Heads are Rolling

It never ceases to amaze me the type of things people will try to pull. I have seen all types of crazy inventions that are supposed to change my life or make things easier in my daily routine and they usually end up being more of a hassle than anything else. Every diet pill I have ever taken or tried usually is not worth the side effects of constant headaches, lack of energy, and explosive bowel movements. I have had people try to sell me Foakleys, Waybans, Polexes, and Goochies. I am sorry but the trunk of a car is not a good place of business. Unless you need a good DvD player at a decent price.

Some people will call in and try to pull one over on us. Because we are on a recorded line if we say something is covered and they go out and have the service provided we have to honor that. Apparently we have subscribers who know this is as well because they will phrase their questions in a way that is misleading to us to get us to cover something ridiculous. For example I had a woman call wondering if we would cover a warm moisture therapy device, at face value this sounds like a peice of medical equipment that would be covered, but when you ask the person to describe the apparatus it is described as a large tub of hot bubbling water... a hot tub.

My favorite one so far is Mrs. Jackaby, here how the conversation went.
"Good morning this is Leroy, may I have your name please?"
"Yes this is Mrs. Jackaby, I was calling to see if a particular medical device is covered."
"Well I would be happy to check for you, what is the device?"
"Well I need to see if a cranial prosthesis is covered."
"Oh my Mrs. Jackaby how are you recovering?"
"Well some days are tougher than others but if I can get this I wouldn't be so embarassed at going out into public."
"Oh right, I could imagine that...well I will check on that and get right back with you."
"Okay, thanks."

So I put her on hold and was just baffled. I checked the contractual exclusions and reviewed her durable medical equipment benefits and was still confused. So I thought I would ask my supervisor. So I walked over to her desk and asked her if a Prosthetic Head would be covered, that I had a lady on the phone wondering if she could get one. She rolled her eyes at me and said, "Leroy...if she needed a prosthetic head how did she even call you? I think you should get her to clarify." That did make sense. So I went back on the phone.

"Mrs. Jackaby thanks for holding for me. I spoke with my manager and she was wondering how you called into us if you need a fake or prosthetic head."
"Leroy I said Cranial Prosthesis..."
"Yes mam, your Cranium is your head."
"Oh...well I must be confused maybe its called something else. It goes ontop of your head and replaces your hair."
"Right the scientific term for that is a wig..."
"Well...yes I guess your right."
"Yeah I'm sorry Mrs. Jackaby a wig is not covered unfer your benefits..."
"So you cover Viagra but you wont cover a damn wig?!"
"Actually no Mrs. Jackaby we would not cover viagra for you either, since your a female."
"Smart ass..." Then she hung up.

Well if anyone knows someone with a prosthetic head let me know, I would really like to check that out. -Leroy

Fat Farm

I like fat people. They can almost get away with anything, if a fat guy farts in the elevator nobody is going to say anything for fear hes holding back a real one. A fat person can get in one of those scooters at walmart and other grocery stores and no one gives it a second glance. Fat people can eat whatever they want in whatever quantities they want without feeling guilty. And if your a fat person you can get out of most anything. Fat people also have their own very tight knit circle of friends.

I'm a half breed, I am just fat enough to fit into most of the fat culture but not so huge that a skinny person wont shake my hand or give me a hug for fear of being pressed up to a man tit. But what I don't get is this mad rush to get surgery to become skinny. Im talking about the gastric bypass, it's where they turn your stomach into about the size of a Wendy's Small frosty and you can only eat about 4 mouthfuls of food. I don't see how someone could torture themselves that way. Maybe its for health reasons...but just think of the benefits your giving up! And somtimes the results are not what people expected, just ask Sue.

Sue called me and had had the gastric bypass almost a year back. She had lost a ton of weight and was feeling a lot better. The problem when you lose weight that much you get rid of the fat, but that stretched out skin remains. Sue was calling to see why her "tummy tuck" was denied and I was forced to help her...
"Top of the morning, this is Leroy may I have your name please?"
" Yessir this is Sue, I was calling to get a better understandin on why my tummy tuck was denied."
"Thats no problem Sue I'll research it and be right back, please hold.."
So I pulled up the information and could see that she met all of the medical criteria except one part. Her excess skin has to go past the pubis for it to be considered under medical benefits. Well there is only one way we can verify that! Pictures! So I had to scroll through them just to make sure. So I pulled the first one up and closed it almost immediately just giving myself a glance so my retinas wouldn't be burned out.
"Well Sue the reason the tummy tuck is being denied at this time is because the pictures we have received doesnt show the excess skin goes past the pubis."
"Well I sure can't see my privates! It's a shame yall paid for my gastro bypass and now I got three sets of titties and you wont help me out! I don't even have a pair of pannies I can stuff all this in!"
I was totally and utterly caught unaware by this womans response. And had to really think it through before I replied.
"Well Sue, acording to our medical review staff we need pictures showing it goes past the pubis, I see where you met all the other criteria but we just need these pictures." I felt so dirty....
"Well yeah I meet the other criteria, I got this awful rash that flares up. And damn it stinks when it starts getting a little hot on days like today, guess its all the skin just rubbin rubbin rubbin."
At this point I was slapping myself in the face just trying not to get a mental image of the rubbin rubbin rubbin...
"Right I understand Sue, I really do but all we need are those pictures and we can go back and review it again."
"Leroy, tell me something...are you married?"
"Well, yes mam I am..."
"Would you still love your wife if she had all this excess skin?"
This brought me back to the three sets of boobs comment and just thinking of that and my dear sweet love for my wife (she reads these...) I was able to reply.
"Sure I would still love my wife."
"Well I feel like I don't turn my husband on anymore, you know he just about has to get a hold on it and lift it up so he can get to the..."
"OKAY, thats to much information Sue, I am empathetic to your situation but I don't see how that has to do with you getting these pictures to us."
"Well your prolly right but being a man I thought you could understand how this hurts the relationship between me and my husband, I mean damn it looks like sails flappin in the wind..."
"Okay Sue here is the Mailing address to where you needa send those too, if you have anymore quenstions about why this denied give me a call back. Have a good Day!"
"Well Alright thanks for listening to me Leroy sorry if I got to hot and heavy for you."

I promptly disconnected the call and threw up in the trash can next to my desk. I prayed for forgiveness of my sins because surely God was punishing me for something awful to let that call come through to me. Anyways the calls keep coming and the fun never stops! Check back often and leave comments to appease my ego. -Leroy

Jack and Jill Fell Down the Hill

Everyday I take anywhere from 80 to 120 calls, and usually they are people I have never talked to before. So I feel like I get a pretty good sampling of everyone who is in our fair country and I am sorry to say but the vast majority of people in this world lack common sense and are retarded. No offense to the vast majority. Now maybe I am wrong, maybe only the not so mentally gifted call me because they have more of a hard time understanding things and really need to ask these stupid questions. Thats fine, that is what I am here for.
I actually had a call today where the person called and said, "You know what...I answered my own question while I was on hold, nevermind, have a good day, goodbye!." I didnt even get a chance to respond but if I had I would have responded like this, " Why the hell didnt you hang up when you figured it out then?." I have even had people ask me for the phone number they just dialed to get me, I'm dead serious. I also had a woman today argue with me for 5 minutes that $2000.00 - $1196.00 = $4.00.
Then Jack called me about his daughter Jill. See Jill turned 21 this year and went down to Panama City for Springbreak with some friends from college. Since she is a full time student she is able to stay on Daddy's insurance. So when Daddy got an 800$ bill for an emergency room visit he was flabergasted at the expense. So I asked him why she went to the emergency room, he responded, "She was outside her hotel room with some friends when these two guys walked up and the two guys were arguing and all of a sudden got into a fight, one on the guys pushed the other one into my daughter and she was knocked down the stairs and had some serious injuries and her friends took her to the emergency room. I am only supposed to have a 50$ copay for an emergency room visit can you explain why I have an 800$ bill?"
" Sure hold just a moment for me sir."
So I pulled the claim up and noticed exactly what had happened as soon as I saw the claim. I knew that this wasn't going to be pretty and the only way I could tell Jack what really happened to Jill was if she gave me permission. But from looking at the claim there was no way in hell Jill was going to let me tell her father what really happened. So I went back in expecting the fury and wrath of Jack...
"Well sir I can only release information on this claim if your daughter gives me permission."
"Oh we are on speaker phone and she is right here go ahead honey..."
Jill: "Yeah it's cool go ahead and tell my Dad whats wrong with the claim.."
Me: So I confirmed it was her...DoB, Address, Social Etc... then say "So are you SURE its okay for me to release this to your dad?"
Jill: "Yeah I'm good."
Me: "Well Mr. Jack the reason this claim is processing this way is because of the diagnosis submitted on the claim, because it was related to substance abuse of alcohol it processed under ..."
Jill: "OH SHIT HOW DID HE KNOW THAT!?"
Jack: "Jill how did you fall down the stairs again?!"
Jill: "Oh God...Dad...I was..." *Click*

Please pray for Jill tonight when you go to bed and always think before you speak. -Leroy

Moment of Silence

I have discovered there are two types of the "Moment of Silence." The first one is a moment of silent reverence for maybe a dead relative, a special day, or a great bowel movement. The second one is more like a guffaw. Where something so hideous or unexpected happens that everything goes silent, jaws drop, and people stare. This is my favorite moment of silence.
Anyone and everyone has experienced a guffaw. The ones I remember are embedded in my memory and unfortunately cannot be erased. For a time I worked in retail at a sporting goods store. It was two levels and we had an escalator in the middle of the store taking people to the top. Some idiot decided we should put buggies next to the escalator where people could get one without having to go all the way to the front of the store. Well one day a little old lady was trying to get a buggy out of the stack and somehow sat on the escalator belt (the one that acts as a moving handrail) and is suddenly on the ride of her life. She only got up about 5 foot up before she panicked and dropped butt first into a buggy. That part alone would have earned a good guffaw in my book but the fact that she was wearing a dress and was baring all her glory left the whole store with jaw dropped and staring as if they were witnessing a train wreck.
There isn't a whole lot that leaves me in a state of guffaw anymore at work. I've heard it all from sex changes, drowning genetetalia, to 60 year old Boob jobs and prosthetic wangs. But Dick caught me off guard on a slow day. The call started off okay then just got weird:
"Good morning! My name is Leroy, may I have your name please?"
"Good morning this is Dick, I was calling to check on my benefits for a certain procedure."
"Okay Dicks what's your date of birth so I can verify its you?"
At this point I had pulled up his information and noticed something very strange Dick was a man, and he had a male spouse on his contract named Rod. I had already had a little blip on the gaydar from the name Dick and the slight lisp and feminine voice. But my Gaydar broke when I saw this.
"Sure here's my Date of birth...(gives DoB..)"
"Alright Sir, (I cant call him Dick anymore at this point...) what was that procedure you wanted to check on?"
" I need to see if a routine colonoscopy is covered."
Here is where the guffaw came into play. First thing that came into my mind is how the hell did I get this call. The second thing that came into my mind is how perfect of a gay couples name is Dick and Rod? The third and final thing that came to my mind is, do I have enough hand sanatizer? So after about 2-3 minutes of silence I was finally able to finish the call and move on to the throwing up.

Until next time, Leroy!

Leroy and Jesus

I try to be a good Christian and read my bible and pray to God as much
as possible. I generally go to church on Sundays and I actively believe
Jesus is my savior. Living in the bible belt of Alabama, church was a
large part of our life. I was saved at summer church camp and was
dragged in and out of church by my mother my whole life. I grew up in
church making friends with people in my youth group. But something I
just realized is I have never experienced a miracle.
Apparently miracles happen in all sorts of strange and mysterious
ways. Mother Mary can be seen in a peice of cheese toast on Ebay, Jesus
is sighted in many a mildew stain on basement walls, and even the
condensation/tears on a statue have brought healing to plantars warts
and other great ailments. As a kid I always prayed for what I thought a
miracle was, like an A on my test, a million dollars buried in the
backyard, and I specifically remember asking for Jesus to talk to me
outloud.
Every morning when I come in to work I turn my computer on, adjust
my chair, and pray. I ask that Jesus help me with all my calls, I ask
that he give me peace of mind and a spirit of calmness when I talk to
our subscribers. Then I sign into the phone and start taking calls. One
morning Jesus called me about his insurance. ( This is something even as
I wrote it I had to sit and stew on it a minute...its a very profound
statement. )
Yes I know what your thinking, a spanish man with the name Jesus
(heyzeus) Martinez called me and had a question. But that is not the
case, Jesus called me and wanted to know if a surgical procedure to
remove his galbladder was covered. Here's how it went:
"Good morning my name is Leroy, may I have your name please?"
"Good morning my name is Jesus and I work for Home Depot I need to
check and see if a procedure is covered."
When we talk to customer for grading purpose there can not be a
period of silence greater than 20 seconds. I'm glad I did not get graded
on this call because there had to be 2 minutes of silence at this point.
"Well....... Jesus... what is your last name so I can verify your
benefits?"
"Oh just call me Jesus"
"And what is your mother's first name?"
"Umm is that really pertinent to my question?"
At this point I was bound and determined to find out if this was the real Jesus.
"No, Jesus your correct, I have to verify that on other contracts, thats my mistake. (But he would know that wouldn't he?) What is the surgical procedure your having?"
"It will be a surgical procedure to remove my gallbladder."
"Yeah that would be considered under your out-patient surgery benefits, Jesus, may I have your telephone number for our records?"
"Listen Leroy, I am not here to help you...you are here to help me. I just need you to help me when I ask okay?"
Jesus needed me to help him, like the great commision! I was to take his gospel around the world and share it from one nation to the next!! I was to be a missionary for Jesus! And he had just called and told me, himself!
"So was there anything else I can help you with, Jesus?"
"Actually there is one more thing, I need a colonoscopy and a colon cleansing what are my benefits for that?"
Then it hit me, why would Jesus need a colonoscopy?

Jesus my ass...

Well hope this makes up for my absence, the calls keep coming and the fun never stops, until next time! - Leroy

Mother Goose and my Golden Eggs

When I was a young boy I used to go to the state park for a summer
program. Basically my mom would drop me off and go to work and come and
pick me up after. I experienced several firsts and learned many of
life's lessons while at the camp. For example I had my first kiss at
this camp, my first case of dehydration, and I learned to watch where
you walk because horses will drop a load anywhere and it goes ankle
deep. But one of the most important lessons I learned is hell hath no
fury like a womans scorn, particularly women that are mothers.
There was a huge lake all around the park and me and the gang always
sat at a picnic table on the back end of the lake. As we were eating
lunch one day I walked down by the edge of the lake and walked around it
eating my sandwich and throwing the crust to the fish. I came upon a
large cluster of bushes and a flash of white caught my eye on the ground
around them. On the ground were about 3 of the biggest eggs I had ever
seen. Being the retard I was I decided to take one back to show my
friends. My finger had just touched the egg at the bushes exploded and
the biggest goose I had ever seen came right at me knocking me flat on
my back. This is where I also learned another important lesson, that
women go for the weakest part on a man first.
With a raging honk and the thunder of flapping wings, the goose bit me
in the nuts. At this point I saw a flash of white pain and then
blackness. I came awake a few moments later at the picnic table with my
friends, they had ran off the goose and pretty much saved my life and
the life of my future children. I had no friends to save me
yesterday...
Our wonderful government in the interest of protecting its citizens has
made it where I cannot release private health information over the
telephone, even if its for the person calling me. And I especially cant
release any information to anyone that is not on the contract. This
cause a lot of frustration and anger on the customers end, which I
sympathize with because I take the heat from these calls.
Mrs. Johnson called me yesterday, the first thing I noticed was she was
not on the contract, so I asked what her relationhip to Mr. Smith was,
her reply was:
"I was his lova, and I had his babies! And I need to axe a question on
ma babies!"
"Well Mrs. Johnson just so you know due to HIPPA privacy laws I can
only release general information regarding the subscribers on the
contract, so how can I help you today?"
"Aww hell naw, you telling me I can't find out about MY babies? I was
in labor for 7 hours cause he passed down his big headedness and you
telling me I cant axe a quarstion about MY Babies?!"
"No mam, you can ask a question about the children on the contract but
i can't give you Private information on the children."
"Oh okay...What I want to know is if my daughter is on birth
control...because I am afraid she is sleeping around and I dont want her
having to marry some idiot like I did."
"Yeah im sorry Mrs. Johnson but i can't tell you if she is on birth
control or not, That is private health information."
"Oh hell naw, you gonna tell me and you gonna tell me right now. Now go
ahead tell me, yes or no."
"I cant tell you.."
"Yes you can and you will."
"I really can't mam due to privacy laws."
"I don't care about no George Bush's damn laws! I voted for him on
accident the first time he was president but I sho didnt vote for him
last time, now tell me if my daughter is on birth control."
"I'm sorry mam but I can't release that information."
"Well I think that is a pile of &^%$ and just so you know, Jesus doesnt
love you and you gonna burn in hell!"

Just remember the next time you mess with a mother's baby, they know
what Jesus thinks and Jesus doesnt like HIPPA privacy laws. -Leroy