aTypical Joe: a gay New Yorker living in the rural South

Wednesday, April 09, 2008

I’m at war with SHPS

Before we begin let me stipulate that I think Flexible Spending Accounts are bad public policy. I sat in the New York living room of a friend arguning as much in 2005, even as I had signed up for a measly $500 in 2006. Well a hernia operation and Sudden Sensorineural Hearing Loss turned that into a bad decision quick!

Anticipating more of the same, I upped my 2007 contribution to $1,500 and monitored it throughout the year. I knew I would come in under, but because my company had a new “2.5 exemption” (we can use medical expenses from January through March 15 of this year against last year’s balance), and because I had not been submitting all of my expenses through the year (mileage, for example, my doctors are in Macon, 45 miles away) I figured I’d adjust things at the beginning of this year.

SHPS don’t like that!

When it came time to do the adjusting, all hell broke loose! I have had to fight lick the dickens to get my money back. And to this minute, April 9, 2008, they are still holding $179 even though I have documented the legitimate medical expense over and over and over again. Here’s my latest email to SHPS:

Ms. Quigley,

I was away for a while, then back and getting caught up. I hope that you have had time to review the [recorded customer service phone] calls* by now. I wonder if you can provide those calls to me so that I can refresh my memory? Without them my memory is limited. Below is the best that I can do.

I remember at least three or four calls. The calls started off very cheerfully. Your service representatives were helpful but not always clear and sometimes confusing. When the first person informed me of a 2007 remaining balance of nearly $600, she acted as if she expected me to get angry.

I did not get angry because I knew there would be a balance. I was, though, surprised and confused at the size of that balance. The confusion was because all through the year I had been getting notices of “Potentially Ineligible Expenses.” I did not know until that call that those expenses were included in the running balance at the upper right of the web page. She explained that they were.

In another call it was explained that my plan did not include a “2.5 exemption.” I argued that it did. The representative, after much looking, ultimately found that I was correct. She then explained that I could not use my SHPS Visa card for those reimbursements. I objected. I asked why and was told something about the card being “emptied” from one year and “loaded” for the next. I argued about the fairness of that.

I have since been told by our Human Resources department that the information that customer service representative gave me was not correct.

In the last call the arguing grew angry. That’s when I sat with my unduly large healthcare records file—the file that contains every receipt for every expense that I have submitted for reimbursement. During that call I was informed for the first time and quite suddenly that I had a $256.80 “overpayment.” An overpayment??? Nowhere on the website is there any mention of an overpayment. In none of the copious correspondence is there any mention of an overpayment. In none of the other phone calls was there any mention of an overpayment. Now, out of the blue, there was an overpayment.

Well, of course, I knew there was no overpayment. But even with all of my records I was at a loss to prove it. And as I rustled through my ungodly large pile of papers trying to find the single one I needed confirming that I had sent a fax I was left sputtering, wondering, what if I didn’t have that one? What if I never received that one? What if I actually lost that one? Then I’d just be lost, wouldn’t I? So, yes, I was angry. Very, very, angry.

I’d love to hear that phone call. Will you provide it to me? As I recall it, in the end I asked, desperately, could I appeal?

Well it turned out that I did have the letter. And the fax receipt. So I faxed it again. And that’s when you got involved. And only then, after who knows how many calls and faxes, did I learn that it was the wrong KIND of receipt. Of course, that was the only receipt that the doctor had given me. So after all of the calls and faxes and service representatives and human resources and visits to the doctor (That’s efficiency??? That’s convenience??? That’s what SHPS has to offer???) I returned to the doctors office and got the correct receipt, faxed that to you—9 business days ago—and the disputed amount has yet to be deposited into my account!!!

So about those IRS requirements you mention… I have no doubt that you are correct. But I want to propose back to you that a company of your size—that does hundreds of millions of dollars in business and has thousands of employees—should have some leverage there. You should be able to do something about those systems. In point of fact, your website boasts precisely that. You say that you are “transforming healthcare” with “health management tools, resources and services.”

I’ve used them. I don’t think so.

Instead I think the receipt I sent you that you ultimately accepted—the one that makes the IRS so happy—could be forged by a 4th grader. In fact, I know that it can be forged by a 4th grader. I work in technology support. So your procedures, if they are designed to thwart theft through false claims, instead thwart only the hundreds, the thousands, of honest people like myself who are merely seeking to be reimbursed with their own funds for their own legitimate healthcare expenses.

Your system thwarts the good guys who are trying to comply and lets the bad guys go free. Those who are trying to scam the system can forge their fake documents like the one I sent you that you accepted. Forgers can easily double the amount for [eye]glasses and have it accepted. Your system doesn’t work! It hurts the good people. It wastes their time, their money, their productivity. It is a sham. What the public is left with is an expensive needless burdensome inefficient system. And deep animosity. I sincerely believe the results of your system have done me wrong.

Now, as promised in my last phone call, I have contacted my congressman, John Barrow, and copied Miss Johnson from his office on this email. But I have since learned that SHPS is a huge provider of services for the federal government and a good many southern states. So if I have to I will expand my quest for allies to include health and other advocacy organizations. I also want to be clear that I do not believe that any individual at SHPS is acting in bad faith. I have no doubt that you and your colleagues are trying to do the best that you can. But I fail to understand how your best efforts leave me without my lousy 179 bucks after all this time and effort.  And for the benefit of Ms. Johnson I will say again that I firmly believe that “healthcare consumerism” is bad policy, but that bad policy has been compounded by very bad implementation.

Sincerely,
Joe Windish

* ABOUT THOSE PHONE CALLS: When you call Chase Manhattan Bank they tell you that they record every call. When you call SHPS they tell you that they may record your call to improve your customer service. But Ms. Quigley told me that she was going to go “pull all my calls.” That sounds to me like they record every call. Is that legal? I have no doubt it is. I should have access to all of those recordings.