income with the rest automatically covered by social programs, the USA might finally get to something sort of like a sane healthcare system.
anonymoushn 5y ago
Last time my wife went to a hospital in California, they delayed care by like half an hour over insurance and then didn't use it, so she got to spend a few days on the phone half a year later when each doctor who managed to visit the room for a few seconds sent us separate bills at the uninsured rate.

geoduck14 5y ago

I heard somewhere that telegraph is a legitimate form of communication for some official routes - unless they aren't specifically prohibited. Has anyone tried this? I would reallt like to force my bank to respond to my telegraphs... or pony express letters

buttocks 5y ago
In the US, telegram service ended in 2006! https://www.nbcnews.com/id/wbna11147506 https://www.nbcnews.com/id/wbna11147506
dan-robertson 5y ago
At my university there was a rumour that you were still allowed to submit your thesis in Latin. I think some people were tempted to try it but I’m not aware of anyone who did (or who pored over the regulations to find out if it was true)
- erik_seaberg 5y ago
  I’m reminded of the unconfirmed stories of a student who exercised “Gentlemen sitting examinations may request and require Cakes and Ale,” and was given burgers and soft drinks but fined for failing to wear a sword.
  - rocqua 5y ago
    I was told this story in Cambridge by the person piloting our gondola.
    - charsi 5y ago
      It is called a "punt".

p1esk 5y ago

A short conversation with Medicare: Never happened. They never pick up the phone, and they don't have any other way to contact them after you applied for benefits. I tried for weeks to resolve an issue with an application for my father, a dozen of calls, every time being on hold for hours. Sometimes the automated system says "leave your number and someone will call you back tomorrow at a certain time". That's a lie, no one has ever called back.

throwoutway 5y ago
If this is what we have to look forward to when Congress eventually makes a nationwide health insurance, I’m not going to be happy
- bscphil 5y ago
  Wait, so the two examples given are someone who can't figure out what their out-of-pocket costs will be, and someone who hasn't heard back about an application, and your conclusion is that universal health insurance, which wouldn't have any out-of-pocket costs or out-of-network doctors and wouldn't have applications because everyone would already have it ... would be a bad thing? That seems a very strange conclusion to me. Health care in the US is a mess right now, public or private, largely because of the mess caused by extreme privatization. Half of the problems people have with health care would vanish overnight if we had universal health coverage.
  - protomyth 5y ago
    I assure you the full health care provided by IHS would cause a new revolution if applied to the rest of the US population.
- adgjlsfhk1 5y ago
  it still will be better than what we have now. medicare spends 95% of it's budget on health care. most private insurance spends 20 to 30% on hiring people to make up reasons to deny your claim.
- 5y ago

Fritsdehacker 5y ago

Email from the dutch government: You have a message from <organization>. Log in to My Government to view. Me: logging in to My Government using DigiD, which takes some effort, like five steps between two different sites and an app, but at least seems to be secure. My Government message: you have a message from <organization>. Log in to <organization> portal to view message. Me: Logging in to <organization> portal, again using DigiD (same steps). <organization> portal message: There is a new document for you to download at My Documents in our portal. Me: Wow, I don't even have to log in again, that's great! Document is not in the list, though. O, you have to select unread documents, otherwise you only get the old ones. Sure, makes sense. Document: You student loan interest has been changed. We will send you your new monthly repayment amount soon. Me: Great, glad I spent an hour finding out what was in that document...

agumonkey 5y ago

My ex job at a courthouse, handwriting documents by pencil was about as performant as using C vs python compared to the computing system. There needs to be a large computing swipe to turn the tool back into a tool and not a straightjacket. Companies incentives are just not there.