SUMMARY: Disputes about payments and coverage with providers and insurers are increasingly common. What can you do to protect yourself? Keep reading for some advice, or…
“I am SERIOUSLY annoyed,” writes the unnamed post author over on The Health Care Blog. “I just got off the phone with my insurer. I’d called a day ago and spoken to a representative (who was very helpful) about a claim. I called back today to follow up and check on a detail. It quickly became obvious that something was very wrong. I realized immediately what had happened. She’d made a mistake. And left out a minor but important detail on my claim. …”
So the representative didn’t acknowledge her error, the writer said, acting as if the conversation never took place.
“I was outraged. I asked to be transferred to a supervisor. The super listened to me for a minute and then took the side of her employee. ‘Why should I believe you? Can you prove it?’
“‘Can I prove it? I’ve been a good customer for years. I shouldn’t have to prove it!!!’
The question then came: “Can I record my conversation with my insurer? After all, they’re recording me for ‘quality purposes’!!!”
Regulations vary by state
We’re journalists, so we know the answer to this question: Some states have one-party consent for recording conversations (meaning you don’t have to ask, since you are a party to the conversation), and some have all-party consent, meaning everybody has to know and agree.
Here is a good handbook, with a link to state-by-state regulations.
Basically, 12 states require that all parties consent, though there are wrinkles in the law: California, Connecticut, Florida, Hawaii, Illinois, Maryland, Massachusetts, Montana (requires notification only), Nevada, New Hampshire, Pennsylvania and Washington, according to the previous citation and Wikipedia’s helpful directory. Other states and the District of Columbia require only one party to consent.
We hope it won’t come to this in any conversation about coverage, and it seems that the blog post writer did know what was said and by whom, but we always emphasize taking good notes in any conversation about coverage with an insurer or a provider.
These notes should include details like who you called, what you asked, what the answer was, who you talked to, an ID or badge or extension number if possible, and so on. Exact names (and procedure codes) are valuable; dates of effective coverage also. It helps in cases of a dispute like what is described here.
