Sunday, September 13, 2009
This blog comes with heavy heart. My favorite store in the world has let me down. I am still very frustrated and angry about my experience yesterday with Target. I’ve always been a huge fan of Target, shopping there several times a week. In fact, there are four Targets in a 10 mile radius of my home and they’ve all been gracious enough to take my money each time. As long as there is a Target close by, all is good in the world.
My sister, Jen, who equally shares in my fondness of the Big Red T, registered there for her wedding. I thought it was a great idea because she would get all her essentials, her guests wouldn’t have to pay an arm and a leg to buy a gift, and there are so many stores around that you could pick it up and not have to pay for shipping charges. Awesome, right? Well, what she quickly found out was Target is not at the top of their game when it comes to gift registries. Their return policy is absolutely ridiculous. It’s so ridiculous, that I wrote a letter to the CEO last night, and woke up at 6:00 AM this morning (Sunday) to blog about this. I would highly recommend not using Target for gift registries. They are not gift recipient-friendly.
I was with Jen when she returned one item from her shower a few weeks ago, because it was a duplicate. The associate was so rude to her and said that she only had x amount of dollars worth of gifts that she could return. Um, huh? What does that mean? I remember the days when friends would return all of their wedding and shower gifts because they needed the money. In this case, my sister actually took the time to register for things they needed. She only returned something because she had already received it. This was her first clue that a Target registry may not have been a good idea.
Last night, we went shopping and of course, Target was one of our stops. Jen had a gift she needed to return, because it was another duplicate from her registry. We got to my favorite store in Manhattan Beach and proceeded to Guest Services to make the return. Since she didn’t have a receipt, the associate had to call Corporate for approval to give a gift card. We didn’t think much of it and said we would do some shopping and come back. As I was in the checkout line, my sister went back to Guest Services to check on her return. I noticed that she was visibly angry, and the associate was back on the phone. Apparently, Corporate could not approve the return without a receipt. How many people actually put gift receipts in with gifts? 10%? The gift did not show up on the registry as being purchased. Something happened where either the purchaser didn’t ask to have the gift registry updated or Target did not update it. In either case, this was no my sister’s fault and she was being penalized for it. I asked to talk to the person on the phone as a last resort. I reiterated what happened and asked what he could do to help the situation. The “gentleman” said that there was nothing he could do without a receipt, regardless if it was on the registry or not. Huh? Seriously? What? I asked to talk to his supervisor and he said he was the highest level of escalation there, and was incredibly rude. Does he realize who he’s talking to? Does he realize that this is not going to go away?
The manager of the store, who they refer to as the ETL (Executive Team Leader), was asked to call Corporate to see what she could do. We explained the situation to her and she completely agreed with us. She admitted that when she got married a few weeks ago, she didn’t even register at Target. She called Corporate and spoke to a few different people. I was shocked at what I was hearing. It was apparent that the “gentleman” on the phone was raising his voice with her. At one point, I heard her say, “I am not a team member, I am an ETL and you are out of line.” She was wonderful, helpful, and really wanted to do the right thing. She was shocked herself that this was the return policy. She kept repeating, “I have a very upset guest in front of me, and this is not her fault. This is on her gift registry and you are telling me that there is nothing we can do, as a corporation, to help her? This is a Target mistake that it’s not showing up as purchased. I think this is ridiculous. Yes, you did hear me, this is ridiculous.” When she hung up, her face was flush and she looked completely defeated. She felt so sorry and kept apologizing. She said that the man on the phone was raising his voice and was threatening to her. Not only was Corporate rude to a guest, but they were rude to their own employees. We waited about an hour, and the result was that we left with a $300 gift that my sister already had.
As I’ve mentioned above a few times, I am still in shock. This is cut and dry. I could see if my sister tried to return something that was opened or clearly didn’t come from Target or was trying to get cash back. None of these were the case. The money was going to be spent right back into Target, and this was on her registry!
I came home and wrote a letter to the CEO. I wish I could hand deliver it to him, because that’s how irate I am over this. I am hopeful that I will be able to update you all in a week that this ended in a positive result. We’ll see if Target holds up to their reputation for excellent guest services. Right now, I am not convinced.
If you're interested in reading about other similar issues, check out the following:
Friday, July 17, 2009
Now is the time to Twitter, blog, or just spread the word, about your experiences. Vonage, among other organizations, are listening to their customers. Publicists are being hired to search social networking sites for anything written about their clients, and the leadership in organizations are watching and listening. Reviews are being brought to the attention of the CEOs and they appear to be paying attention to what their customers have to say. This will be the difference between the companies who survive during this economy and those who do not. It all comes down to the customer and the reputation. Make yourself be heard.
I just received an update from a friend in San Diego, who recently asked for some advice on fighting a vendor.
I took your advice and sent a certified letter to the President of the company that did the electrical work for San Diego Gas and Electric and broke my thermostat! Guess what??? Today, I got a call from the original person who told me he was denying my claim, that they are now promptly sending me a check to cover the cost of my broken thermostat!! WOO HOOO!!
Thanks, Gumptionista for the awesome advice!"
My recommendation, as always, is to send a certified letter to the President of the company and do not take no for an answer. If you have to threaten that you will report them to the Better Business Bureau, blog, or Twitter about the issue, do it.
Monday, June 29, 2009
VONAGE SUMMER TRAVEL TIPS:
The best part of summer is getting away, but even when taking a break from the real world, everyone still needs to be in touch with work, loved ones, or both. Vonage offers a number of ways to do just that:
- Domestic Travel: Did you know that if you take your Vonage adaptor with you while traveling domestically you can make and receive calls for the same cost of using the adaptor at home? Just plug in an adaptor in to a high-speed Internet connection, and your home phone number comes with you virtually.
- International Travel: If you are traveling or moving abroad this summer, Vonage offers a way to make calls back to the U.S. without getting charged an arm and a leg on your cell or using cumbersome calling cards. Plug in your Vonage adaptor and you can make calls to the U.S. for free.
- Virtual Number: While abroad, you may want to add a local phone number to your Vonage account so locals can call you for free. Vonage has you covered here, as you can add a local international number in several locations for an additional $4.99-$9.99 per month (more details here).
- Vonage’s $24.99 Residential Premium Unlimited Plan includes calls to the U.S., Canada, Puerto Rico, and landlines in Italy, France, Spain, England and Ireland are included.
Friday, June 26, 2009
In an effort to solve my phone issues, I did some research on Vonage. They provide voiceover IP service, which is an adapter that connects to your internet box. You must have high-speed internet in order to qualify. My last company used VoIP service exclusively, because we worked from home when we weren't traveling and it was very cost efficient. A good friend of mine (you know who you are), who is my technical guru and hero, came to my rescue when my cell phone service went out. He's had Vonage for years and has never had a problem, and convinced me to give it a try.
I called and spoke to a Vonage representative on Monday and then ordered my service online. What my technical guru didn't know was that if I put him down as a referral, we would both receive two months free. What a bonus!
I received my Vonage adapter today via UPS. All that was required of me was to plug in a cable from the Vonage box to my internet box. Voila! So far, so good.
If you are considering putting in another phone line or switching to a less expensive plan, I would recommend considering Vonage. They can port over existing cell or home numbers. One of the bonuses is that you can take the Vonage box with you anywhere you move in the country (as long as you have high-speed internet) and keep the same number. It's great for those of us with home businesses, because you never have to change your number. You can also pick any area code in the country you want. If you always wanted to live in New York, pick a New York area code.
If you try Vonage and are referred by an existing customer, make sure you click on Benefits---Benefits of VoIP---Refer-a-Friend, or mention the Refer-a-Friend if you call to order the service. You just need their phone number. This is the only way to get two months free for you and your referral. If you do not personally know someone who has Vonage, I would appreciate if you would use me as your referral. You have 30 days to try it so if you don't like it, you didn't pay for the first month, so nothing lost. Depending on the phone package you order, the adapter is usually free. If you don't want to wait to receive the adapter from Vonage, you can buy it at your local electronics store (Best Buy).
Just presenting another cost savings idea!
Wednesday, June 24, 2009
Remember, always go to the top. I know I keep saying this; it is definitely my mantra, but it works. There is no way any of my letters would be addressed had they not been sent certified to the CEO. You deserve to be heard. Also, keep in mind that you are not only fighting issues for yourself, but for others. There is more power in numbers, so never think what you are fighting for is not important. It could be impacting others, who do not think its important enough to fight, and if we all thought this way, nothing would be get fixed.
Thursday, June 18, 2009
I've been Twittering on this issue for the past few days, and my Twitter updates go to my Facebook page. A dear friend of mine in San Diego, who knows me very well and who has been following this issue, posted this on my Facebook page:
Given your reputation for extracting fine customer service I'm surprised that:
(1) The CEO of AT&T hasn't personally called you to apologize.
(2) He isn't onsite personally directing the erection of the replacement cell tower.
(3) The replacement cell tower isn't named after you.
(4) He hasn't invited you to work from his office and use his personal cell phone while yours is out.
(5) You haven't rearranged his personal staff, including firing two executive VPs where just laying around to make the entire operation more efficient at a cost savings of more than $1M annually.
This is the same friend who returned from Iraq several years ago, after serving there for a year in the US Marine Corps, and turned to me and said "JM, you could get the Shiites and Sunnis to stop fighting!"
You know the personality profiles and leadership exercises where you have to ask the people closest to you to describe who you are as a person? Well, it seems pretty unanimous. I am now, and will always be, a Gumptionista.
Monday, June 15, 2009
A friend of mine, who sensed that I was going to slit my wrists over this issue, came over after work last night. He is my technical guru friend. As soon as he stepped foot in my parking structure, he lost his cell service. Thank God! I am not crazy after all! He called AT&T via Skype from my house, and was told that a cell tower had been down in my neighborhood since 8:00 AM. They were having issues bringing it back up and expected that it would be up with service back to normal by the morning.
This morning I woke up to the wonderful sights and sounds of Call Failed, again. I decided to get in my car and drive to see where I could get a signal. I got less than a 1/2 block from my house and was able to make a call. I called AT&T Customer Service and talked to them for 30 minutes before they switched me to technical support. Customer Service said that there was no report of an outage, but then Technical Support said there was an outage, and it was expected to be back up in 1 hour. Here we go again. While I was on the phone with technical support, the office of the CEO of AT&T left me a voicemail. I called him back and we discussed my e-mails and the situation. He was a nice guy, and very helpful. He has since called me twice today to give me updates. As of 1:00 PM, my service is still out so needless to say, I am getting frustrated. I am looking forward to a resolution. I supposed I should go back to a home phone for these types of situations, but I am fighting it tooth and nail.
Regardless of the situation or the problem, always go to the top. It may seem like a small issue, but if it's important to you, let yourself be heard. Also, it helps to blog and twitter on these issues. As someone recently told me, companies are starting to pay attention to social networking, because of the press issues.
I'll keep you posted.
My first letter was to the CEO of Southwest Airlines. As I mentioned in a previous blog, I send all letters certified to the president or CEO of the company. The letter was in regards to a few different issues. The first issue was the expiration date policy on rewards tickets. I had two rewards tickets, which I gave to my parents as a Christmas gift, to be used to fly to Las Vegas for my sister’s wedding in October 2009. The tickets did not expire until August 2009, but since I was giving them as a gift in December, I went online in November and paid the $50 to extend the expiration date. Since their was no written policy on the website, I “assumed” that when I paid the $50 it would push out the expiration date to one year from the current date. It makes sense, doesn’t it? Well, surprise, surprise, that’s not how it works. When I paid the $50 online, I immediately received a new confirmation receipt showing the expiration date as one year from the day I paid. I called Southwest Airlines and asked why it was not one year from the original expiration date. They responded that the policy was that the new expiration date was one year from the day you pay for the extension. I indicated that there was nothing in writing on the website. They said they could not give me a refund (something I regret fighting for now), but would give me a $50 voucher to be used towards a future ticket. I was furious because the new expiration date was prior to October, which meant I had to pay another $50 to stop it from expiring.
In April, I was supposed to fly to San Francisco for a conference. I purchased my ticket on the website and applied the $50 credit voucher. I ended up terribly sick in April and had to cancel. I gave the voucher to my sister to use for a flight in October and when she tried to apply it to her total it said that it was not valid, because it would be expired by October. I knew that the credit voucher would expire in August, but the other half of my ticket which was paid by credit card should be able to be applied. I called Southwest and was told that when you use a credit voucher, your entire ticket expires per the credit expiration date. The ticket defaults to the earliest expiration date. What this means is if you apply a credit voucher to your ticket and your credit expires in two weeks, and for some reason you have to cancel your travel plans, your entire ticket expires in two weeks. If you don’t use it by the expiration, you lose the entire ticket amount. Absolutely absurd policy! No wonder why they are the only profitable airline. I have not received a response from the CEO, however I did call Customer Relations and explained the situation. They said if I could get a letter from my doctor proving I was sick during this time, they would refund the amount paid on my credit card. I faxed a letter today and am awaiting a refund. I do feel that this policy will come back to haunt them. Nothing is clear as day on their website. If you don’t search for every possible scenario, you will get screwed! It’s just a matter of time before a class action suit appears. I actually e-mailed an attorney about a class action, because I really think there is something there, but I really just wanted to resolve my issue at the moment, which I did. It may be resurrected, however. You cannot take someone’s money and not deliver. Because your website is technically challenged and cannot include two expiration dates, it's ok to take someone's money and not deliver? It’s similar to expiring a gift certificate, which is against the law in California.
Wednesday, June 10, 2009
I get asked often why I offer to revise resumes and connect people when I know I am not going to get a commission from it. I truly enjoy connecting people. I like to be a conduit for future relationships. I want to see others succeed. It makes me feel good. Why wouldn’t I help someone if it is within my power to do so? Whatever connection they make with the other person, is their connection. I know the person I am and I know whatever happens in my life, I’ll be ok.
Tuesday, May 26, 2009
After all of this reflection, I decided to throw myself a big 40th birthday party. No, I didn’t have a boyfriend or husband to throw me a party at the country club, but since I was throwing the party for myself, I did have control over how, when, and where it was going to be planned. So what if I didn’t have someone else throw me a party? So what if I wasn’t married or involved with someone at 40? I was honoring me, who I had become at 40, and celebrating that. My party was held at the Elks Lodge across the street from my apartment. I made my invitations from scratch, and included an old picture of me at my 5th birthday party. I planted an idea in my sister’s head…why not e-mail the invite list and ask them to send a note about how they know me and our experiences together. It was not about my friends telling me how wonderful I was, but it was about them reminiscing about old stories, and how and why we are in each other’s lives. I wanted this book as a keepsake. Luckily, my sister did put the book together, and it was the best gift I could’ve ever received. I still pick it up and read it from time to time. My Dad, who is a very proud, manly man, even sent in an unforgettable note. As tough as I am, I am also very sentimental, and it was an unbelievable gift.
I have about 10 close girlfriends, whom I’ve known for 20 years. We are all part of the same group and celebrate our birthdays together. I don’t know how it worked out this way, but our birthdays all fall on a different month. We decided to celebrate with just our small group every month by a potluck brunch or Saturday night wine and cheese, and celebrate the bigger birthdays (21, 30, 40) with a bang. As my 40th was approaching, I decided that I would register at Crate and Barrel and Amazon. I knew that my friends and family would buy me a nice gift for this special birthday, so why not get something that I wanted? I figured I might never get married, so it was finally my chance to register. I’ve been to everyone’s showers, bachelorettes, weddings, baby showers, kid’s birthday parties, and bar mitzvah’s. It was my turn. Ask and you shall receive. It was a great party, and I got some wonderful gifts from the registry. It’s too bad that as 50 comes in a mere 8 years, I might be registering again!
Monday, May 11, 2009
If there is money to be saved, why not put it back in your pocket? It just takes a little bit of effort to look around before purchasing. My favorite site for promo codes is www.retailmenot.com. It has the best promo codes. It’s really great! One of my biggest pet peeves is paying a lot for shipping, and you can usually find free shipping codes on this site. If you can’t find a code there, just Google for a coupon or promo code for whatever site or store you are shopping at. I have even called stores such as Land’s End with an expired promo code from the site, and they have honored it. I also call the store directly if I can’t find a free shipping code, and 9 times out of 10, they’ll waive the shipping.
eBates.com is a site that you can earn money by shopping at stores that you normally shop at. Instead of going to the store’s website, you go through the www.ebates.com site. If you are going to shop at these stores anyway, why not get a little bit of money back for it. Membership is free, and I have never received any junk e-mails from them, which is always something to consider when you join these sites.
My favorite shoe store online is Shoebuy.com. Very similar to Zappos with free shipping on both purchases and returns, but they always have promo codes available on Retail Me Not for 20% off. They also give you an extra 10% when you register, which you need to do to purchase. I purchased $80 shoes for my sister’s wedding, and ended up paying $56 and free shipping. Not bad! These same shoes were $89 at Nordstrom’s. Visit www.shoebuy.com for unbelievable sales.
If you live in Los Angeles, there is a terrific Aveda salon called Vicara in El Segundo (also a location in Torrance), who offers 50% off for first visits. If you go to their website and register, they will give you a 20% coupon immediately, and then e-mail you two coupons every month. The first coupon is 25% off any appointment (which also includes waxing, massages and skin treatments). This coupon usually needs to be used for last minute appointments (same day). The second coupon they send is for 50% off and 10% off products. This coupon is good for the entire month. Although I love my Beverly Hills salon for cut and color, I can’t always get over there. I’ve started going to Becky for roots every 6 weeks, which ends up costing $35 with the 50% coupon. Amazing! During these economic times, it’s businesses like this who will prevail.
I don’t know about you, but I love getting and giving magazines. One of the best magazine subscriptions sites is Best Deal Magazines at www.bestdealmagazines.com. There are popular magazines for as low as $4.69, and you can find a promo code on Retail Me Not and bring the price down even further!
If you are an American Express cardholder and have Membership Rewards (www.membershiprewards.com), there are so many things you can buy with your points besides travel. If you go to www.shopamex.com, there are gift cards, books, beauty products, etc., which you can purchase using your rewards points. There are thousands of items, and if you are a person who has a lot of points and don’t want to use them for travel, you can buy pretty much anything you want here. I have purchased many gifts for friends and family using my points.
My friends still tease me to this day about the overalls I got at Robinson’s-May many years ago (when overalls were in) for $.65. They were on sale for 50% off; I used a coupon, and then used my store credit card, which took it down even further. I turned around and sold them the following month at a garage sale for $5.00.
There are just a few of my favorite sites. Please comment and share your favorites.
Thursday, May 7, 2009
My sister, Jackie, was attending a conference in Los Angeles two years ago, so decided to make a vacation out of it and brought her husband and two boys. At the time, my nephews were five and three. They were staying at a hotel for a few nights and then with me the remainder of the trip. I offered to give them a date night, and keep my nephews overnight. I had a fun night planned with Disney movies and junk food (all the food their parents won’t let them eat). The next morning I asked Charlie, the three year old, what he wanted for breakfast and he immediately answered, “I’ll have cereal.” When I asked Benjamin, the five year old, what he wanted, he simply said, “auntie, what are my options?” Trying not to laugh, I said “you can have cereal, eggs, or pancakes.” Benjamin said he wanted pancakes with bananas and whipped cream. Charlie piped up and said, “me too!” As I was preparing their breakfast, I heard the boys talking in the other room. Benjamin said, “Charlie, always ask for options. If I hadn’t asked for options, we’d be eating cereal.” Charlie, looking up to his big brother, just shook his head and agreed.
Even at a young age we have options and choices, and they are negotiable.
Tuesday, May 5, 2009
In these economic times, more than ever, it is important to keep pushing the envelope. It never hurts to ask, and if it’s a no, it’s a no, but you have to try. I was recently at my dentist’s office and I overheard his assistant telling another office assistant that I was the only person she had ever met that had gotten a veneer paid for. I had completely forgotten about that story.
A few years ago, I had a tooth that kept breaking. Every few weeks it would break, I would visit my dentist, and he would glue it back on. On more than one occasion, he told me that I should get a veneer, but I was stubborn and didn’t want to pay for it. I knew that the insurance company would not cover the veneer, because veneers are always considered cosmetic, for any reason. They would, however, continue to pay for the tooth repair.
The last gluing came on Valentine’s weekend, 2005. It was the first Valentine’s day that I was actually happy to be alone and dateless. It was a Saturday night, and I was at home eating dinner. My tooth fell into my hand, and completely broke off this time. I called my dentist on his cell phone to tell him that I was, again, a toothless wonder. He was willing to leave his dinner, but I told him it could wait until the morning. I finally gave in to the veneer! It was $900! As I was writing the check, I told him that I would be submitting it to my insurance company just to see if they would cover anything. He said, “in all the years I’ve been doing this, I have never seen them cover veneers.” I reminded him who he was talking to.
I called the dental insurance company on Monday, and explained the situation. I said, “I have been getting my tooth glued back on every other month, which you have been covering. I decided to save you money and me, time, and get the veneer. I would like you to cover at least half of it.” The woman explained that veneers were not covered, but to send the claim in anyway. About a month later, I received a call from my dentist’s office indicating that they had received a check for $500 from the insurance company. I laughed to myself…I wasn’t even going to try this, because I didn’t think it would go through. Wouldn’t I have kicked myself if I hadn’t tried! Do not believe everything you hear. You just never know!
Sunday, April 19, 2009
Back in 2002 during the dotcom crash, I worked for a start-up company in Los Angeles. We had grown from 10 to 200+ employees in four years, and it was challenging and exciting. I moved up quickly, because I had such passion for the work, ran with the opportunities given to me, and took complete control of my tasks, always delivering in this very fast-paced environment.
After acquiring another company and changing our business direction, we started to go through layoffs. By the fifth round, which was purely salary-based, I was gone. The woman who hired me and mentored me throughout my employment (who I remain very close to) had left a year earlier. When she found out I got laid off, she was very upset. I moved to San Diego just following the layoff, and lived with friends until I settled in. About four months later, a letter arrived from my mentor. I would like to share it with you here. I just re-read it after 7 years, and it still resonates as much now as it did back then.
“This is not a loan. This is a gift. I purposefully am sending a money order to be sure that you will accept it/cash it. Again, it’s not a loan. It’s something I want to do for you because I really care about you and have been very sad with the turn of events in your life. At the same time, I am heartened by your spirit and your refusal to give up. I ask two things of you. When you are able and however you can do/choose to do it, pass on the gesture to someone in your life. This does not necessarily need to be with money. It is whatever gesture is right for you. Second, please try to adopt this prayer into your daily prayers; it has helped me so much, especially when I was in big transitions."
"God, help me to see the opportunities you are putting in front of me. Help me keep my eyes open. Help me to live not by my will, but yours. And when I see it, give me the courage to act on it. I trust that you have a plan for me God. Help me see it, help me realize it."
Whether you are spiritual or not, there is a message to take away. Being a Gumptionista is not just about fighting for yourself or your cause, but often fighting for others who may have lost some of their fight. It's not always about giving money, but providing direction, reassurance, and a listening ear. Now is the time to offer a helping hand, however you can.
Sunday, April 12, 2009
"Dear Gumptionista: Thank you, thank you thank! Your advice worked! I faced a terrible dilemma. I bought plane tickets to Hawaii for my upcoming honeymoon, but when I went onto the airline's website one month before our trip to check on our flights, I faced a screen that said "this airline has filed Chapter 11 and all flights are cancelled. Click here for more information." The airline was neither willing to transfer any flights to sister airlines, nor refund any purchases. I was devastated! This was my h-o-n-e-y-m-o-o-n. I e-mailed you for help and you gave me sage advice: Send a letter to the CEO asking for a refund and explaining my personal situation, and do not take no for an answer. I was hesitant because I thought there was no way I would see any money back. It seemed overwhelming to "fight" a bankrupt corporation. I usually don't do this type of thing. But, for once, I was fired up by the "Gumptionista's" words, and I followed through. It took a total of one e-mail, one file claim, and a little patience (6 months to be exact). Sure, the company sent me endless court documents about the current bankruptcy case. But, my claim stayed unfazed and intact.
Yesterday, after a long day of work, I came home to find a full refund check in my mailbox! Maybe now I will go on a honeymoon. Thank you, Gumptionista!-a fan."
If you can get a full refund from a bankrupt corporation, then anything is possible. Fight, fight, fight for what's right!
Tuesday, April 7, 2009
Have you ever wanted to fight a corporation, but didn’t think you could win so you said the heck with it? Well, I am living proof that if you are persistent, patient, and you plead a logical case, you will prevail. I hope this story convinces you that you can fight and win, and be the tenacious gumptionista you were born to be!
In 2005, I had a bilateral reduction mammaplasty surgery. Basically, I came out of the womb a DD-cup, and it was starting to impede on my life. There were certain pre-surgery criteria I had to meet in order for the surgery to be covered by insurance: height/weight requirements, a letter from my doctor and chiropractor indicating the need for the surgery, and the insurance company needed to see a photograph of my naked chest (still not sure to this day why that was necessary, but grateful the pictures haven’t resurfaced on the Internet). A few weeks later, I received an acceptance letter from the insurance company. They said that there was, however, one more piece of criteria that had to be met post-surgery. Insurance required that a certain amount of tissue be removed. My doctor explained to me that if he removed the amount of tissue that they requested, I would be disproportionate. With that being said, I authorized my surgeon to make his best judgment, and I would take on the insurance company later. While I was recuperating, I decided that there was no better time than the present to send a letter to the insurance company. I sent the following to the President and CEO of the health insurance company:
“The problem I am about to state has not arisen yet, however, I fully expect it to present itself in the very near future. I had mammaplasty surgery one week ago, and although you pre-approved the surgery, the amount of tissue removed was less than the allowable. Although I have not yet received a rejected claim, the fact that the insurance company was adamant that the claim rely on the amount of tissue removed, I fully expect to receive the rejected claim any day now. I feel a great relief from the surgery, so I am not sure why the amount of tissue removed should be determined by the insurance company. Shouldn’t you base it on how the patient feels? Do you think a woman would go through the emotional and physical pain of having surgery if they didn’t have to? This is a major surgery, and no surgery is deemed reasonable unless it is going to help you physically. I am not the type of person to just go away. I am relentless and will continue to fight this for other women, and change the insurance policies, law, etc.”
As fully expected, I received a letter three weeks later rejecting the claim because “the surgeon removed less than the amount of tissue that was authorized.” I then sent another certified letter to the CEO and President of the insurance company.
“I sent a letter to you on 8/25/05, which addressed a recent mammaplasty surgery, and the fact that the claim would most likely be denied. In December, I received a letter from indicating that, in fact, the claim had been denied. Just as I had stated in my letter to you, the amount of tissue which was considered “allowable” was not removed. I further explained that the surgery had changed my life, despite that the “allowable” amount was not removed. I understand that insurance companies need to have some standards for approving and rejecting claims however, this is ridiculous. For you to make a determination on how much tissue needs to be removed to make me feel better, is unacceptable. I trusted my surgeon to make the right decision. He is the person that should determine what will relieve my pain. I will continue to fight this and will be going to the medical board to change this approval process for other women. I would appreciate a response, as I would hope you are taking your subscriber complaints seriously. We are the backbone to your business, and do have a say in how our employers choose their providers.”
In February 2006, I received another letter denying my claim. Now the insurance company was indicating that “the services have been determined to be cosmetic and not medically necessary.” Interesting how they have now completely changed the reason for the denial. At the end of the letter it said that I had the right to request an Independent Medical Review (IMR) through the Department of Managed Health Care (DMHC). The fight has now just begun!
I went to the website and downloaded the IMR application. In the application, I said that the issue is not with the claim being denied, it is with the way criteria is established for these surgeries. Three weeks later, I received a response from the Center for Health Dispute Resolution. The CHDR is under contract to perform an independent medical review. They employ doctors and health care professionals who study the case file and medical records to decide if the claim is medically necessary. The report said, “the patient underwent the procedure to relieve her documented symptoms. It was therefore medically appropriate and indicated. The patient indicates that her symptoms were relieved by the procedure. That a smaller amount of tissue than authorized volume was removed does not negate the necessity of the procedure, and as such, the health plan’s denial should be overturned.” Hallelujah, Hallelujah, Hallelujah!!! Am I dreaming? Did a doctor of sound mind really say that I was right? Within two weeks, I received an 80% reimbursement.
The key to fighting a corporation is:
- Document the situation. As soon as you realize there may be an issue, be sure to document everything including names of individuals you spoke to, the dates of the phone calls, and dates and copies of all correspondence.
- Certified letter to CEO. Send correspondence, certified, to the President or CEO of the company. You will always receive a response.
- Clear and concise correspondence. In your correspondence, be clear and concise. Ask for what you want and always include the fact that what has happened is “unacceptable.” I am not sure why that word has so much power, but it does.
- Consequences. Include a consequence if the issue is big enough, and be prepared to follow-through. In some situations, I have said that I will contact the State Medical Board, consumer advocacy agency, or an attorney.
- Be reasonable. If you truly believe in your heart that what you are asking for is reasonable, then it probably is. If you are writing to an airline because you had a bad experience, but you are asking for two first class tickets around the world, you are setting yourself up for rejection.
- Give them a timeframe. If you expect to hear back from someone within 5 business days, let them know that. Indicate what will happen if you don’t hear back from them in the timeframe you requested.
- Documented back-up. Always request that they get back to you in writing. This way you will always have backup.
- Be patient, but persistent. Companies have all the time in the world to continue to deny your issue/claim. It doesn’t matter to them if they fight you for a year.
- Stick to your guns. Stay on top of it until you get the response you want, and only accept no, if you can live with it. If you no longer have the energy to fight, then it’s time to stop. Remember though, it may only take one more letter to resolve in your favor.
Thursday, April 2, 2009
Although 90% of the SUV’s license plate number was embedded in my bumper, it wasn’t enough for the police to identify. I couldn’t believe that in bumper-to-bumper traffic, not one person took the time to write down the license plate number of the car who hit me. From that day on, I swore that if I ever witnessed a hit and run, I would do the right thing, and almost a year to the date of my own accident, that’s exactly what I did.
Wednesday, April 1, 2009
About an hour later, I got a call from Officer Canterbury, indicating that the same car had hit another vehicle and the man left the car at the scene and walked home. I was asked to come and identify the man, who was drunk out of his mind, standing in his yard with another officer. I positively identified him and he was taken into custody. I received a call from Officer Canterbury later that night, thanking me for taking the time out of my day and doing the right thing. Apparently, I was the only person who came forward and this man went to jail for DUI for the second time for hitting three cars that day, drunk. I thought at that moment, I have on my Gumptionista bullet proof vest and as long as I was doing what I believed, nothing and no one could hurt me.
When I think of the word Gumptionista, I think of a “gutsy broad.” It doesn’t matter if you’re single, married, divorced, old, or young. It’s an inherent quality of taking charge, going after what you want, and not being afraid of standing up for what you believe in. The word most reminds me of my east coast, Italian grandmother, who has never been afraid of anything and who at 82 years old, won the fight against breast cancer. Several years ago, my grandmother was jumped in a mall parking lot by two punks. They pushed her to the ground and pulled at the gold jewelry around her neck. She calmly looked up at them and said "you little bastards, I got a good look at your face and my husband is in the mob." My grandfather wasn't really in the mob, but that seemed to be a good thing to say at the time. It seemed to work, because it didn't take long for those guys to take off running. My grandmother, who is all but 4' 11", stood up, dusted herself off, and went on her with her day. I’ve always admired her strength and whenever I start to have a weak moment, I think about the essence of my grandmother, and I immediately snap out of it.