A little background: I've been writing about the tangled process of appealing a denied claim because I think it's important, even as Congress tries to enact reform on the macro level, to keep an eye on what's happens on the micro level, where we plain old citizens dangle on hold for 30 minutes at a time, chasing down thousands of out-of-pocket dollars.

In earlier dispatches, I've discussed how financial disincentives and egregious SOP lead to summarily denied claims, and why I'd rather get my health care through Banana Republic. Now, after weeks of Muzak, paper clips and stress, I've found that the solution to all our health care woes actually resides in the persons of a certain Miss C. and Miss V.

But first, some more tangle.

The first thing an active user of her insurance learns is to take nothing for granted. The third phase of chasing down my claim was to check if anything I'd done in the second phase had actually happened. Two weeks before, I'd sent my former physicians a release form mailed to me promptly by the kindly Miss W., who'd assured me I'd have my complete billing history within 10 days. But on my follow-up call to the physician's office, user prompts carried me directly to billing outsourcer Psychbill, where a perplexed employee told me she had no history of any request, but she could send the records immediately to my current address.

"I don't need a release?" I asked. "No form is necessary," she answered. "And these records contain what my physician charged, what insurance paid, and what I paid?" I asked. This was something Miss W. hadn't been able to confirm. "Yes, I see it right here," she answered. "I'll mail them out right now."

Then, unprompted, the woman did something remarkable. "If you don't get these in a week, call me," she said firmly. "My name's Miss C., and I'm extension 30."

In the previous weeks, I'd been treated richly to the health care industry's Kundera-like interpretation of customer service: I was put on hold, transferred without comment, hung up on, given wildly differing answers, given no answers, given non-answers. Now, I was shocked into silence. Not only had someone confirmed they would handle a task personally, they'd told me where to call them if they didn't.

My follow-up call to CareFirst seeking the same records also launched with a battery of user prompts, delivered in the sonorous tones of a warm, chuckly Stepford wife. As I sat on hold and pondered the merits of the robo-ads I was subjected to, an operator -- mirabile dictu! -- picked up the phone. "Can I have your member ID and social?" she asked crisply.

"Can I ask you a question?" I said. It is, in many ways, the question of our age: "Why do we always have to put our numbers into the keypad when you never know who we are when we get there?" The operator had obviously figured out a successful deflection ages earlier. "I apologize, they're not populating over," she said. "I do apologize for that."

I'd dated my notebook and written out a list of questions to ask, something I learned to do after a similar experience with MegaLife insurance company years before necessitated a six-inch stack of supporting documentation. I needed to confirm that my billing history had been sent to me and that, with my insurance, residence and doctor all in different places, I was sending my claims to the correct state. I was also going to see if she'd confirm I could send an appeal to the state and CareFirst at the same time.

I received an entirely different, but far more pertinent, body of information. First, did you know those operators have IM? They do! And they IM each other to check on things, right while you're sitting there, because they do keep customer service records accessible! It was in this fashion that I discovered that my request had been closed out, but no one knew where my records were. The operator hazarded that it was because I was asking for archived records, which would take a little longer, though she couldn't say how long.

So far, 0 for 2. I sighed, not for the first time. "Now, I know you can't tell me anything about why you're denying my claim," I began. "I mean, I know you're not denying my claim."

"Oh, I know," she laughed.

Good! Laughter. "But before I appeal, can I speak to my claims analyst?" I asked. "Just to find out why the claim was denied?"

She gave another silently empathetic pause. "They're not phone representatives," she said, not unkindly.

Of course they're not! Why would anyone be available to discuss claims at an insurance company? "Well, can you tell me anything about what would help?" I asked. "I mean, should I send letters from my doctor? Is it the state thing? I just want to know the general area."

I heard another empathetic silence coming on, until she suddenly perked up. "Your codes don't match!" she said. I could almost see a neighbor sneaking me a cookie behind my mother's back. "You have a medical procedure code, but your doctor is a Ph.D. You need a mental procedure code."

"The code is wrong?" I asked eagerly. "Can you tell me the right code?"

I'd pushed too far, gone over the edge. Another silence. "I cannot state what the correct code should be," she said.

I went back to basics. "Okay, I know you can't tell me the code," I began slowly, "but is what you are saying that my claim was denied because I have a medical procedure code for a mental procedure -- but if I get a mental code for a mental procedure and resubmit, they will fill the claim?"

She coughed, agreeably.

"What is your name?" I asked. I couldn't believe my luck. I had already spent weeks copying documents and chasing down leads. The next step would have been a bundle sent to the Maryland Insurance administration and CareFirst, both of whom would have a full 60 days before they had to get back to me. Not to mention the appeal I would have had to file when they simply repeated the same non-answer they'd given me in the first place. But by giving me the one piece of information the insurance company, by copious e-mail, mail and by phone, had somehow managed not to provide me with, the operator had saved me months of stress and worry -- to stay nothing of my deductible plus 80 percent of allowable charge. All I had to do was ask my doctor to fiddle with the code, and they'd have to pay up -- or find a new thing to deny.

"You can call me Miss V.," she said. "Can I help you with anything else today?"

"You've been the most helpful person I've spoken to this year," I said truthfully.

"Okay!" she said. "Take care."

I'm trying.