> Posted by Joshua Goldstein aka Mr. Provocative
In the seventh Client Protection Principle, the Smart Campaign lays out the way that financial services providers should handle complaints: 1) Effective client feedback mechanisms are in place; 2) Clients are aware of how to submit complaints and do so as needed; and, 3) Complaints are handled promptly and adequately.
Seems easy and straightforward enough. But making this process truly client friendly is truly a daunting challenge. On the “demand side,” poor customers may feel ill-equipped to pose questions to company representatives who come from a different class, caste, or ethnicity. The Smart Campaign’s Client Voice research found as much in both Asian and African markets. It may be psychologically next to impossible—even in the most client friendly institution.
And if the psychological issue is not an obstacle, the technical and procedural challenges may be opaque enough to lead to failure anyway.
Even educated and savvy consumers can get lost in the complex maze of call center options delivered by that hideously cheerful computer voice – you know the one. “Lower touch” often means “no touch.” And even if a well-meaning customer service representative finally answers the phone and tries to help, he or she may be just a cog in a far flung system – unable to get the needed answers.
I experienced this maddening complexity first hand when I joined a new health plan with a “cost saving” mail order prescription plan. A common medication that cost $75 for a three month supply under my old plan cost $600 under my new plan, or more than seven times as much, according to the health plan website.
“It has to be a mistake, right?”, I said to the call center representative after a long time on hold. When you actually reach a human being, there is almost a kind of species recognition–the excitement of speaking to a fellow human. You want to hug them over the phone.
“Well, no, sir, I looked at your plan again, and that is what it says.”He was truly sorry. I could hear it in his voice. Sympathy among members of the family of the great apes.
Now what? I was not going to take this lying down. Not a master of the universe like me with a litigator’s zeal for combat. I would get the system to see that something had gone out of whack.
The drug plan rep advised me to take up my complaint with the health plan of which the mail order prescription company is a mere subcontractor. The health plan set the rates for the medication, not them. This shuffling between companies also arises in digital financial services, when banks, telcos and third party agents are all involved in a digital transaction and it is hard to determine who is responsible to solve which problem.
When I called the health plan the next day a representative answered within just a few seconds. He was sympathetic, and agreed that this seemed very strange.“I’m gonna put you on hold for a few minutes and get this sorted out,” he assured me. So far, so good.
When he came back on the phone a few minutes later, he said that the price was correct: this was the price the health plan charged for this particular medicine. No mistake. He was sorry but that was the way it was.
At this point, my anxiety was ramping up. Hyperventilation and out of control cortisol levels were surely next. “Oh come on. This is crazy. You can’t do anything? Ok, then who can do something?”
“You can appeal. You need to have your physician send a letter to our review board.”
“And where is that located?”
He wasn’t sure. He thought Salt Lake City. But all the necessary instructions to initiate an appeal could be found on their website.
Don’t panic, I said to myself, panicking. Do I just somehow absorb this extra cost? I had been told by my employer a couple of months before that my new plan’s benefits virtually matched the old benefits with only minor differences. Was this price discrepancy considered a minor difference? Didn’t seem minor to my wallet.
I found information on the website about how to file the appeal. And I contacted my physician’s office and had them “do the paper work.”
Weeks went by and I heard nothing. At this point I reluctantly decided it was time to bother someone from my employer’s human resources department to see if they could expedite things. By this time I was nearly running out of pills. She was great, immediately calling her contact with the health plan. She couldn’t have been more sympathetic or determined to help.
I had a warm feeling inside. Finally, I was on the right track.
Another couple of weeks passed with no response. So she called again and the rep said the appeal was still going on in the Salt Lake City office or wherever it was. Though she didn’t really know, and in any case, there was nothing she could do. It was up to me to get in touch with them directly. “Up to me? Up to me?” I was fuming. What kind of nonsense was this? My HR colleague agreed and promised to put the pressure on. We were not a negligible account and should have some clout.
By then only a couple of pills were left. So should I just pay $600 and get the meds? No. I was going to keep fighting even if my cholesterol (the reason for the pills) was going to spike. This had to have a just resolution. I believed that if I paid I would have no leverage to pursue the fight further. I would have been exhausted into acquiescence. But social justice fighters like me don’t give up on righteous causes easily, especially when it costs us more than $2,000 a year.
In a week my HR friend emailed me sorrowfully to say my appeal in Salt Lake City had been turned down. By now I was in a cardiac red zone, the ticker revving out of control. And I repeated my cri de coeur that by now she had heard ad nauseam about how outrageous this was. But she promised to figure out how to appeal the appeal.
Suddenly, on a day like any other day, the unexpected happened: my HR colleague emailed me that health care account managers urgently needed to speak with me. Something was up. Had the tariff gone even higher because of my complaining?
When I called the health plan not one but two representatives got on the line. People with names, yes names—both first and last. They began by apologizing and continued to apologize throughout the call. It turned out that there was a “coding error,” made no doubt in another far flung office, which had put my common generic drug in the “highest tier.” Clearly, up to this point, no human in the appeals process had ever checked the amount the computer spat out as the price. Not the call representatives, the doctors, the account executives. Not anyone. Computer says, hominid do.
“What can we do to make this up to you? Our company puts our clients first. We are very embarrassed.” The “touch” that had been almost no touch couldn’t have been higher now.
I said something like make sure that you correct your processes so nothing like this happens to anyone else. That is the way you can thank me.
Even an arrogant, Ivy-educated SOB like me was brought to his sobbing knees by this ordeal. Most people would have in resignation submitted to the system long before I did. They would have assumed they were wrong. They might have seen it through the lens of fatalism.
Low income financial services clients don’t have a chance when a system goes as wrong as it did in my case. So setting up a complaint mechanism, as well intended as it is, may not be nearly enough. Say one of our poor customers overpays a loan due to a “coding error” made by some back office operator hitting the wrong key. What happens if this customer calls the complaint hotline? Will they get anywhere? Imagine encountering such a problem with the first financial institution you’ve ever used, and not having a formal education or an employer with business clout.
Big data, big systems, and poor human oversight make it all but impossible for everyone but the most privileged to have a fighting chance to redress their grievances. It is a terrible problem that is only getting worse.
Following this episode, the beleaguered health plan did a thorough review. It turned out that “coding errors” had infected a number of my claims and indeed the claims of some of my colleagues. I recently got a check in the mail for more than $100 for overpayments I hadn’t even known about, let alone challenged. I will let this speak for itself.
Editor: I think Josh feels that vindication is very sweet.
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