## Easy-to-use frustration

That's what the letter from Independence Blue Cross said. Dated 7/28/2015, it arrived 8/4/2015, and informed me that I need to "call or respond online within seven business days to ensure that your future claims and those of your family members can be processed in a timely manner." So today is the deadline.

What do I need to contact them about? "We are required to determine if you or your family members have other health insurance coverage to process your claims."

OK, fair enough. And they inform me that "You can choose the most convenient way to provide this information to us". The first option is to "Simply dial 1-866-507-6575 and follow the prompts on our easy-use interactive voice response system"; the second option is "to visit our member website at www.ibxpress.com".

But it turns out that there are a couple of problems. The first problem is that both methods fail at the first step. And the second problem is that there's apparently no other way to contact them to "provide more information … to ensure that your future claims and those of your family members can be processed in a timely manner".

I started with the member website. I'm already registered, so I figured it would be easy. But when I try to sign in, I get this:

That was the response Tuesday evening when I first saw the letter, and that's still the response now, 60 hours later.

So I tried the "easy-to-use interactive voice response system". It starts out this way:

What appears on the front of my Independence Blue Cross identification card is a sequence of three letters and 12 digits. So apparently it's the digits they want, right?

But when I enter the 12 digits, the "easy-to-use interactive voice response system" confirms only the first six digits of my choice, and asks me to press 1 if this is right, or 2 if it's not. I tried pressing 1, but was told in response that what I had entered was not a valid number.

So to make a long story short, I tried all seven six-digit substrings of the 12-digit number on my ID card. Each of these six-digit strings was rejected in turn.

So what to do? The help button at ibxpress.com leads to an email form for contacting them with an "Inquiry or Comment":

https://ecom.ibx.com/ibx/htdocs/email_forms/contact_us/ibxpress_tech.html

So Tuesday evening I sent an email explaining the situation briefly and asking what to do. Yesterday evening I sent another one. No response so far.

I've experienced a lot of bad user interfaces, and written about some of them — see e.g. "When bad interaction happens to good people", 8/15/2007 (and the associated User Guide,  "The Legend of Facility Focus"), or "Annals of human-computer interface improvement", 2/1/2010. But for sheer power of fast and efficient easy-to-use frustration, you can't beat the automated customer interaction systems deployed by Independence Blue Cross.

This would be funny, except that it's part of why insurance-company administration consumes about a third of U.S. health-care costs — and this doesn't count the customer time and energy spent dealing with such things. Also, on a personal level, I have a family member dependent on this insurance policy for treatment of a chronic illness.

Update 8/8/2015 — Giving up on the number and internet address given in the letter, I called the company's main help number, which is an IVR (interactive voice reponse) system rather than one the relies only on touch-tone responses. That system accepted my SSN, which it understood correctly, and then asked me which of a half-dozen irrelevant issues I wanted to address. The response to "none of those" was to patiently ask me again about the same irrelevant list, four or five times, but eventually it conceded defeat and connected me to a human operator, who was able to update the relevant information in my file with  no problem.

1. ### KeithB said,

August 6, 2015 @ 8:43 am

One of my peeves – that I hoped the socialist ACA had fixed – is that the nomenclature between group number, member ID, account number, plan number and so on, are used randomly between my ID cards and the forms that ask me to fill in the information.

2. ### Andrew D said,

August 6, 2015 @ 8:48 am

Do you hope that an employee of Independence Blue Cross reads Language Log, or are you just venting?

[(myl) First, the whole thing is funny, in a "look at what these idiots have done" kind of way, and therefore worth blogging about. Second, there are actually some meaningful issues involved, about the source of administrative costs and the problems of crappy interface design. And third, if somebody at the company reads this and can fix the "system unavailable" problem, or can tell me how to find the ID number that the phone interface wants, well, so much the better.]

3. ### mike said,

August 6, 2015 @ 8:52 am

Three things:

Thing one: "our easy-use-interactive voice response system," bwa-ha-ha.

Thing two: This is another example of an interface designed by someone who has domain expertise. You could probably haul anyone out of the programming group that created this site and ask them to go through the user flow, and hey, they'd probably do fine! It's just the civilians who seem to have problems with it. You'd think a company that's this size would have both the resources and the experience to subject a website to considerable usability testing. But a surprising number of sites are not tested or barely tested with actual users, and then become very expensive to fix after release.

[(myl) I don't see how one of the authors of the site would be able to navigate past "We are sorry, but the system is temporarily unavailable. Please try again later. (ECMD8052)".]

Thing three: Is it truly in their interest that you have an easy way to interact with them? I think here of certain cable providers who seem to want to make it very difficult to alter your plan, turn in your equipment, or otherwise make any change to the flow of their monthly billings. Just sayin'.

[(myl) I don't think that delays in learning that my family doesn't have any other insurance will lower IBX's costs or increase their revenue in any way — they still collects the same premiums and they're still on the hook for whatever they owed before. The only consequence of the snafu is added administrative costs. Maybe that's in the interests of the company's middle-level bureaucracy, but it certainly doesn't help the overall bottom line.]

4. ### Victor Mair said,

August 6, 2015 @ 8:54 am

I got one of those letters from Independence Blue Cross a few months ago too, but I applied my three minute frustration time limit rule. That is to say, I tried for about three minutes to comply, and then just totally ignored what they were asking me to do.

I received a whole series of similar letters and notices from TIAA-CREF several years ago, but since I could not readily do what they were requesting through the automated systems and there was no way for me to get through to a human being, I finally just gave up. Nothing bad has happened to me as a result of ignoring them, at least not that I'm aware of.

I get notices like this all the time from my banks, insurance company, lawyers who are suing Toyota, and so forth. If they look as though they might be important, I apply the three minute rule, and after that I just forget about them. Most times I don't even spend one second on them, even though they make it sound as though there will be dire consequences if I don't jump through all their hoops.

I think these elaborate ploys are mainly make-work for company VPs and their staffs.

5. ### Rowan said,

August 6, 2015 @ 8:58 am

Finally, a Language Log post I have relevant expertise to comment on! (I have worked on the IVR system for a different insurance company. I think ours is way better designed than theirs, but I'm also obviously biased.)

Pressing * or # at the prompt may give you more information on what they're looking for, if their prompt is anything like ours. Pressing 0 at the prompt, or saying "representative" may be able to get you to a live person.

There are all sorts of things that can go wrong in the innards of an IVR system. If you do reach a live person either by phone or email, make sure that you explain what happened, so that they can get whoever's in charge of the IVR to make the necessary fixes.

[(myl) I already tried these, alas. '0' is just treated as a digit like any other. '*' does nothing. '#' gets "The identification number you have entered is not valid".]

6. ### Carol Saller said,

August 6, 2015 @ 9:37 am

This is maddening – sometimes a tweet to the company's marketing dept. can get attention. You might try it!

7. ### Chips Mackinolty said,

August 6, 2015 @ 10:03 am

I'm on Mark's side with this. In my life I have experienced few moments of sheer murderousness other than in recent years in dealing with online or on-phone so-called "services".

If there isn't a post-analogue phrase for "going postal", there should be.

In on-phone dialogue, whenever I have expressed anger, I have been warned about being aggressive … even after being totally frustrated for an hour trying to track down any useful information, or even being able to give the information being demanded of me.

Online is worse for the absolutely impenetrable, mind numbingly recursive demands for the information you have already supplied, then to be told the information you have supplied is invalid.

Dante told us there were nine levels of hell. There is a tenth, and that is the Cyber.

The three minute rule sounds good to me.

8. ### MattF said,

August 6, 2015 @ 10:03 am

I've tried dealing with IVRs that ask you to 'speak' your ID number. Which has lead, every time, to a dead end. And I don't have an obscure accent or a damaged phone line– the system just doesn't work. One wonders what they consider to be an acceptable failure rate.

9. ### David L said,

August 6, 2015 @ 10:07 am

Some years ago I called the Dell 800 number to get some help with my computer. After going through various Q&As to establish that I needed technical assistance, the automated voice asked me to name the type of computer I was asking about. "Vostro 220," I said. Pause. "I'm sorry, I don't recognize that name. Please tell me what computer you are asking about." "Vostro 220," I repeated, enunciating slowly and clearly. Same response. After about four iterations of this I said, "It's a fucking Vostro 220, for fuck's sake." Pause. "OK, it seems you need to speak to an operator. Please wait while I transfer you."

So there is some intelligence in these systems.

10. ### Ralph Hickok said,

August 6, 2015 @ 10:31 am

I made the serious error of going to paperless billing for my utilities. When the utility company, NStar, became EverSource and the website also changed, I was asked for my account number when I logged on to pay my bill. Since I had no paper bill to consult, I didn't know my account number.

So I called the 800 number listed on the website for customer service. I was immediately asked for my account number and there was no way of getting past that to talk to a real person (and, believe me, I tried all the possibilities).

I finally wrote a letter to the company, received a reply nearly a month later, and was finally able to pay my bill.

11. ### Chrisj said,

August 6, 2015 @ 11:20 am

Re this: [(myl) I don't see how one of the authors of the site would be able to navigate past "We are sorry, but the system is temporarily unavailable. Please try again later. (ECMD8052)".]

It's fairly easy to create a system that works properly from within the company network, but fails when anyone in the outside world tries to access it. It's also possible that it works fine with the particular build of IE 7 (or whatever) that they've standardized on internally, but fails in every other web-browser ever. Of course, their IT dept. usually can't replicate problems caused by either of these…

12. ### Bean said,

August 6, 2015 @ 11:23 am

I had to write a paper letter to Virgin Mobile because they had a logic flaw* in their automatic top-up system and the flowchart given to their call centre/text assistance people was not able to cope with someone questioning the structure. They appear to have fixed the problem but never wrote me back.

So this paper letter thing might work, but only as long as not enough people realize they can use it, keeping the total volume small, so they can actually respond to the letters…

*logic flaw: automatic top-up when your account is below $5, threshold not user-controllable. If your monthly prepaid bill is, say$n, and you have $m left in your account, and 5 < m < n, you don't have enough to pay your bill, and not enough to trigger an automatic top-up either, so you end up with them saying your payment of$n didn't go through and could you please top up your account. So you curse and wonder why you signed up for automatic top-up in the first place if it wasn't topping up your account when needed?

13. ### MattF said,

August 6, 2015 @ 11:36 am

@Ralph Hickok

I had a recent run-in with my bank along those lines– I'd figured out that if I called customer service, I'd be asked for my account numbers, but assumed I'd be able to get the numbers from my online account. But that didn't work… the online account apparently only gave the last four digits of my account numbers, so I had to go fetch the paper statements.

When I (eventually) talked to a human customer service rep and complained, she explained that if I'd right-clicked the headings in the online account form, I'd have seen the full account number. Not at all obvious.

14. ### Old Gobbo said,

August 6, 2015 @ 11:40 am

I sympathize, and yes, live testing on real users is important. Happily, though, it probably is a lot of fuss about nothing (though not in Mr Hickock's case). But you wait till Chronopost in France fail to deliver something to you, and then send a message to the effect, repeated on their website, that they tried to deliver at an hour and minute during the time you were standing at the open front door for half an hour, talking with neighbours. They then do not follow the options you request but e.g. in one instance, and over 9 days, sent the flowers from Montpellier (which we are about 25 miles west of) to Toulouse (140 miles west of Montpellier), back to Montpellier and then to (I think) Valence (or somewhere at least 140 miles east of Montpellier) – at which point the only option was return to sender. And this is not untypical.

15. ### David Fried said,

August 6, 2015 @ 12:00 pm

FWIW–In Massachusetts we have a so-called "Little FTC" Law, G.L. c. 93A, which prohibits any sort of "unfair or deceptive acts or practices in the conduct of any trade or business.": It is meant to be, and is, liberally interpreted. If the complaining consumer complies with the procedures, starting with writing a proper demand letter, (s)he may collect at least double damages–treble in the discretion of the court.

18. ### Eric P Smith said,

August 6, 2015 @ 3:14 pm

Not directly in point, but on health care administration in general. Can anyone explain to me why almost everybody in the UK thinks that the UK National Health Service is Very Good, while almost everybody in the US thinks that the UK National Health Service is Very Bad?

19. ### Eric P Smith said,

August 6, 2015 @ 3:46 pm

My comment above is right off topic and should never have been posted. Please ignore it and accept my apologies. I've had a bad day.

20. ### mark dowson said,

August 6, 2015 @ 4:31 pm

The website gethuman.com has a searchable database which provides codes/instructions to get to a human customer service representative for a lot of organizations when faced with an appalling speech recognition/type an unknown ID interface.

21. ### ohwilleke said,

August 6, 2015 @ 6:01 pm

If all else fails, vent about your problem in a post at their Facebook page. Facebook pages are often managed by the marketing department and a different set of IT people who have a different attitude than the customer service people and IT system that you encountered. It often gets results in these dead end situations.

22. ### ohwilleke said,

August 6, 2015 @ 6:05 pm

@ arthur

Other tips: take names and keep a log with date and time which is readily recapped.
insist on escalating the process to a manager and even to a manager's manager.

Consider writing a letter addressed to the registered agent of the company on file with the Secretary of State's business registration department or the equivalent and start the letter by explaining that there was no other way that you could communicate.

Follow up sooner than the recommended check back time which is often artificially long and just delays the try, try again process.

Ask for tracking numbers, confirmation in their system that things have happened, etc.

23. ### Bobbie said,

August 6, 2015 @ 6:06 pm

Try obtaining Medicare Part D! First of all, the website says very clearly you cannot obtain Part D on line. I called to my local Social Security office which faxed the necessary paperwork which had to be submitted to show my husband's former place of employment. I sent that paperwork in and received a signed authorization via fax. I took it back to the Social Security office, only to be told that an original signature was required from the authorizing person. So I sent off another request, by registered mail, three days before most of the US government ground to an almost-halt for sequestration. Never received any notification that my registered mail had been received. Several months later I returned to the Social Security office and presented my predicament to a different clerk, who told me that the faxed paperwork was sufficient! She also told me (after I had asked) that she had been trained in Louisiana, and that was standard policy in New Orleans. (I am in Virginia). This entire process took over 7 months!
In addition, I should note that I sought assistance from my local US representative, whose office had incorrect information about the entire procedure.

24. ### Viseguy said,

August 6, 2015 @ 7:41 pm

It took me almost a year to resolve a coordination of benefits issue with my health insurance plan after my wife went onto Medicare. Actually, it wasn't an "issue"; it was simply a matter of getting the insurer to honor the plain language of its own coordination of benefits policy. After going around in circles for many months, I contacted my state Attorney General's office. The (non-)issue was resolved — in writing, and for good — in a matter of days. Prof. L., I suggest that you contact the Health Care Section of the Pa. AG's Office. If they're as good as my state's AG, you'll get results fast.

PS: Don't use the website. Call and talk to a live human being. The time IVRs and other "interfaces" is over!

25. ### Viseguy said,

August 6, 2015 @ 7:57 pm

@David L: I once unleashed a long string of profanities after trying repeatedly to get voice-activated 411 system to understand the address I was saying. A live operator immediately came on the line and helped (after some tsk-tsking about my French). I wonder if these systems aren't programmed to recognize profanity and switch the call to a human being. It would be nice to be able to calmly say "Fuck you" to every prompt until a person came on the line. Easier than guessing whether to push 0, # or *.

26. ### Mr Punch said,

August 6, 2015 @ 8:05 pm

@ Bobbie – A big problem with Medicare is that the public interface is through Social Security, which is an entirely different program that does not begin at the same age. My experience is that the online process for Medicare is awful, but that (some of) the real people in my local Social Security office do understand Medicare and can be very helpful.

27. ### Rubrick said,

August 6, 2015 @ 8:17 pm

I think many of these sorts of nightmares are attributable to something I've given some thought to. It's reminiscent of the Peter Principle. I wouldn't be surprised if economists already have a name for it, but if so I don't know what it is.

The principle is thus: Many jobs require a skill set such that, if you've mastered it, you could get a better job instead. This is why computer store clerks are usually clueless dolts: Anyone with real computer expertise can probably land a less-shitty job than computer store clerk. If you really understand the quite-gnarly details of network configuration, why would you be working in a Comcast call center? So these jobs are filled with people who aren't qualified to perform them; the qualified people are in better jobs.

(Of course, there are exceptions. Maybe you're still in high school. Maybe you're a screenwriter with computer skills who needed a part-time job to make ends meet. But there aren't nearly enough such people to fill all the crappy jobs which actually require competence and knowledge.)

In the current case: Writing and maintaining a really good customer management database system, and UIs to interact with it, is hard. If you're the sort of person who can really do that sort of thing well, you're probably not working for Independence Blue Cross.

(Okay, so Blue Cross probably didn't develop their own system in-house, and I suppose there's no particular reason working for a 3rd-party customer management systems company would be an especially crappy job for someone with that skill set. But I still like my Principle. :-) )

28. ### dd said,

August 6, 2015 @ 8:39 pm

I use BCBS phone lines every day where I work. Did you try using the number on the card rather than the one on the letter? If you can get to a regular customer service rep, they can likely get you to another human who can help you.

29. ### Chris C. said,

August 6, 2015 @ 9:30 pm

@Rubrick — There's no reason to think an in-house software development job with Independence Blue Cross is any shittier or less shitty than 95% of all software development jobs.

30. ### Gregory Kusnick said,

August 6, 2015 @ 9:33 pm

Rubrick: I agree with your principle, and find that it applies as well to embedded software in consumer electronics such as TVs and DVD players. People who are really good at systems architecture and UI design aren't building cable DVRs; they're working for Apple, Google, Amazon, etc.

31. ### Laxton F said,

August 7, 2015 @ 6:57 am

When it only confirms 6 digits and asks if it's right, did you try pressing 2? Perhaps there are two sets of ID numbers, one is 6 digits (the ones they first used) and after those filled up they moved to 12 digits, and instead of putting in another prompt ("Press 1 if your ID number is 6 digits. Press 2 if your ID number is 12 digits") they decided to default to 6 digits, read back 6, and then let you enter 12 digits if 6 wasn't correct?

[(myl) I tried pressing '2' (for "no, that's not right") — the system then asked me to enter the ID number again, with the same results as before.]

32. ### Will Thomas said,

August 7, 2015 @ 1:10 pm

Got one. Didn't understand it. Ignored it. The world hasn't stopped.

33. ### Jonathan said,

August 7, 2015 @ 1:43 pm

Before Metro-North Railroad here in NY created a passable website with functional apps, the easiest way to get information was through an IVR system which had a hilarious feature: "Enter the first four letters of the station you wish to go to and then press #." I wished to go to RYE. You can only imagine the iterations I went through until I hit on the trick: type "RYE" then do not under any circumstances press anything else until, after about 45 seconds, the IVR system came back with "You wish to go to RYE." This system had all the best features: (a) an impossible request; (b) a request to press a button which should not under any circumstances be pressed; and (c) a wait that exceeds normal human patience levels leading to the clear inference (by the human) that he should do SOMETHING rather than the correct response — nothing.