I’m glad I have health insurance; I’ve had some health problems, now under control, that were expensive to fix. My insurance company, Anthem, has paid the claims.
Still, I can’t help being impressed by how many actions of this health insurance giant are stupid, wasteful, incompetent and worse. To be clear: I don't claim they're worse or better than the others; they just happen to be the one that I have.
I’ve just had a new stupidity inflicted on me by them that is low on the “it matters” scale, and high on the “a smart high school student could have done better” scale. What's interesting is that while the stupidity itself is minor in the overall scheme of things, it's the result of a serious dysfunction causing widespread trouble and hassle for patients and providers, while adding expense to Anthem. The extra painful thing is that, for anyone with a moderate amount of software knowledge, it could easily be fixed!
When I think about all the big, important, highly paid executives involved in and in charge of this, it does make me wonder whether we’d all be better off if they refused to hire any more people with college degrees for any job, and in particular, management.
The only reason this story is worth telling is that it's not about Anthem; it illustrates how the techniques taught in business and computer science schools and embodied in endless standards and regulations keep large organizations locked into acting in ways that are both expensive and ineffective.
Summary
The root of the issue is my company negotiating a new plan for its employees. Anthem then sent an email (how modern!) welcoming me and inviting me to go digital with card images and an app. I suspect there were self-congratulatory executive meetings about the wonderful modernity of all this. See this for the inexcusably bumbling reality.
A few weeks ago I went to the dentist, got an exam and cleaning and then scheduled for a crown. My dentist submitted claims as usual and got denied, and I received denial EOB's in the paper mail. I sent my new digital card to the office, and that led to another denial and another paper EOB. Finally the office person was able to get through to a human being at Anthem and somehow resolved the issue.
Then I received a survey from one of Anthem's contracted firms to see how impressed I was by Anthem's new plan signup experience. The survey design and implementation resembled a 1995 paper-based process cluelessly "updated" to use, uhhhh, computers.
The whole mess could have been avoided by having a simple system that took incoming claims and checked them against a database of patients and plans, including plans that had been updated and/or replaced. When a claim arrived for a person with a no-longer-in-effect plan, a simple lookup would enable translating it to the new plan information and everything would take place seamlessly, with ZERO action, trouble or inconvenience to patient or provider. You wouldn't even need to send out a survey to ask how the transition went, because it would have been seamless.
An Email asking for Feedback
Some Anthem exec wanted to get some customer feedback about how their new plan roll-out was going. I got an email. Here’s the lead paragraph:
As you’ll guess from my past blog posts regarding Anthem (a summary with links is below), I clicked, hopeful that they’ve gotten moderately competent, but suspecting that some new sophomoric amateur-hour performance will ensue. (BTW, I’ve always been curious about the use of “sophomoric,” since it is the second year of a four year education program. Shouldn’t a performance that’s worse than “sophomoric” be called “freshmanic” or something?)
Sure enough, I clicked, my browser came up and showed me … a blank screen. Yup, nothing. Nada. I refreshed, tried again, same results. Then I thought, “remember this is Anthem we’re dealing with here; what would someone who dropped out of Computer Engineering 1.01 do? Sure, they’d test their stuff on their favorite browser and declare it working!” I strongly suspected that the kid’s (or highly paid seasoned professional with the skill of a kid who dropped out) browser was today’s most widely used one, Chrome. The next one is Safari, Apple’s browser on the Mac. Behind Safari’s share but still with substantial use are Firefox and Microsoft’s Edge. I copied the URL, brought up Edge and plugged it in. It worked! But it failed totally with my Firefox browser. I visit a large number of websites, and this is the first time in years that I’ve gone to a site that managed a complete face plant on Firefox. It takes a certain kind of perverse skill to pull off a feat like that!
With such a great start, who knows what joys would follow? Could this be a candidate for “freshmanic” status??
The Survey
The very first question puts this survey in the running for un-great-ness. Would you take a look at the never-before-seen way for formatting answers to a multiple choice question? With the major choices ending with “that”?
The second question continues the fun.
After asking me whether I remembered receiving this or that communication and answering “no,” the next question was always an huge graphic reproducing what they sent with the question (in effect) now do you remember? Not once -- several times.
Finally came a request to allow Anthem to follow up with me to help improve their experience. To see what would happen, I said yes.
I then got a form in which I was supposed to enter my name, telephone number, email, and best time to reach me. Right. You already know all this. Anthem gave you my email with an ID. All you need to do is give them my answers with the associated ID. That would make it easy for me. Instead, in typical brain-dead, big-corporate manner, you make me enter all the information you already know AGAIN. So NO, I’m not going to fill it in. So I hit Next. What do I get? You can guess, I bet. Yup!
Lots of red with the same questions in red backgrounds. Of course if this stupidity was supposedly all about protecting my privacy, they could have said something about that, apologizing for the inconvenience of entering information they already have. But no. Just ERROR. And I've already agreed to have my answers and identity shared with Anthem!
I could have just closed the browser, but they provided a button labelled “log off.” Which leads to a screen titled “Logged Off,” informing me of my “success” in logging off. But I haven’t “exited” the survey! They close with “Please close your browser to exit the survey.” OMG! If I don’t close the browser I haven’t “exited” the survey even though I’ve “logged off of this survey.” All these years in the business and I’m only just now hearing a new level of sophistication, about how “exiting” and “logging off” are different. Could I possibly screw things up here?
The Anthem Market Strategy and Insights team
I went back to the original email, and clicked on the link “To find out more about Anthem’s research surveys.”
I found out lots of interesting things like how “we’ll never ask for any personal data in our surveys, like social security or ID numbers.” I guess my name, phone, email and (on another question) age aren’t personal. Who knew?
I found out that the geniuses who put together this survey are just one of a crowd:
Always friendly, always available to answer your questions:
I could go on, but what’s the point. Anthem is incapable of doing the simplest kind of market research on their own, so they turned to a bevy of outsiders who can’t do it either, but Anthem can’t tell the difference between good and bad, so who cares? Except it takes a certain kind of genius to consistently pick the worst on multiple dimensions. I guess that’s why they have a “team” working on it – no mere “department” could do it on their own.
How Anthem could leap decades ahead and get to 2010
Anthem doesn't need to invent a thing. All they have to do is copy methods that are decades ahead of the ones they use -- and are quicker, cheaper and more effective to boot. Here are things they could do:
- Make the transition of employees to a new plan seamless.
- The best thing would be to keep the plan number the same and put in a switch to adjudicate and give plan information according to the date of the switch-over. No new cards or numbers, digital or otherwise!
- The next best thing would be to issue new numbers but keep a database of employees/patients enrolled in the prior plan, and automatically update things like newly arriving claims with the old numbers to the new ones as needed.
- If you do one of these you won't need a survey!
- Dump the whole survey thing.
- Track customer actions in detail like modern web companies do and detect when things don't go as they should. If someone isn't getting what they want, detect it and fix it, and give them an opportunity to tell you what's wrong at the time they experience it.
- Track customer actions in detail like modern web companies do and detect when things don't go as they should. If someone isn't getting what they want, detect it and fix it, and give them an opportunity to tell you what's wrong at the time they experience it.
- Dump the whole paper thing.
- I've opted out of paper every way I can at Anthem. I still get loads of paper mail. Why is it so hard?
- Fire your design department and start over.
- I get lots of to-the-point communications from Amazon. Copy them!
- Keep it simple. Test everything in small scale with real people before inflicting it on your customers.
Those are just highlights. There's lots more Anthem could do if their august team of highly experienced professionals would stoop to it. See the next section for some samples.
Past Anthem issues
Just to make it easy for anyone researching giant health insurance company outstanding achievements, here is the list of Anthem issues that I’ve looked into.
Again, I make no claim that Anthem is better or worse than any other insurance company. It’s just the one I experience, so theirs are the stories I tell.
Sometime in 2014 Anthem “lost” tens of millions of patient records. And completely botched telling their customers about it.
I discovered on my own that my data was in the stolen data. Anthem then offered a worse-than-useless plan to “help” me.
Somebody at Anthem decided that I would be cheaper to insure if I acted better and made an expensive botch job of offering a pre-paid card as an incentive.
At one point they decided to send me an email to get me to use a primary care physician they had selected for me. Everything about the experience was a nightmare. A case study in stupidity.
Then I discovered on an offer on Anthem’s website to enable me to pay my patient co-pays. Wonderful idea! Except it doesn’t work. Not just a big screw-up, a huge face-plant.
While I was discovering the joys of Anthem’s inability to help with co-pays, I got and responded to a customer survey. It was a model of how to p*ss customers off, not to mention being decades behind standard practice.
Most recently I discovered that my insurance ID changed and that they botched the change and the wonderful new app that was supposed to replace my card.
Big companies can't build software that works. They can't even do surveys. Hiring people from Big Tech companies doesn't help, because they can't do it either. The good news is, that gives LOTS of room for small, innovative groups that get stuff done that people need, building effective software that works quickly along the way. Hooray!
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