Thursday, August 26, 2010

Anthem - Putting the Hell in Health Insurance

My corporate health care insurance is administered by Anthem.

Tonight we tried to find out if a particular physician is in their coverage network.

First I tried their Account Registration. It includes a CAPTCHA test.

Why does it include a CAPTCHA test? Really you don't need to ask. Since CAPTCHA hacking software exceeds human performance, it's really a filter to eliminate humans. Particularly elderly humans who might need expensive services.

I kept failing the test. Emily checked, and I seemed to be typing the correct response. We even tried the audio test. That one would  have impressed Mephistopheles.

So Emily tried their customer service number. Voice recognition of course, no keypad entry. It couldn't understand anything she said. Her voice kept rising, but it didn't help. I tried not to laugh too much.

So I tried the web site again. This time I got a different response: "Sorry, we're experiencing technical difficulties at this time. Please try again later or contact Customer Care. Error ID: 21573301".

Terry Gilliam couldn't have done it better.

It's moments like these that make me more optimistic about the future of humanity. Our civilization is sure to collapse before we can create the sentient machines that will end us. We will be saved by our own greed and incompetence.

PS. The coup de grace came as a post-visit survey. An opportunity to provide feedback! So I started answering questions. The questions kept coming. I noticed the the scroll bar size -- I was only through 15% of what must have been 50 questions. I tried scrolling to the end and submitting. Of course that was rejected; I hadn't answered all the questions. I had to smile at the style of it; sadism with a flourish.

Update 8/27/10: There's an old joke that the best way to improve health insurance plan revenues is to put the registration office on the top floor of a building with no elevators. Only the healthy can join, so that even low rates will be profitable.

The CAPTCHA is the modern equivalent of the top floor office without elevators. In this case there was a web site failure, but I'd wager their web site is always fragile. Since Anthem has already been paid, their incentive is to deny services altogether.

The beauty of these sorts of scams is that they're emergent. They develop in the same fashion as antimicrobial resistance in bacteria, or lousy service in AT&T's flat rate data network. Entropy and funding choices provide the "mutations", the commercial market provides the "selection", the system irresistibly evolves until we get the Anthem web site.

This kind of perverse incentive is built into many systems, but it's particularly strong in the health insurance business. If we recognize and understand these processes we can work around them -- much like modern HIV therapy works with an understanding of the the virus evolves. I suspect oncology is going to go the same way -- using therapies that "guide" the "evolution" of the cancer / tumor ecosystem towards forms that may be most vulnerable to a 2nd wave treatment -- or most compatible with the life of the human "host". (I kind of like that cancer idea btw, I do hope it's really part of modern therapy.)

As a society, however, we're only in the most early stages of understanding the evolution of emergent corporate dysfunction and how to manage it.

3 comments:

Hoosiermom said...

Every time I log into the Anthem website I get the message, "sorry, we're experiencing technical difficulties." Every. Single. Time. I am at my wit's end with them. I do not want to call and speak to a subscriber service rep. I used to be one of those. I know the game they play. So I thought online access would be better - I could get the claim info I needed without having to interact with any of their employees. No luck. Technical difficulties, every time. I really, really, really hate Anthem.

John Gordon said...

I assume they have no financial incentive to provide services, either on the phone or via the web site. So it's a happy accident that their web site doesn't work.

Anonymous said...

Hey Mr Gordon - you gotta be kidding me - I've used the online Provider Newtork tool of Anthem and never had a problem. I have absolutely NEVER seen a Captcha feature anywhere at any time on an Anthem site. NEVER. EVER.

Your commentary on preventive exam? Wrong: It's easy to blame the insurer when you should have walked into the doctor's office and said: Here's the deal doctor: I'm here for a FREE preventive care exam. Anything that takes me outside the parameters of that I will be charged for. As my doctor I need you to help me control my health care spending. If you are going to code soemthing that will cost me money I would appreciate a heads up IN ADVANCE. When you have a HSA YOU are in control of how your healthcare dollars are being spent. By extension your doctor is a partner in that process. If your doctor won't help you do that - you got the wrong doctor.