I Win!

This week has been a big week for me in the "I Win" department.  Rex may or may not have learned some new crude phrases as I won my various battles against The Man that I won't share here.  But know that more than one happy dance was done.

Now, in order of awesomeness, my victories:

1. Me v. USAA.  This is only the slightest of victories because it was unintended and was due to USAA being pretty awesome and having amazing customer service.  A month or so ago, I got a weird letter from them so decided to call about it.  The issue with the letter was quickly resolved, but then because they are awesome, USAA noticed a few ways they could save me money on my insurance.  Forty-five minutes later, they were saving me hundreds of dollars.  We got statement for our refund check (no check yet) in the mail Saturday.  Refund check means: I WIN!

2. Me v. UnitedHealth Care.  We have pretty minimal health insurance with a fairly limited listed of in-network doctors.  And guess what, mine is not on the list.  Well, guess again?  I won anyway.  After several hours on the phone with UnitedHealth Care, actually visiting a primary care doctor, more time on the phone with her staff, a bit of chatting with my preferred doctor--who got the in network exception?  Me!  Because I win.  Take that The Man.  Currently, I am working with my primary care doctor and her awesome staff to further maximize my insurance benefits.

3. Me v. Time Warner Cable.  Here is where I pulled out the expletives because this is where the fighting got nasty.  A few weeks ago, I was shocked when I opened my internet bill to find that the bill had gone up $11.  No thank you.  Apparently whatever promotion we had was expired.  Well, I don't care my service wasn't $11 better.  So I called Time Warner and after being hung up on several times, transferred to at least 3 different people, having to call back, sit on hold and using that last hour of nap time, I was told by a very unfriendly lady that I should be glad was only paying what I was paying.  No dice.  In all my time on hold, I'd gone back through our Time Warner history and noticed that our bill had increased $25 in 18 months.  Not cool.  Well, the unfriendly lady told me there was nothing she could do, so I said we'd switch providers.  She was not impressed with my semi-idle threats and we parted ways.  That was a Friday.  Over the weekend, I discussed the situation with Greg and we decided that we really didn't want/need to pay that much for internet so we would drop some of our services.  I called back on Monday to drop some of our services and the first guy I talked to agreed that we were paying too much, asked how much I'd like to pay, said he couldn't get me that low but maybe another guy could, transferred my call, and I won again.  Got my bill down by $15--lower than it was before the spike.  .  I got what I wanted.  I win.

4.  Me v. Aetna.  This one merited a 5 minute happy dance as I had lost all hope of actually winning.  You see, over a year ago, on September 26, 2012, Greg went to the doctor and got a new prescription, which he filled later that day.  As he filled it, the pharmacists informed him that Aetna (our insurance company at the time) would only pay for half of the prescription and that we would have to pay the rest out of pocket, which was no small amount.  Greg called Aetna and they said they needed a letter from the doctor saying the prescription was medically necessary (is that what a prescription is though?)  Greg asked the doctor to do this.  She did.  We were later informed that Aetna didn't care what the doctor said, they were still only going to pay for half.  That's when I got involved.  I appealed Aetna's decisions with a letter from the doctor and Greg's medical history from his previous doctor.  My appeal was denied.  Keep in  mind that while all this is going on, we are continuing to pay for Greg's expensive drugs plus over 10% of Greg's paycheck in insurance premiums.  I appealed again with an additional 20 pages of medical history showing that Greg had taken this medication with success in the past.  Denied again.   I appealed again and this time included a 2 page annotated bibliography of peer reviewed journal articles explaining that insurance companies should not dictate the amount of medication a person should take but that should be between the patient and the doctor.  Again, denied because by now it was March and our coverage with Aetna ended in December.  They told me that they could no longer review my claim because we weren't Aetna members.  So I resubmitted my previous appeal with an more in-depth cover letter.  All the while, Greg was telling me not to spend too much time on this as they would never pay up.  I called to check on the progress in May.  Nothing.  They didn't know what to do with the letter so they put it in some "we don't want to deal with" pile.  I had it moved.  Called again in June to check up on it.  Still no progress so I explained the situation again.  July I threaten to sue.  August I spent two hours on the phone just to find out that the doctor the previous year needed to speak to someone at Aetna and not just send a fax.  Are you kidding me?  September I start asking around about a lawyer.  Greg gets a call from Aetna.  They are re-examing our claim.  I decide to be patient.  Two days ago, we get a letter from Aetna.  Greg opened it and said it didn't say anything.  I later reread it.  Aetna finally accepted our appeal and would be re-reimbursing us for four months of Greg's medication.  I happy danced it up and threw in some choice words just for fun.  I stuck it to the man and I WON!!!! No check yet, but that's my chore for tomorrow.

Point is: I'm feeling pretty amazing about my winning skills--I'm about to run a seminar on how to make large corporations actually provide the services you pay for because you don't have to be nice to them.  Legally they may be people, but I'm not so sure that that counts in God's book.  More details on that to follow.