Initial Business Response /* (1000, 5, 2015/10/12) */
As Manager of Customer Service at Hill Physicians Medical Group I ([redacted] S. [redacted]) received this consumer complaint. As with any member correspondence I begin researching the member issue using the information listed in the Revdex.com letter...
submitted. I found this complaint was filed by the daughter on her mother's behalf.
On 10/5 I contacted the member's daughter [redacted] to gather her mom's member information for me to begin my research of the matter. After locating her mother [redacted] in our system I contacted the manager of our Case Management department. In my communication with the manager I informed her of the matter the member is having with getting a response from her assigned Case Manager. It was explained the member's daughter is stating they have tried contacting two Case Managers. The member states she has left messages for both of them and no one has returned her phone calls. I requested the manager research this matter and look to resolve it for this member by contacting her to get the details as to how we can assist her.
On 10/8 I was informed by the manager of the Case Management department that she contacted the member's daughter, [redacted]...and listened to her concerns. After speaking with the manager the daughter stated that she is satisfied at this point and feels like the issues are resolved.
The manager provided her with her contact information so she can call her directly if she has any further concerns.
Initial Business Response /* (1000, 9, 2015/08/20) */
As Manager of Customer Service at Hill Physicians Medical Group I ([redacted] S. [redacted]) received this consumer complaint. As with any member correspondence I begin researching the member issue using the information listed in the Revdex.com letter...
submitted. I performed a name search in our member database. I was unable to locate a member [redacted] with an address in [redacted], CA. I also entered his son's name [redacted] in our system database and was again unsuccessful at locating him in our member database.
On Monday, August 17th,2015 I contacted [redacted] at the phone number (XXX-XXX-XXXX) listed in the letter. I left a voicemail for [redacted] identifying myself as the Customer Service Manager at Hill Physicians Medical Group. In the voicemail I acknowledged my reason for calling was to assist with his claim issue for his son. I left my direct phone number for him to contact me along with my time of availability Monday through Friday 8am to 5pm.
On Tuesday, August 18th, 2015 I contacted [redacted] for a second time at the same phone number listed in the letter. I left another voicemail identifying myself as the Customer Service Manager at Hill Physicians Medical Group. In the voicemail I acknowledged my reason for calling was to assist with his claim issue for his son. Again I left my direct phone number for him to contact me along with my time of availability Monday through Friday 8am to 5pm.
On Wednesday, August 19th, 2015 I contacted [redacted] again for the third time at the same phone number listed in the letter. I left another voicemail with the same information as my previous two messages.
I have not received a return call from [redacted]. Due to the limited amount of information in the letter I do not have the ability to further research this complaint/issue. A member ID number, claim number or health plan name would provide me with the information needed to fully research the issue. At any time if [redacted] contacts me with the necessary information to research and provide next steps or resolution to this claim issue I will be happy to assist him.
Thank you
[redacted] S. [redacted]
Manager of Customer Service
XXX-XXX-XXXX
Initial Consumer Rebuttal /* (3000, 11, 2015/08/24) */
(The consumer indicated he/she DID NOT accept the response from the business.)
I have been in contact with [redacted] and would like to wait until payment has actually been received before I consider this closed.
Final Business Response /* (4000, 15, 2015/09/09) */
In response to Revdex.com letter received on 8/25/15 I ([redacted] S. [redacted]) contacted the appropriate party at the health plan. I received confirmation that the claim was paid on 8/25/15. I contacted the member [redacted] and left a message to inform him that the claim was paid on 8/25/15.
Final Consumer Response /* (2000, 17, 2015/09/10) */
(The consumer indicated he/she ACCEPTED the response from the business.)
Initial Business Response /* (1000, 5, 2015/10/12) */
As Manager of Customer Service at Hill Physicians Medical Group I ([redacted] S. [redacted]) received this consumer complaint. As with any member correspondence I begin researching the member issue using the information listed in the Revdex.com letter...
submitted. I found this complaint was filed by the daughter on her mother's behalf.
On 10/5 I contacted the member's daughter [redacted] to gather her mom's member information for me to begin my research of the matter. After locating her mother [redacted] in our system I contacted the manager of our Case Management department. In my communication with the manager I informed her of the matter the member is having with getting a response from her assigned Case Manager. It was explained the member's daughter is stating they have tried contacting two Case Managers. The member states she has left messages for both of them and no one has returned her phone calls. I requested the manager research this matter and look to resolve it for this member by contacting her to get the details as to how we can assist her.
On 10/8 I was informed by the manager of the Case Management department that she contacted the member's daughter, [redacted]...and listened to her concerns. After speaking with the manager the daughter stated that she is satisfied at this point and feels like the issues are resolved.
The manager provided her with her contact information so she can call her directly if she has any further concerns.
Initial Business Response /* (1000, 9, 2015/08/20) */
As Manager of Customer Service at Hill Physicians Medical Group I ([redacted] S. [redacted]) received this consumer complaint. As with any member correspondence I begin researching the member issue using the information listed in the Revdex.com letter...
submitted. I performed a name search in our member database. I was unable to locate a member [redacted] with an address in [redacted], CA. I also entered his son's name [redacted] in our system database and was again unsuccessful at locating him in our member database.
On Monday, August 17th,2015 I contacted [redacted] at the phone number (XXX-XXX-XXXX) listed in the letter. I left a voicemail for [redacted] identifying myself as the Customer Service Manager at Hill Physicians Medical Group. In the voicemail I acknowledged my reason for calling was to assist with his claim issue for his son. I left my direct phone number for him to contact me along with my time of availability Monday through Friday 8am to 5pm.
On Tuesday, August 18th, 2015 I contacted [redacted] for a second time at the same phone number listed in the letter. I left another voicemail identifying myself as the Customer Service Manager at Hill Physicians Medical Group. In the voicemail I acknowledged my reason for calling was to assist with his claim issue for his son. Again I left my direct phone number for him to contact me along with my time of availability Monday through Friday 8am to 5pm.
On Wednesday, August 19th, 2015 I contacted [redacted] again for the third time at the same phone number listed in the letter. I left another voicemail with the same information as my previous two messages.
I have not received a return call from [redacted]. Due to the limited amount of information in the letter I do not have the ability to further research this complaint/issue. A member ID number, claim number or health plan name would provide me with the information needed to fully research the issue. At any time if [redacted] contacts me with the necessary information to research and provide next steps or resolution to this claim issue I will be happy to assist him.
Thank you
[redacted] S. [redacted]
Manager of Customer Service
XXX-XXX-XXXX
Initial Consumer Rebuttal /* (3000, 11, 2015/08/24) */
(The consumer indicated he/she DID NOT accept the response from the business.)
I have been in contact with [redacted] and would like to wait until payment has actually been received before I consider this closed.
Final Business Response /* (4000, 15, 2015/09/09) */
In response to Revdex.com letter received on 8/25/15 I ([redacted] S. [redacted]) contacted the appropriate party at the health plan. I received confirmation that the claim was paid on 8/25/15. I contacted the member [redacted] and left a message to inform him that the claim was paid on 8/25/15.
Final Consumer Response /* (2000, 17, 2015/09/10) */
(The consumer indicated he/she ACCEPTED the response from the business.)