A mother called her insurer for help with complex medical claims for her infant daughters, born at 23 weeks. She struck an 18-year bond with the woman who helped her.
On a Tuesday in early May, Gena Misouria got a card in the mail – an invitation to a high school graduation celebration. Two pretty brunette girls, smiling with the promise of the future ahead of them. Gena isn’t their aunt, or a neighbor, or an old college friend of their mom. Still, she is a long-time friend of the family, in a way.
Gena first met Susan Heintzleman in 2000. Her girls were premature infants just home from the hospital neonatal unit and Susan had called Blue Cross and Blue Shield of Texas about some of the many, many bills for her daughters’ complex care.
Susan was an organizational tour de force. Her detailed spreadsheets tracked hundreds of medical claims, and she needed help sorting out some of them. But Susan had more than just spreadsheets to deal with. Her daughter, Shannon, needed constant care to keep her alive. She had a tracheotomy and needed special equipment and supplies to keep her breathing and eating.
“It was the most difficult time of my life having premature twins,” Susan says. The twins were born at 23 weeks. They were labeled as “micro preemies,” which are babies born weighing less than 1 lb. 12 ounces or before 26 weeks’ gestation. Micro preemies typically have long stays in the neonatal intensive care unit.
Baby Hannah was soon able to leave the NICU, but Shannon had underdeveloped lungs. And when Shannon was well enough to go home, she required in-home nursing 24 hours a day for the first two years of her life.
Susan’s call to Blue Cross and Blue Shield Member Services made its way to Gena, who was then a customer service center supervisor.
Meeting them makes it all real.
The duties of a member services supervisor are not always easy. Gena’s job at the time was specialized in serving a specific type of member – those with pre-existing chronic conditions or illnesses. Gena worked with very sick members, or the caretakers or family members of someone living with a serious illness.
Gena took a deep dive into the girls’ medical bills and worked with a claims technician to review each line item and make sure the claims were processed correctly.
For the first two years, Gena talked to Susan weekly to go through new claims. Over time, the girls’ medical needs lessened and the calls spread to monthly. But with those calls Gena developed a connection that went beyond the nuances of managing claims: How did the latest doctor’s visit go? How is Shannon doing?
When Shannon could breathe on her own without the help of equipment, Gena felt a sense of relief right along with the family.
Gena became such an important part of the fabric of the Heintzleman family’s life that she received a Christmas card each year. She saw photos of how the girls were growing. Although Gena moved many times over the years, the cards still found her.
In 2005, Susan was randomly selected to be part of a Blue Cross and Blue Shield marketing campaign. When Susan shared her story about her connection with Gena, organizers at Blue Cross and Blue Shield brought Gena and Susan’s family together for a dinner so they could meet in person for the first time.
Coming face to face with the girls, she could understand clearly the difference she made in the family’s lives.
“It was one thing to hear someone on the phone or in a letter tell you what a difference you’ve made, but meeting them makes it all real,” Gena says.
Although Gena has moved on to other responsibilities, she still believes the best part of working in Member Services is knowing that you are taking care of members. “When people call us, they are already upset and frustrated. It is up to us to listen and do everything we can do to resolve their issue. We can’t always do whatever it is they are asking, but it makes a difference when we spend the time to help them understand the reasons why.”
Eighteen years have gone by since those first frantic calls from Susan. Those preemies became little girls whose lungs grew strong enough to allow them to swim, and then became bigger girls who achieved black belts in karate. The graduation card has given Gena a chance to reflect on what advice she’d give Shannon and her sister at graduation.
“I would tell her to live her life doing what makes her happy, to always be kind and to serve others. That’s what makes a difference in the world. Regardless of your role, you can do these things to help others. You don’t know the impact you can have on someone’s life.”