How about a Master Class in DSAT?

The term Master Class comes from music. It’s a class taught by someone who has an expert knowledge or skill in a particular area. There was a show on the PBS affiliate in New York when I was a kid, called Maria Callas Master Class. The legendary opera singer provided counsel to up-and-coming singers, musicians, and students at (I think) Lincoln Center. Her students had the benefit of learning from a master.

My master class in DSAT was taught by my now-former health insurance plan. I purchased membership in one of their plans via the Affordable Care Act website. The ACA team was certainly helpful and pleasant. The master class in DSAT is not about them.

My suspicion is my new plan stack-ranked their agent queues. Because it was an ACA (lower-cost) plan, my calls to their toll-free number were routed to people who knew less about the plan than I did. Ouch. Every sentence started with “may I know…” which told me right away that their agents were hardly local. I developed a theory that lower-priced plans such as my ACA plan were sent to a lower-skilled agent queue. Although I’ve worked for companies that provide outsourced contact center services to health insurance plans for years, nobody has confirmed nor denied my theory.

The story gets progressively worse. My primary care physician recommended I have a common diagnostic procedure. People should have one every ten years or so. This one would be my first being insured by the new plan. My doctor recommended the specialist who performed his procedure, and I was thrilled to find them in my plan’s provider directory. A few days before the appointment, the specialist’s office called me to say they don’t accept the ACA plan from my insurer, and that the procedure would be out of network. I’d have to pay full price, as if I did not have insurance. When I called my plan, the agent was obviously confused. They asked me several times for my member ID and email address, neither of which had changed during the 30-minute call. But the provider was clearly in their directory! I looked up all the other specialists in their directory and called each office to confirm that they accepted the insurance. Out of 20+ specialists in the directory, only 2 accepted the ACA plan from my insurer. Of course, the insurer’s customer service agents were less than helpful when I emailed them with my findings.

The master class in DSAT went from worse to worse. Thanks to my power use of ZoomInfo, I was able to find email addresses for several C Suite denizens at my insurer. Their response was to ask a very junior person to help me find a specialist. I found one on my own despite their offer to help.

When I learned I needed to have life-saving surgery to correct an unrelated condition, the best surgeon for this happened to be out of my plan’s network. I was originally quoted a co-pay of $18,000 but there was no response from my plan. The surgery was scheduled. Three days before the surgery, the hospital called to say my plan refused to pay anything and I would be obligated to pay $155,000 on the day of the surgery. Do you know anyone with that kind of money just sitting around waiting to be spent? None of the C Suiters responded. I wrote again. And again. I was forced to postpone the surgery, putting my own health at risk. All because my insurance plan refused to help or even bothered to respond. Eventually their response was sending me a stack of paper – postage due, I might add – detailing their appeal process.

Fortunately, my relationship with that insurance company ended before they could inflict further damage. I qualified for a new plan, the surgery went well, and I am on the way to recovery.

Lessons learned from this master class:

Some companies simply do not care about customer experience. They don’t get it. It just isn’t within their culture.

It is not a website or a customer portal, it is not about offering round-the-clock phone support. It’s not about chat or AI. It is all bout treating your customers with respect, dignity, and providing the best possible experience. Never in my life has my every interaction been met with zero empathy, a complete lack of understanding by their (in-house or outsourced) employees, and an overall disregard for whether a paying customer lives or dies due to the choices made by their firm.

Choose your suppliers and vendors wisely. Your life may depend on it.


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